Document 0826
 DOCN  M9650826
 TI    Disseminated Penicillium marneffei infection in human immunodeficiency
       virus-infected children.
 DT    9605
 AU    Sirisanthana V; Sirisanthana T; Faculty of Medicine, Chiang Mai
       University, Thailand.
 SO    Pediatr Infect Dis J. 1995 Nov;14(11):935-40. Unique Identifier :
       AIDSLINE MED/96147524
 AB    Disseminated infection with the fungus Penicillium marneffei is one of
       the most common opportunistic infections in human immunodeficiency virus
       (HIV) disease in northern Thailand. We report the clinical, laboratory
       and therapeutic features of 21 human immunodeficiency virus-infected
       children with disseminated P. marneffei who were prospectively followed.
       Significant clinical and laboratory features included generalized
       lymphadenopathy (90%), hepatomegaly (90%), body temperature > 38.5
       degrees C (81%), papular skin lesions with central umbilication (67%),
       splenomegaly (67%), failure to thrive (52%), severe anemia (hemoglobin <
       60 g/liter) (43%) and thrombocytopenia (platelet count < 0.5 x
       10(11)/liter) (21%). The response rate in patients who were treated with
       appropriate antifungal therapy (amphotericin B, fluconazole or
       ketoconazole) was 82%. No relapse was observed in patients given
       ketoconazole prophylactically. Skin lesions, usually papules with
       central necrotic umbilication, provide the most significant clue to the
       diagnosis. Early diagnosis based on finding P. marneffei in the skin
       smear or lymph node provides the basis for prompt administration of
       antifungal therapy and improved outcome.
 DE    Antifungal Agents/THERAPEUTIC USE  AIDS-Related Opportunistic
       Infections/*DIAGNOSIS/DRUG THERAPY/  MICROBIOLOGY  Child  Child,
       Preschool  Dermatomycoses/*DIAGNOSIS/DRUG THERAPY/MICROBIOLOGY  Female
       Fungemia/*DIAGNOSIS/DRUG THERAPY/MICROBIOLOGY  Human  HIV
       Infections/CONGENITAL  Infant  Male  Penicillium/DRUG EFFECTS/*ISOLATION
       & PURIF  Prospective Studies  Thailand  JOURNAL ARTICLE

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