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Mycopathologia

, Volume 170, Issue 1, pp 47–50 | Cite as

Indigenous Case of Disseminated Histoplasmosis from the Penicillium marneffei Endemic Area of China

  • Cunwei Cao
  • Glenn Bulmer
  • Jushang Li
  • Ling Liang
  • Youkun Lin
  • Yongjia Xu
  • Qinghua Luo
Article

Abstract

This is the first indigenous case of disseminated histoplasmosis reported from the Penicillium marneffei endemic area in southern China. It was diagnosed by histopathology of tissue, gross and microscopic morphology of the culture and PCR assay of the isolated fungus. Successful antifungal treatment was with itraconazole 400 mg/day for 5 months. This case suggests that histoplasmosis should be an important differential diagnosis in immunocompromised patients in southern China and South East Asia (the only endemic area for P. marneffei).

Keywords

Histoplasmosis Penicillium marneffei China 

Notes

Acknowledgments

The study was supported by Natural Science Foundation of Guangxi Province of China (No. 2009144). We thank Jin Yu, Xiaohong Wang, Zhe Wang, in Peking University First Hospital, for providing assistance in fungal species identification and the PCR assay. None of the authors have any commercial interests that would influence the findings.

References

  1. 1.
    Kauffman CA. Diagnosis of histoplasmosis in immunosuppressed patients. Curr Opin Infect Dis. 2008;21(4):421–5.CrossRefPubMedGoogle Scholar
  2. 2.
    Adam O, Merad M, Antoun S, Bourhis JH, Gachot B, Casiraghi O, et al. Usefulness of panfungal PCR for the diagnosis of fungal infection in immunocompromised patients. Pathol Biol (Paris). 2004;52(9):544–9.Google Scholar
  3. 3.
    Julg B, Elias J, Zahn A, Koppen S, Becker-Gaab C, Bogner JR. Bat-associated histoplasmosis can be transmitted at entrances of bat caves and not only inside the caves. J Travel Med. 2008;15(2):133–6.CrossRefPubMedGoogle Scholar
  4. 4.
    Swick BL, Walling HW. Papular eruption in an HIV-infected man. Disseminated histoplasmosis with cutaneous and gastrointestinal involvement. Arch Dermatol. 2007;43(2):255–60.CrossRefGoogle Scholar
  5. 5.
    Wheat LJ, Freifeld AG, Kleiman MB, Baddley JW, McKinsey DS, Loyd JE, et al. Clinical practice guidelines for the management of patients with histoplasmosis: 2007 update by the Infectious Diseases Society of America. Clin Infect Dis. 2007;45(7):807–25.CrossRefPubMedGoogle Scholar
  6. 6.
    Li X, Li J, Feng GQ, Gui XE, Zeng XC. A primary investigation on disseminated histoplasmosis in Hubei. Zhonghua Liu Xing Bing Xue Za Zhi. 2003;24(8):708–10.PubMedGoogle Scholar
  7. 7.
    Zhao B, Yin J, Xia X. Investigation on the epidemiology of Histoplasma capsulatum infection in Nanjing district. Zhonghua Liu Xing Bing Xue Za Zhi. 1998;19(4):215–7.PubMedGoogle Scholar
  8. 8.
    Wen FQ, Sun YD, Watanabe K, Yoshida M, Wu JN, Baum GL. Prevalence of histoplasmin sensitivity in healthy adults and tuberculosis patients in southwest China. J Med Vet Mycol. 1996;34(3):171–4.CrossRefPubMedGoogle Scholar
  9. 9.
    Wong KH, Lee SS, Chan KC, Choi T. Redefining AIDS: case exemplified by Penicillium marneffei infection in HIV-infected people in Hong Kong. Int J STD AIDS. 1998;9(9):555–6.CrossRefPubMedGoogle Scholar
  10. 10.
    Cao C, Li R, Wan Z, Liu W, Wang X, Qiao J, et al. The effects of temperature, pH, and salinity on the growth and dimorphism of Penicillium marneffei. Med Mycol. 2007;45(5):401–7.CrossRefPubMedGoogle Scholar
  11. 11.
    Li ZS. Histoplasmosis in south Guangxi (report of 5 cases). Zhonghua Yi Xue Za Zhi. 1982;62(5):267–9.PubMedGoogle Scholar
  12. 12.
    Deng ZL, Connor DH. Progressive disseminated penicilliosis caused by Penicillium marneffei. Report of eight cases and differentiation of the causative organism from Histoplasma capsulatum. Am J Clin Pathol. 1985;84(3):323–7.PubMedGoogle Scholar
  13. 13.
    Deng Z, Ribas JL, Gibson DW, Connor DH. Infections caused by Penicillium marneffei in China and Southeast Asia: review of eighteen published cases and report of four more Chinese cases. Rev Infect Dis. 1988;10(3):640–52.PubMedGoogle Scholar
  14. 14.
    Deng Z, Liu X. Disseminated Penicilliosis marneffei in a patient with acquired immunodeficiency syndrome: a first case report from China. Chin Med J (Engl). 2000;113(11):1049–50.Google Scholar
  15. 15.
    Li JS, Pan LQ, Wu SX, Su SX, Su SB, Shan LY. Disseminated Penicilliosis marneffei in China. Report of three cases. Chin Med J (Engl). 1991;104(3):247–51.Google Scholar
  16. 16.
    Ma Y, He RK. Pathology of AIDS-related lymphadenopathy: a study of 18 biopsy cases. Zhonghua Bing Li Xue Za Zhi. 2005;34(12):776–9.PubMedGoogle Scholar
  17. 17.
    Wei XG. Report of the first case of Penicilliosis marneffei in China. Zhonghua Yi Xue Za Zhi. 1985;65(9):533–4.PubMedGoogle Scholar
  18. 18.
    Liyan X, Changming L, Xianyi Z, Luxia W, Suisheng X. Fifteen cases of Penicilliosis in Guangdong, China. Mycopathologia. 2004;158(2):151–5.CrossRefPubMedGoogle Scholar
  19. 19.
    Bulmer AC, Bulmer GS. Incidence of histoplasmin hypersensitivity in the Philippines. Mycopathologia. 2001;149(2):69–71.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2010

Authors and Affiliations

  • Cunwei Cao
    • 1
  • Glenn Bulmer
    • 2
  • Jushang Li
    • 1
  • Ling Liang
    • 1
  • Youkun Lin
    • 1
  • Yongjia Xu
    • 1
  • Qinghua Luo
    • 1
  1. 1.Department of DermatologyThe First Affiliated Hospital of Guangxi Medical UniversityNanningPeople’s Republic of China
  2. 2.Department of DermatologyFirst Hospital, Xinjiang Medical UniversityUrumqi CityPeople’s Republic of China

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