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Mycopathologia

, Volume 184, Issue 1, pp 129–139 | Cite as

A Literature Review of Blood-Disseminated P. marneffei Infection and a Case Study of this Infection in an HIV-Negative Child with Comorbid Eosinophilia

  • Xiu-jing HanEmail author
  • Dan-hong Su
  • Yi Jian-yun 
  • Ya-wei Zou
  • Yu-ling ShiEmail author
Original Paper

Abstract

Background

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.

Case presentation

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.

Conclusions

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.

Keywords

P. marneffei (T. marneffeiInfection Eosinophilia HIV-negative Child 

Abbreviations

P. marneffei

Penicillium marneffei

T. marneffei

Talaromyces marneffei

HIV

Human immunodeficiency virus

GPMCCC

Guangdong Provincial Maternity and Child Care Center

CT

Computed tomography

WBCs

White blood cells

PBMCs

Peripheral blood mononuclear cells

Th

T helper cells

Ts

CD3+CD8+ T cells

NK

Natural killer cells

GM

Galactomannan

HB

Hemoglobin

LDH

Lactate dehydrogenase

Fer

Ferritin

CMV

Cytomegalovirus

EBV

Epstein–Barr virus

HSV

Herpes simplex virus

TB

Tuberculosis

Mp

Mycoplasma pneumoniae

Notes

Acknowledgements

We thank Dingqiang Chen and Weiqiang Liu for providing medical writing and revision services.

Author Contributions

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.

Funding

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.

Informed Consent

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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Copyright information

© Springer Science+Business Media B.V., part of Springer Nature 2018

Authors and Affiliations

  1. 1.Graduate SchoolSouthern Medical UniversityGuangzhouChina
  2. 2.Clinical LaboratoriesFirst Affiliated Hospital of Guangzhou Medical UniversityGuangzhouChina
  3. 3.Department of PediatricsFirst Affiliated Hospital of Guangzhou Medical UniversityGuangzhouChina
  4. 4.Clinical Laboratory CenterGeneral Hospital of Guangzhou Military Command of People’s Liberation ArmyGuangzhouChina

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