PMID- 22289885
OWN - NLM
STAT- MEDLINE
DCOM- 20120517
LR  - 20220408
IS  - 1471-2334 (Electronic)
IS  - 1471-2334 (Linking)
VI  - 12
DP  - 2012 Jan 31
TI  - Immune reconstitution inflammatory syndrome from Penicillium marneffei in an 
      HIV-infected child: a case report and review of literature.
PG  - 28
LID - 10.1186/1471-2334-12-28 [doi]
AB  - BACKGROUNDS: Disseminated Penicillium marneffei infection is one of the most 
      common HIV-related opportunistic infections in Southeast Asia. Immune 
      reconstitution inflammatory syndrome (IRIS) is a complication related to 
      antiretroviral therapy (ART)-induced immune restoration. The aim of this report 
      is to present a case of HIV-infected child who developed an unmasking type of 
      IRIS caused by disseminated P. marneffei infection after ART initiation. CASE 
      PRESENTATION: A 14-year-old Thai HIV-infected girl presented with high-grade 
      fever, multiple painful ulcerated oral lesions, generalized non-pruritic 
      erythrematous skin papules and nodules with central umbilication, and multiple 
      swollen, warm, and tender joints 8 weeks after ART initiation. At that time, her 
      CD4+ cell count was 7.2% or 39 cells/mm3. On admission, her repeated CD4+ cell 
      count was 11% or 51 cells/mm3 and her plasma HIV-RNA level was < 50 copies/mL. 
      Her skin biopsy showed necrotizing histiocytic granuloma formation with 
      neutrophilic infiltration in the upper and reticular dermis. Tissue sections 
      stained with hematoxylin and eosin (H&E), periodic acid-Schiff (PAS), and Grocott 
      methenamine silver (GMS) stain revealed numerous intracellular and extracellular, 
      round to oval, elongated, thin-walled yeast cells with central septation. The 
      hemoculture, bone marrow culture, and skin culture revealed no growth of fungus 
      or bacteria. Our patient responded well to intravenous amphotericin B followed by 
      oral itraconazole. She fully recovered after 4-month antifungal treatment without 
      evidence of recurrence of disease. CONCLUSIONS: IRIS from P. marneffei in 
      HIV-infected people is rare. Appropriate recognition and properly treatment is 
      important for a good prognosis.
FAU - Sudjaritruk, Tavitiya
AU  - Sudjaritruk T
AD  - Division of Infectious Diseases, Department of Pediatrics, Faculty of Medicine, 
      Chiang Mai University, 50200 Chiang Mai, Thailand.
FAU - Sirisanthana, Thira
AU  - Sirisanthana T
FAU - Sirisanthana, Virat
AU  - Sirisanthana V
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
DEP - 20120131
PL  - England
TA  - BMC Infect Dis
JT  - BMC infectious diseases
JID - 100968551
RN  - 0 (Anti-HIV Agents)
SB  - IM
MH  - Adolescent
MH  - Anti-HIV Agents/*administration & dosage
MH  - Asia, Southeastern
MH  - Dermatomycoses/microbiology/pathology
MH  - Female
MH  - HIV Infections/*complications/*drug therapy
MH  - Hand/diagnostic imaging/pathology
MH  - Histocytochemistry
MH  - Humans
MH  - Immune Reconstitution Inflammatory Syndrome/*diagnosis/microbiology/pathology
MH  - Leg/diagnostic imaging/pathology
MH  - Microscopy
MH  - Mycoses/*diagnosis/microbiology/pathology
MH  - Osteomyelitis/microbiology/pathology
MH  - Penicillium/*isolation & purification
MH  - Radiography
PMC - PMC3285031
EDAT- 2012/02/01 06:00
MHDA- 2012/05/18 06:00
PMCR- 2012/01/31
CRDT- 2012/02/01 06:00
PHST- 2011/05/10 00:00 [received]
PHST- 2012/01/31 00:00 [accepted]
PHST- 2012/02/01 06:00 [entrez]
PHST- 2012/02/01 06:00 [pubmed]
PHST- 2012/05/18 06:00 [medline]
PHST- 2012/01/31 00:00 [pmc-release]
AID - 1471-2334-12-28 [pii]
AID - 10.1186/1471-2334-12-28 [doi]
PST - epublish
SO  - BMC Infect Dis. 2012 Jan 31;12:28. doi: 10.1186/1471-2334-12-28.