Clinical and laboratory characteristics of penicilliosis marneffei among patients with and without HIV infection in Northern Thailand: a retrospective study

BMC Infect Dis. 2013 Oct 5:13:464. doi: 10.1186/1471-2334-13-464.

Abstract

Background: Penicilliosis marneffei is increasingly observed in individuals without HIV infection. This study aimed to compare the clinical and laboratory features among HIV infected and uninfected individuals with penicilliosis marneffei.

Methods: A retrospective cohort study was conducted between January 1, 2007 and December 31, 2011 at Chiang Mai University Hospital. We included individuals who were ≥15 years of age and presented with culture-proven P. marneffei infection.

Results: 116 HIV-infected and 34 HIV-uninfected patients were enrolled. Comparing to HIV-infected patients, HIV-uninfected patients were older; less likely to have fever, splenomegaly, and umbilicated skin lesions; more likely to have Sweet's syndrome and bone and joint infections; had higher white blood cell count, platelet count, and CD4 cell count; had lower alanine transaminase (ALT); and less likely to have positive fungal blood cultures. The mortality rates were 20.7% and 29.4% among HIV infected and uninfected patients, respectively.

Conclusions: Clinical manifestations of penicilliosis marneffei are different between patients with and without HIV infection. Physician's awareness of this disease in HIV-uninfected patients may prompt the diagnosis and timely treatment, and can lead to a better outcome.

MeSH terms

  • Adult
  • Aged
  • Antifungal Agents / therapeutic use
  • Female
  • HIV Infections / complications*
  • HIV Infections / immunology
  • HIV Infections / virology
  • Humans
  • Male
  • Middle Aged
  • Mycoses / drug therapy
  • Mycoses / epidemiology
  • Mycoses / etiology
  • Mycoses / microbiology*
  • Penicillium / genetics
  • Penicillium / isolation & purification*
  • Retrospective Studies
  • Thailand / epidemiology

Substances

  • Antifungal Agents