A Literature Review of Blood-Disseminated P. marneffei Infection and a Case Study of this Infection in an HIV-Negative Child with Comorbid Eosinophilia
The typical manifestations of Penicillium marneffei (nowadays Talaromyces marneffei) infection in children without human immunodeficiency virus (HIV) remain unclear. The current work presents the case of a child without an underlying disease who was infected with P. marneffei comorbid with eosinophilia.
A 2-year-old male was infected with P. marneffei. A physical examination revealed a high-grade fever, ulcerated lesions in the oral mucosa, anemia, pruritic erythematous papules on the sac and thigh and watery diarrhea. A chest enhanced computed tomography scan showed multiple small, nodular, high-density shadows in the lungs, multiple lymphadenectasis in the hilum of the lungs and mediastinum, and liquid in the right pleural cavity. The patient’s plasma was negative for HIV. Routine blood tests initially indicated that the patient had leucopenia; however, later tests indicated that he had leukocytosis. This peak was caused by a significant increase in eosinophils. The total IgE and specific allergen levels were normal. The stool was negative for parasite eggs. Aspergillus antigen (galactomannan, GM) levels were significantly increased and were present in the serum for a relatively long period.
Eosinophilia can occur during P. marneffei infection, and this finding might provide additional information on the activity of this intracellular parasite. In addition, GM detection might be useful for monitoring the effect of antifungal treatments; however, this theory requires more data for verification.
KeywordsP. marneffei (T. marneffei) Infection Eosinophilia HIV-negative Child
- P. marneffei
- T. marneffei
Human immunodeficiency virus
Guangdong Provincial Maternity and Child Care Center
White blood cells
Peripheral blood mononuclear cells
T helper cells
CD3+CD8+ T cells
Natural killer cells
Herpes simplex virus
We thank Dingqiang Chen and Weiqiang Liu for providing medical writing and revision services.
HX acquired the data and helped draft the manuscript. SD and YJ identified P. marneffei in the blood culture and performed drug sensitivity tests. ZY analyzed and interpreted the imaging data, diagnosis, and treatment of the patient. SY critically revised the manuscript with respect to intellectual content as well as analyzed and interpreted the data.
This work was supported by research grants from Guangzhou Medical University and the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Compliance with Ethical Standards
Conflict of interest
All authors declare that they have no conflict of interest.
Written informed consent was obtained from the parents of the boy, and any accompanying images are published with his approval. A copy of this written consent was made available for review by the editor of this journal.
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