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Differences in clinical characteristics and prognosis of Penicilliosis among HIV-negative patients with or without underlying disease in Southern China: a retrospective study

BACKGROUND: The incidence of Penicillium marneffei infection has recently increased. This fungus can cause fatal systemic mycosis in both immunocompetent and immunocompromised patients without HIV infection. METHODS: We retrospectively analysed Penicilliosis patients between January 1, 2003 and Augu...

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Autores principales: Qiu, Ye, Liao, Haifei, Zhang, Jianquan, Zhong, Xiaoning, Tan, Caimei, Lu, Decheng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4647585/
https://www.ncbi.nlm.nih.gov/pubmed/26573268
http://dx.doi.org/10.1186/s12879-015-1243-y
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author Qiu, Ye
Liao, Haifei
Zhang, Jianquan
Zhong, Xiaoning
Tan, Caimei
Lu, Decheng
author_facet Qiu, Ye
Liao, Haifei
Zhang, Jianquan
Zhong, Xiaoning
Tan, Caimei
Lu, Decheng
author_sort Qiu, Ye
collection PubMed
description BACKGROUND: The incidence of Penicillium marneffei infection has recently increased. This fungus can cause fatal systemic mycosis in both immunocompetent and immunocompromised patients without HIV infection. METHODS: We retrospectively analysed Penicilliosis patients between January 1, 2003 and August 1, 2014 at the First Affiliated Hospital of Guangxi Medical University. HIV-negative patients with Penicilliosis were divided into two groups: patients with underlying disease (Group D) and patients without underlying disease (Group ND). HIV-positive patients were excluded. The relationships between overall survival and the study variables were assessed using univariate and multivariate analyses. RESULTS: During 11 years, Penicillium marneffei infection was diagnosed in 109 patients. Sixty-six (60.55 %) patients were HIV-positive and excluded from these cases. Forty-three patients were HIV-negative were enrolled. Among these patients, 18 (41.86 %) patients were in Group D, and 25 (58.14 %) were in Group ND. The most common underlying disease was diabetes. There were no statistically significant differences between the two groups in clinical characteristics, except for immune state and prognosis. Group ND had higher lymphocyte cell counts, CD4 cell counts, and CD4 T-cell percentages than Group D (P < 0.05). Patients in Group D had higher recurrence and mortality rates than Group ND (P < 0.05). In the univariate analysis, only underlying disease, CD4 cell percentage, and T lymphocyte cell percentage were significantly associated with overall survival. CONCLUSIONS: Penicillium marneffei can infect HIV-negative patients and can cause fatal systemic mycosis. There were no clear differences in clinical manifestations among HIV-negative patients with and without underlying disease. However, Penicillium marneffei in HIV-negative patients in with underlying diseases may cause immune function decline and a deficiency in T-cell-mediated immunity. Underlying disease, CD4 cell percentage, and T lymphocyte cell percentage may be potential risk factors affecting prognosis. Timely, effective, and longer courses of antifungal treatments are important in improving prognoses.
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spelling pubmed-46475852015-11-18 Differences in clinical characteristics and prognosis of Penicilliosis among HIV-negative patients with or without underlying disease in Southern China: a retrospective study Qiu, Ye Liao, Haifei Zhang, Jianquan Zhong, Xiaoning Tan, Caimei Lu, Decheng BMC Infect Dis Research Article BACKGROUND: The incidence of Penicillium marneffei infection has recently increased. This fungus can cause fatal systemic mycosis in both immunocompetent and immunocompromised patients without HIV infection. METHODS: We retrospectively analysed Penicilliosis patients between January 1, 2003 and August 1, 2014 at the First Affiliated Hospital of Guangxi Medical University. HIV-negative patients with Penicilliosis were divided into two groups: patients with underlying disease (Group D) and patients without underlying disease (Group ND). HIV-positive patients were excluded. The relationships between overall survival and the study variables were assessed using univariate and multivariate analyses. RESULTS: During 11 years, Penicillium marneffei infection was diagnosed in 109 patients. Sixty-six (60.55 %) patients were HIV-positive and excluded from these cases. Forty-three patients were HIV-negative were enrolled. Among these patients, 18 (41.86 %) patients were in Group D, and 25 (58.14 %) were in Group ND. The most common underlying disease was diabetes. There were no statistically significant differences between the two groups in clinical characteristics, except for immune state and prognosis. Group ND had higher lymphocyte cell counts, CD4 cell counts, and CD4 T-cell percentages than Group D (P < 0.05). Patients in Group D had higher recurrence and mortality rates than Group ND (P < 0.05). In the univariate analysis, only underlying disease, CD4 cell percentage, and T lymphocyte cell percentage were significantly associated with overall survival. CONCLUSIONS: Penicillium marneffei can infect HIV-negative patients and can cause fatal systemic mycosis. There were no clear differences in clinical manifestations among HIV-negative patients with and without underlying disease. However, Penicillium marneffei in HIV-negative patients in with underlying diseases may cause immune function decline and a deficiency in T-cell-mediated immunity. Underlying disease, CD4 cell percentage, and T lymphocyte cell percentage may be potential risk factors affecting prognosis. Timely, effective, and longer courses of antifungal treatments are important in improving prognoses. BioMed Central 2015-11-16 /pmc/articles/PMC4647585/ /pubmed/26573268 http://dx.doi.org/10.1186/s12879-015-1243-y Text en © Qiu et al. 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Qiu, Ye
Liao, Haifei
Zhang, Jianquan
Zhong, Xiaoning
Tan, Caimei
Lu, Decheng
Differences in clinical characteristics and prognosis of Penicilliosis among HIV-negative patients with or without underlying disease in Southern China: a retrospective study
title Differences in clinical characteristics and prognosis of Penicilliosis among HIV-negative patients with or without underlying disease in Southern China: a retrospective study
title_full Differences in clinical characteristics and prognosis of Penicilliosis among HIV-negative patients with or without underlying disease in Southern China: a retrospective study
title_fullStr Differences in clinical characteristics and prognosis of Penicilliosis among HIV-negative patients with or without underlying disease in Southern China: a retrospective study
title_full_unstemmed Differences in clinical characteristics and prognosis of Penicilliosis among HIV-negative patients with or without underlying disease in Southern China: a retrospective study
title_short Differences in clinical characteristics and prognosis of Penicilliosis among HIV-negative patients with or without underlying disease in Southern China: a retrospective study
title_sort differences in clinical characteristics and prognosis of penicilliosis among hiv-negative patients with or without underlying disease in southern china: a retrospective study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4647585/
https://www.ncbi.nlm.nih.gov/pubmed/26573268
http://dx.doi.org/10.1186/s12879-015-1243-y
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