Penicilliosis

Penicilliosis (or penicillosis) is an infection caused by Penicillium marneffei.

It is a dimorphic fungus.

Epidemiology

Once considered rare, its occurrence has increased due to AIDS. It is now the third most common opportunistic infection (after extrapulmonary tuberculosis and cryptococcosis) in HIV-positive individuals within the endemic area of Southeast Asia.

Diagnosis and symptoms

Diagnosis is usually made by identification of the fungi from clinical specimens. Biopsies of skin lesions, lymph nodes, and bone marrow demonstrate the presence of organisms on histopathology.

The most common symptoms are fever, skin lesions, anemia, generalized lymphadenopathy, and hepatomegaly.

Treatment and prognosis

Penicillium marneffei demonstrates in vitro susceptibility to multiple antifungal agents including ketoconazole, itraconazole,miconazole, flucytosine, and amphotericin B. Without treatment patients have a poor prognosis; death occur by liver failure as the fungus releases toxins in the bloodstream. The elevation of liver enzyme in the blood helps to establish a diagnosis.