Document 0824
 DOCN  M9470824
 TI    Disseminated Penicillium marneffei infection in southeast Asia.
 DT    9409
 AU    Supparatpinyo K; Khamwan C; Baosoung V; Nelson KE; Sirisanthana T;
       Faculty of Medicine, Chiang Mai University, Thailand.
 SO    Lancet. 1994 Jul 9;344(8915):110-3. Unique Identifier : AIDSLINE
       MED/94285643
 AB    Disseminated infection with the fungal pathogen Penicillium marneffei
       is, after extrapulmonary tuberculosis and cryptococcal meningitis, the
       third most common opportunistic infection in HIV disease in northern
       Thailand. We report the clinical, microbiological, and therapeutic
       features of a large series of HIV-infected adults with disseminated P
       marneffei infection. From August, 1987, to June, 1992, 92 patients with
       P marneffei infection confirmed by culture were seen at Chiang Mai
       University Hospital, of whom 86 were also infected with HIV. Clinical
       information was available for 80 of these patients. The most common
       presenting symptoms and signs were fever (92%), anaemia (77%), weight
       loss (76%), and skin lesions (71%). 87% of patients presenting with skin
       lesions had generalised papules with central umbilication. Presumptive
       diagnosis was made in 50 patients by microscopic examination of
       Wright's-stained bone-marrow aspirate and/or touch smears of skin biopsy
       or lymph-node biopsy specimens. Most patients who were diagnosed
       responded initially to amphotericin or itraconazole, whereas most who
       were not diagnosed and treated died. 12 patients relapsed within 6
       months of cessation of treatment. P marneffei has become an important
       pathogen of HIV-associated opportunistic infection in Thailand.
 DE    Adolescence  Adult  Antifungal Agents/THERAPEUTIC USE  AIDS-Related
       Opportunistic Infections/DIAGNOSIS/DRUG THERAPY/  *MICROBIOLOGY  CD4-CD8
       Ratio  Dermatomycoses/DRUG THERAPY/MICROBIOLOGY  Female  Human
       Leukocyte Count  Male  Middle Age  Mycoses/DIAGNOSIS/DRUG
       THERAPY/*MICROBIOLOGY  Penicillium/*ISOLATION & PURIF  Thailand  T4
       Lymphocytes  JOURNAL ARTICLE

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