Disseminated Penicillium marneffei infection with fungemia and endobronchial disease in an AIDS patient in China

Objective: To present a rare Chinese case of disseminated Penicillium marneffei infection with fungemia and endobronchial disease in an AIDS patient. Clinical Presentation and Intervention: A 26-year-old policeman who had resided in Guangxi Province, China, for 3 years presented to his county hospital with a 2-month history of high fever and cough. A provisional diagnosis of pulmonary tuberculosis (TB) was made. Accordingly, the patient was treated with anti-TB drugs for 1 month but with no clinical improvement; he was then referred to West China Hospital. Blood and bone marrow cultures as well as a bronchoscopic biopsy were positive for P. marneffei. A confirmatory serologic test for HIV was positive. A combination therapy with amphotericin B and itraconazole was instituted, and the patient responded well to treatment. Conclusion: This case shows endobronchial involvement caused by an emerging fungal microorganism. HIV-positive patients with a history of residence in or travel to southern China and a clinical presentation suggestive of TB but responding poorly to anti-TB treatment may have P. marneffei infection. Copyright (C) 2006 S. Karger AG, Basel.