AJTMH Transactions of the Royal Society of Tropical Medicine and Hygiene
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Am. J. Trop. Med. Hyg., 78(1), 2008, pp. 11-13
Copyright © 2008 by The American Society of Tropical Medicine and Hygiene

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CLINICAL CASE REPORT


Hemophagocytic Syndrome in a Patient with Acquired Immunodeficiency Syndrome and Acute Disseminated Penicilliosis

Sung-Nan Pei, Chen-Hsiang Lee*, AND Jien-Wei Liu
Divisions of Infectious Diseases and Hematology/Oncology, Department of Internal Medicine, Chang-Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan, Republic of China

 

ABSTRACT

Penicilliosis marneffei, which is caused by the opportunistic fungus Penicillium marneffei, is one of the troublesome infections in patients infected with human immunodeficiency virus (HIV) in southeast Asia. We report an HIV-positive patient with acute disseminated penicilliosis marneffei that manifested as hemophagocytic syndrome. Numerous nucleated erythrocytes were also found in peripheral blood of the affected patient. Bone marrow aspirate histopathologically showed hemophagocytosis and abundant P. marneffei. The hemophagocytic syndrome and peripheral nucleated erythrocytes improved after therapy with amphotericin B. Our report underscores the importance of recognition of this peculiar phenomenon in penicilliosis marneffei. This awareness may alert clinicians to potential penicilliosis marneffei in HIV-positive patients, therefore making early diagnosis and timely effective treatment of the infectious disease possible.

Received September 10, 2007. Accepted for publication October 9, 2007.

* Address correspondence to Chen-Hsiang Lee, Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, 123, Ta Pei Road, Niao Sung Hsiang 833, Kaohsiung Hsien, Taiwan, Republic of China. E-mail: lee900{at}adm.cgmh.org.tw

Authors’ addresses: Sung-Nan Pei, Division of Hematology/ Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, 123 Ta Pei Road, Niao Sung Hsiang, Kaohsiung Hsien, Taiwan 833, Republic of China. Chen-Hsiang Lee and Jien-Wei Liu, Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, 123 Ta Pei Road, Niao Sung Hsiang, Kaohsiung Hsien, Taiwan 833, Republic of China.






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Copyright © 2008 by the American Society of Tropical Medicine and Hygiene.