Comparison of Talaromyces marneffei Infection in Human Immunodeficiency Virus-positive and Human Immunodeficiency Virus-negative Patients from Fujian, China

BACKGROUND: Talaromyces (Penicillium) marneffei (TM) is an emerging dimorphic human pathogenic fungus that is endemic to Southeast Asia. TM mostly occurs as an opportunistic infection in patients with human immunodeficiency virus (HIV). The objective of this study was to compare the clinical and lab...

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Autores principales: Li, Hong-Ru, Cai, Shao-Xi, Chen, Yu-Sheng, Yu, Mei-E, Xu, Neng-Luan, Xie, Bao-Song, Lin, Ming, Hu, Xin-Lan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4852673/
https://www.ncbi.nlm.nih.gov/pubmed/27098791
http://dx.doi.org/10.4103/0366-6999.180520
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author Li, Hong-Ru
Cai, Shao-Xi
Chen, Yu-Sheng
Yu, Mei-E
Xu, Neng-Luan
Xie, Bao-Song
Lin, Ming
Hu, Xin-Lan
author_facet Li, Hong-Ru
Cai, Shao-Xi
Chen, Yu-Sheng
Yu, Mei-E
Xu, Neng-Luan
Xie, Bao-Song
Lin, Ming
Hu, Xin-Lan
author_sort Li, Hong-Ru
collection PubMed
description BACKGROUND: Talaromyces (Penicillium) marneffei (TM) is an emerging dimorphic human pathogenic fungus that is endemic to Southeast Asia. TM mostly occurs as an opportunistic infection in patients with human immunodeficiency virus (HIV). The objective of this study was to compare the clinical and laboratory parameters of patients with TM infections who were HIV-positive and HIV-negative and to assess therapies and outcomes. METHODS: This was a retrospective analysis of 26 patients diagnosed with disseminated TM infection from September 2005 to April 2014 at Fujian Provincial Hospital, China. RESULTS: Patients with TM infection tend to present with fever, weight loss, and anemia. The time from symptom onset to confirmed diagnosis was greater for HIV-negative patients (n = 7; median: 60 days, range: 14–365 days) than for HIV-positive patients (n = 19; median: 30 days, range: 3–90 days, Mann–Whitney U = 31.50, P = 0.041). HIV-negative patients were more likely to have dyspnea (57.1% vs. 5.3%, χ(2) = 8.86, P = 0.010), low neutrophil count (Mann–Whitney U = 27.00, P = 0.029), high CD4 count (Mann–Whitney U = 0.00, P = 0.009), and high lymphocyte count (Mann–Whitney U = 21.00, P = 0.009). There were no significant differences in other demographic, clinical, or biochemical characteristics. Among all the patients, 12 HIV-positive patient and 1 HIV-negative patient received amphotericin and fluconazole treatment, 9 of whom improved, 1 died, 2 had kidney damage, 1 had hypokalemia due to exceeded doses. CONCLUSIONS: HIV-negative patients with TM infections tend to have a longer diagnostic interval, a higher percentage of dyspnea, higher levels of CD4 and lymphocytes, and lower neutrophil counts than TM infection in HIV-positive patients. Treatment programs with amphotericin and fluconazole are mostly effective.
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spelling pubmed-48526732016-05-10 Comparison of Talaromyces marneffei Infection in Human Immunodeficiency Virus-positive and Human Immunodeficiency Virus-negative Patients from Fujian, China Li, Hong-Ru Cai, Shao-Xi Chen, Yu-Sheng Yu, Mei-E Xu, Neng-Luan Xie, Bao-Song Lin, Ming Hu, Xin-Lan Chin Med J (Engl) Original Article BACKGROUND: Talaromyces (Penicillium) marneffei (TM) is an emerging dimorphic human pathogenic fungus that is endemic to Southeast Asia. TM mostly occurs as an opportunistic infection in patients with human immunodeficiency virus (HIV). The objective of this study was to compare the clinical and laboratory parameters of patients with TM infections who were HIV-positive and HIV-negative and to assess therapies and outcomes. METHODS: This was a retrospective analysis of 26 patients diagnosed with disseminated TM infection from September 2005 to April 2014 at Fujian Provincial Hospital, China. RESULTS: Patients with TM infection tend to present with fever, weight loss, and anemia. The time from symptom onset to confirmed diagnosis was greater for HIV-negative patients (n = 7; median: 60 days, range: 14–365 days) than for HIV-positive patients (n = 19; median: 30 days, range: 3–90 days, Mann–Whitney U = 31.50, P = 0.041). HIV-negative patients were more likely to have dyspnea (57.1% vs. 5.3%, χ(2) = 8.86, P = 0.010), low neutrophil count (Mann–Whitney U = 27.00, P = 0.029), high CD4 count (Mann–Whitney U = 0.00, P = 0.009), and high lymphocyte count (Mann–Whitney U = 21.00, P = 0.009). There were no significant differences in other demographic, clinical, or biochemical characteristics. Among all the patients, 12 HIV-positive patient and 1 HIV-negative patient received amphotericin and fluconazole treatment, 9 of whom improved, 1 died, 2 had kidney damage, 1 had hypokalemia due to exceeded doses. CONCLUSIONS: HIV-negative patients with TM infections tend to have a longer diagnostic interval, a higher percentage of dyspnea, higher levels of CD4 and lymphocytes, and lower neutrophil counts than TM infection in HIV-positive patients. Treatment programs with amphotericin and fluconazole are mostly effective. Medknow Publications & Media Pvt Ltd 2016-05-05 /pmc/articles/PMC4852673/ /pubmed/27098791 http://dx.doi.org/10.4103/0366-6999.180520 Text en Copyright: © 2016 Chinese Medical Journal http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Original Article
Li, Hong-Ru
Cai, Shao-Xi
Chen, Yu-Sheng
Yu, Mei-E
Xu, Neng-Luan
Xie, Bao-Song
Lin, Ming
Hu, Xin-Lan
Comparison of Talaromyces marneffei Infection in Human Immunodeficiency Virus-positive and Human Immunodeficiency Virus-negative Patients from Fujian, China
title Comparison of Talaromyces marneffei Infection in Human Immunodeficiency Virus-positive and Human Immunodeficiency Virus-negative Patients from Fujian, China
title_full Comparison of Talaromyces marneffei Infection in Human Immunodeficiency Virus-positive and Human Immunodeficiency Virus-negative Patients from Fujian, China
title_fullStr Comparison of Talaromyces marneffei Infection in Human Immunodeficiency Virus-positive and Human Immunodeficiency Virus-negative Patients from Fujian, China
title_full_unstemmed Comparison of Talaromyces marneffei Infection in Human Immunodeficiency Virus-positive and Human Immunodeficiency Virus-negative Patients from Fujian, China
title_short Comparison of Talaromyces marneffei Infection in Human Immunodeficiency Virus-positive and Human Immunodeficiency Virus-negative Patients from Fujian, China
title_sort comparison of talaromyces marneffei infection in human immunodeficiency virus-positive and human immunodeficiency virus-negative patients from fujian, china
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4852673/
https://www.ncbi.nlm.nih.gov/pubmed/27098791
http://dx.doi.org/10.4103/0366-6999.180520
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