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Khuanchai Supparatpinyo - One of the best experts on this subject based on the ideXlab platform.
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clinical and laboratory characteristics of Penicilliosis marneffei among patients with and without hiv infection in northern thailand a retrospective study
BMC Infectious Diseases, 2013Co-Authors: Rathakarn Kawila, Romanee Chaiwarith, Khuanchai SupparatpinyoAbstract:Background Penicilliosis marneffei is increasingly observed in individuals without HIV infection. This study aimed to compare the clinical and laboratory features among HIV infected and uninfected individuals with Penicilliosis marneffei.
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clinical and laboratory characteristics of Penicilliosis marneffei among patients with and without hiv infection in northern thailand a retrospective study
BMC Infectious Diseases, 2013Co-Authors: Rathakarn Kawila, Romanee Chaiwarith, Khuanchai SupparatpinyoAbstract:Penicilliosis marneffei is increasingly observed in individuals without HIV infection. This study aimed to compare the clinical and laboratory features among HIV infected and uninfected individuals with Penicilliosis marneffei. A retrospective cohort study was conducted between January 1, 2007 and December 31, 2011 at Chiang Mai University Hospital. We included individuals who were ≥15 years of age and presented with culture-proven P. marneffei infection. 116 HIV-infected and 34 HIV-uninfected patients were enrolled. Comparing to HIV-infected patients, HIV-uninfected patients were older; less likely to have fever, splenomegaly, and umbilicated skin lesions; more likely to have Sweet’s syndrome and bone and joint infections; had higher white blood cell count, platelet count, and CD4 cell count; had lower alanine transaminase (ALT); and less likely to have positive fungal blood cultures. The mortality rates were 20.7% and 29.4% among HIV infected and uninfected patients, respectively. Clinical manifestations of Penicilliosis marneffei are different between patients with and without HIV infection. Physician’s awareness of this disease in HIV-uninfected patients may prompt the diagnosis and timely treatment, and can lead to a better outcome.
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Discontinuation of secondary prophylaxis against Penicilliosis marneffei in AIDS patients after HAART.
AIDS (London England), 2007Co-Authors: Romanee Chaiwarith, Noppawan Charoenyos, Thira Sirisanthana, Khuanchai SupparatpinyoAbstract:A retrospective cohort study was conducted to determine the relapse rate of Penicilliosis marneffei after the discontinuation of itraconazole secondary prophylaxis in 33 HIV-infected patients who received HAART and had CD4 cell counts of 100 cells/mul or greater for at least 6 months. The observed incidence of relapse of Penicilliosis marneffei was zero cases per 641 person-months (95% confidence interval 0-0.6 cases per person-month) after a median follow-up of 18 months (range 6-45).
Chien-ching Hung - One of the best experts on this subject based on the ideXlab platform.
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cytological diagnosis of penicillium marneffei infection
Journal of the Formosan Medical Association, 2008Co-Authors: Ishiow Jan, Chien-ching Hung, Pingfung Chung, Jannyuan Wang, Minghsiang Weng, Lina LeeAbstract:Background/Purpose Penicillium marneffei is an emerging opportunistic pathogen. The goal of this study was to study its clinical and radiographic presentation, and the diagnostic value of a cytological study of Penicilliosis. Methods A total of 24 patients with Penicilliosis were found by culture in an 8-year period. Thirteen patients had cytological examination, which were retrospectively reviewed to analyze the morphological characteristics of P. marneffei and diagnostic yields of different cytological specimens. Results Twenty (83%) of the 24 patients (20 males) had human immunodeficiency virus (HIV) infection. In eight (40%) patients, Penicilliosis was the initial manifestation of HIV infection. Penicilliosis was diagnosed in all patients antemortem from culture of blood or other body sites. One (4%) died. Six of 13 patients who had cytological study had intraor extracellular yeast-like organisms with transverse septum found in fine needle aspirate, imprint or sputum cytology studies. The cytological diagnostic yields for P. marneffei from lung biopsy imprint smears, lung aspirates, neck lymph node aspirates and sputum were 2/2, 2/4, 2/2 and 2/4, respectively. The cytological diagnosis could be made immediately after aspiration, much quicker than diagnosis from cultures. Conclusion P. marneffei causes disseminated infection, and can be the initial manifestation in HIV-infected patients in Taiwan. Penicilliosis can be diagnosed rapidly with cytological study of lung biopsy imprint smears, lung aspirates, neck lymph node aspirates or sputum.
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Cytological Diagnosis of Penicillium marneffei Infection
Elsevier, 2008Co-Authors: Ishiow Jan, Chien-ching Hung, Pingfung Chung, Jannyuan Wang, Minghsiang Weng, Lina LeeAbstract:Penicillium marneffei is an emerging opportunistic pathogen. The goal of this study was to study its clinical and radiographic presentation, and the diagnostic value of a cytological study of Penicilliosis. Methods: A total of 24 patients with Penicilliosis were found by culture in an 8-year period. Thirteen patients had cytological examination, which were retrospectively reviewed to analyze the morphological characteristics of P. marneffei and diagnostic yields of different cytological specimens. Results: Twenty (83%) of the 24 patients (20 males) had human immunodeficiency virus (HIV) infection. In eight (40%) patients, Penicilliosis was the initial manifestation of HIV infection. Penicilliosis was diagnosed in all patients antemortem from culture of blood or other body sites. One (4%) died. Six of 13 patients who had cytological study had intraor extracellular yeast-like organisms with transverse septum found in fine needle aspirate, imprint or sputum cytology studies. The cytological diagnostic yields for P. marneffei from lung biopsy imprint smears, lung aspirates, neck lymph node aspirates and sputum were 2/2, 2/4, 2/2 and 2/4, respectively. The cytological diagnosis could be made immediately after aspiration, much quicker than diagnosis from cultures. Conclusion: P. marneffei causes disseminated infection, and can be the initial manifestation in HIV-infected patients in Taiwan. Penicilliosis can be diagnosed rapidly with cytological study of lung biopsy imprint smears, lung aspirates, neck lymph node aspirates or sputum
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detection of circulating galactomannan in serum samples for diagnosis of penicillium marneffei infection and cryptococcosis among patients infected with human immunodeficiency virus
Journal of Clinical Microbiology, 2007Co-Authors: Yutsung Huang, Chien-ching Hung, Chunhsing Liao, Hsinyun Sun, Shanchwen Chang, Yeechun ChenAbstract:Galactomannan (GM) is a heteropolysaccharide in the cell walls of most Aspergillus and Penicillium species. Cross-reactivity of Cryptococcus neoformans galactoxylomannan in an Aspergillus GM test has also been reported. In this study, we used a Platelia Aspergillus enzyme immunoassay kit (Bio-Rad) to test serum samples obtained from 48 human immunodeficiency virus (HIV)-infected patients (15 with Penicilliosis [7 with fungemia alone, 4 with cavitary lung lesions alone, 3 with both fungemia and cavitary lung lesions, and 1 with disseminated disease], 22 with cryptococcosis [11 with fungemia alone, 5 with cavitary lung lesions, 3 with both, and 3 with meningitis alone], and 11 without any invasive fungal infection [control]) for GM levels. None of the patients had aspergillosis or concurrent use of piperacillin-tazobactam or amoxicillin-clavulanate. The median time between diagnosis of fungal infection and collection of serum samples was 0 days for Penicilliosis and 1.5 days for cryptococcosis. Of patients with Penicilliosis, cryptococcosis, and controls, 73.3%, 13.6%, and 9%, respectively, had GM optical density (OD) indices of >0.5 (P = 0.0001). GM OD indices were higher for Penicilliosis (median OD index, 4.419; range, 0.158 to >20) than for cryptococcosis (median, 0.247; range, 0.112 to 3.849) cases (P 20) than patients with nonfungemic Penicilliosis (median, 0.378; range, 0.158 to 4.419) and patients with cryptococcemia (median, 0.231; range, 0.112 to 1.168) (P 20) than those with cryptococcosis (median, 0.227; range, 0.112 to 3.849) (P = 0.011). This study showed that the GM OD index was significantly elevated for HIV patients with Penicilliosis. The use of the GM antigen assay may facilitate earlier diagnosis of Penicillium marneffei infection for HIV-infected patients in areas of endemicity.
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endemic fungal infections caused by cryptococcus neoformans and penicillium marneffei in patients infected with human immunodeficiency virus and treated with highly active anti retroviral therapy
Clinical Microbiology and Infection, 2006Co-Authors: Hsinyun Sun, Chien-ching Hung, M Y Chen, Chinfu Hsiao, Szumin Hsieh, Shanchwen ChangAbstract:ABSTRACT This study compared the clinical presentations of 58 episodes of cryptococcosis in 50 patients and 26 episodes of penicillosis in 25 patients infected with human immunodeficiency virus (HIV) between June 1994 and June 2004, and assessed the safety of discontinuation of secondary prophylaxis for endemic fungal infections in those patients responding to highly active anti-retroviral therapy (HAART). Neurological symptoms were seen more commonly in patients with cryptococcosis, whereas respiratory symptoms, lymphadenopathy, hepatomegaly and/or splenomegaly, and non-thrush-related oral presentations were seen more commonly in patients with penicillosis. Patients with penicillosis were more likely to have abnormal chest radiography results and radiographic presentations of interstitial lesions, cavitations, fibrotic lesions and mass lesions. At the end of the study, maintenance antifungal therapy had been discontinued in 27 patients with cryptococcosis and in 18 patients with penicillosis in whom the median CD4 count had increased to 186 cells/µL (range, 9–523 cells/µL) and 95 cells/µL (range, 15–359 cells/µL), respectively, after HAART. Only one episode of penicillosis recurred (a relapse rate of 1.72/100 person-years; 95% CI, 1.44–2.10/100 person-years) after a median follow-up duration of 35.3 months (range, 2.6–91.6 months). No relapses occurred in patients with cryptococcosis after a median follow-up duration of 22.3 months (range, 1–83.4 months). These findings suggest that there are differences in the clinical presentations between endemic cryptococcosis and penicillosis in patients with HIV infection, and that it is safe to discontinue secondary antifungal prophylaxis for cryptococcosis and penicillosis in patients responding to HAART.
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Endoscopic diagnosis of intestinal Penicilliosis marneffei: report of three cases and review of the literature.
Gastrointestinal endoscopy, 1999Co-Authors: Chien-ching Hung, Mao-yuan Chen, Po-ren Hsueh, Cheng-hsiang Hsiao, Jau-min WongAbstract:Chow-In Ko, MD, Chien-Ching Hung, MD, Mao-Yuan Chen, MD, Po-Ren Hsueh, MD, Cheng-Hsiang Hsiao, MD, Jau-Min Wong, MD Diarrhea is the most common GI presentation of immunocompromised patients, especially those with acquired immunodeficiency syndrome (AIDS).1,2 More than 50% of patients with AIDS have diarrhea caused by a variety of pathogens during their illness.1,2 Intestinal mycoses are uncommon in immunocompromised patients, however, and may be caused by Cryptococcus neoformans3 and Histoplasma capsulatum.4 Penicillium marneffei, an emerging facultative intracellular pathogen and the only thermally dimorphic fungus of the genus Penicillium, can cause disseminated infection in patients residing in or traveling to areas where the organism is endemic, which include southeast Asia, southern China, and Hong Kong.5-17 With the human immunodeficiency virus (HIV) pandemic, the number of cases of Penicilliosis marneffei has increased markedly during the past 5 years, from 30 cases during the period between 1973 and 1990 to more than 160 by the end of 1995.16 After extrapulmonary tuberculosis and cryptococcosis, Penicilliosis marneffei ranks as the third most common opportunistic infection in HIV-infected patients in Thailand.14 Although P marneffei has become an increasingly important cause of invasive mycoses in immunocompromised hosts, it has been rarely implicated as a cause of intestinal mycoses. As of December 1997, only four cases of intestinal Penicilliosis marneffei have been reported in English language publications and only one was diagnosed antemortem by endoscopy.8,9,12,17 Here we report three cases in which immunocompromised patients, two with AIDS and one after renal transplantation, presented with intestinal Penicilliosis marneffei where early diagnosis was made possible by endoscopy.
Kwok-yung Yuen - One of the best experts on this subject based on the ideXlab platform.
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Vaccine mediates protection against Penicilliosis in BALB/c mice (MPF2P.810)
Journal of Immunology, 2014Co-Authors: Fengjuan Yang, Kwok-yung Yuen, Susanna Kp Lau, Patrick C. Y. WooAbstract:Dimorphic pathogenic fungus Penicillium marneffei can cause Penicilliosis which is a common infectious disease in AIDS patients in Southeast Asia and southern parts of China. Mp1p is a highly antigenic cell wall mannoprotein encoded by MP1 gene of P. marneffei and it is a pivotal factor for the pathogen infection and survival. Recombinant protein Mp1p produced in E.coli and Pichia pastors was used as an antigen vaccine against Penicilliosis. While administered with different adjuvants and injection routes to BALB/c mice, this vaccine protein combination with Sigma Adjuvant System by intraperitoneal injection elicited a strong immunoglobulin G antibody response and conferred protection against a lethal P. marneffei challenge. These results showed that protein Mp1p could protect BALB/c mice in a dose, adjuvant and injection dependent manner. Protein vaccine Mp1p induced resistance was assessed in terms of survival, fungal growth (CFU) and histopathological examination. Immunised BALB/c mice could be protected against P. marneffei with 100% survival. CFU and histopathological analysis implied that fungal growth was systemically restricted at target organ of vaccinated mice, especially in liver where there was a significant lower value of CFU than non-vaccinated mice. Our results support the further development of an effective vaccine against Penicilliosis.
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vaccine mediates protection against Penicilliosis in balb c mice mpf2p 810
Journal of Immunology, 2014Co-Authors: Fengjuan Yang, Kwok-yung Yuen, Susanna Kp Lau, Patrick C. Y. WooAbstract:Dimorphic pathogenic fungus Penicillium marneffei can cause Penicilliosis which is a common infectious disease in AIDS patients in Southeast Asia and southern parts of China. Mp1p is a highly antigenic cell wall mannoprotein encoded by MP1 gene of P. marneffei and it is a pivotal factor for the pathogen infection and survival. Recombinant protein Mp1p produced in E.coli and Pichia pastors was used as an antigen vaccine against Penicilliosis. While administered with different adjuvants and injection routes to BALB/c mice, this vaccine protein combination with Sigma Adjuvant System by intraperitoneal injection elicited a strong immunoglobulin G antibody response and conferred protection against a lethal P. marneffei challenge. These results showed that protein Mp1p could protect BALB/c mice in a dose, adjuvant and injection dependent manner. Protein vaccine Mp1p induced resistance was assessed in terms of survival, fungal growth (CFU) and histopathological examination. Immunised BALB/c mice could be protected against P. marneffei with 100% survival. CFU and histopathological analysis implied that fungal growth was systemically restricted at target organ of vaccinated mice, especially in liver where there was a significant lower value of CFU than non-vaccinated mice. Our results support the further development of an effective vaccine against Penicilliosis.
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Candida tropicalis and Penicillium marneffei Mixed Fungaemia in a Patient with Waldenström's Macroglobulinaemia
European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2001Co-Authors: Samson S. Y. Wong, Patrick C. Y. Woo, Kwok-yung YuenAbstract:A patient with Waldenstrom's macroglobulinaemia who had previously been treated with cladribine presented with septic arthritis caused by Escherichia coli. The patient's condition subsequently deteriorated, and he succumbed to pneumonia and mixed fungaemia due to Candida tropicalis and Penicillium marneffei. Profound lymphopenia coexisted with fungaemia. This is the first reported case of mixed Penicillium marneffei and Candida fungaemia and Penicilliosis marneffei in a patient with Waldenstrom's macroglobulinaemia. Penicilliosis marneffei should be considered as a potential complication in patients with markedly impaired cell-mediated immunity who have travelled to or resided in endemic areas. Patients who have undergone therapy with purine nucleoside analogues such as fludarabine and cladribine are also at risk.
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detection of specific antibodies to an antigenic mannoprotein for diagnosis of penicillium marneffei Penicilliosis
Journal of Clinical Microbiology, 1998Co-Authors: Liang Cao, Daliang Chen, Cindy Lee, Cheman Chan, K H Chan, Nongnuch Vanittanakom, Dominic N C Tsang, Kwok-yung YuenAbstract:The disseminated and progressive fungal disease Penicillium marneffei Penicilliosis is one of the most common infectious diseases in AIDS patients in Southeast Asia. To diagnose systemic Penicilliosis, we developed an enzyme-linked immunosorbent assay (ELISA)-based antibody test with Mp1p, a purified recombinant antigenic mannoprotein of P. marneffei. Evaluation of the test with guinea pig sera against P. marneffei and other pathogenic fungi indicated that this assay was specific for P. marneffei. Clinical evaluation revealed that high levels of specific antibody were detected in two immunocompetent Penicilliosis patients. Furthermore, approximately 80% (14 of 17) of the documented Penicilliosis patients with human immunodeficiency virus tested positive for the specific antibody. No false-positive results were found for serum samples from 90 healthy blood donors, 20 patients with typhoid fever, and 55 patients with tuberculosis, indicating a high specificity of the test. Thus, this ELISA-based test for the detection of anti-Mp1p antibody can be of significant value as a diagnostic for Penicilliosis.
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Penicillium marneffei infection in a patient with SLE
Lupus, 1995Co-Authors: D.t.m. Chan, Kwok-yung Yuen, K.p. ChengAbstract:We describe a patient with SLE who was infected by the fungus Penicillium marneffei. She was initially misdiagnosed as having disseminated tuberculosis. The correct diagnosis was finally made by bone marrow culture and she responded to a prolonged course of amphotericin B, flucytosine and itraconazole. The clinical presentation and histology of Penicilliosis are very similar to those of Mycobacterium tuberculosis. In Southeast Asia, Penicilliosis should be considered as a differential diagnosis in patients with SLE who present with fever and lymphadenopathy.
Rathakarn Kawila - One of the best experts on this subject based on the ideXlab platform.
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clinical and laboratory characteristics of Penicilliosis marneffei among patients with and without hiv infection in northern thailand a retrospective study
BMC Infectious Diseases, 2013Co-Authors: Rathakarn Kawila, Romanee Chaiwarith, Khuanchai SupparatpinyoAbstract:Background Penicilliosis marneffei is increasingly observed in individuals without HIV infection. This study aimed to compare the clinical and laboratory features among HIV infected and uninfected individuals with Penicilliosis marneffei.
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clinical and laboratory characteristics of Penicilliosis marneffei among patients with and without hiv infection in northern thailand a retrospective study
BMC Infectious Diseases, 2013Co-Authors: Rathakarn Kawila, Romanee Chaiwarith, Khuanchai SupparatpinyoAbstract:Penicilliosis marneffei is increasingly observed in individuals without HIV infection. This study aimed to compare the clinical and laboratory features among HIV infected and uninfected individuals with Penicilliosis marneffei. A retrospective cohort study was conducted between January 1, 2007 and December 31, 2011 at Chiang Mai University Hospital. We included individuals who were ≥15 years of age and presented with culture-proven P. marneffei infection. 116 HIV-infected and 34 HIV-uninfected patients were enrolled. Comparing to HIV-infected patients, HIV-uninfected patients were older; less likely to have fever, splenomegaly, and umbilicated skin lesions; more likely to have Sweet’s syndrome and bone and joint infections; had higher white blood cell count, platelet count, and CD4 cell count; had lower alanine transaminase (ALT); and less likely to have positive fungal blood cultures. The mortality rates were 20.7% and 29.4% among HIV infected and uninfected patients, respectively. Clinical manifestations of Penicilliosis marneffei are different between patients with and without HIV infection. Physician’s awareness of this disease in HIV-uninfected patients may prompt the diagnosis and timely treatment, and can lead to a better outcome.
Eleftherios Mylonakis - One of the best experts on this subject based on the ideXlab platform.
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Detection of Talaromyces marneffei from Fresh Tissue of an Inhalational Murine Pulmonary Model Using Nested PCR.
PloS one, 2016Co-Authors: Yinghui Liu, Xiaowen Huang, Eleftherios MylonakisAbstract:Penicilliosis marneffei, often consecutive to the aspiration of Talaromyces marneffei (Penicillium marneffei), continues to be one of the significant causes of morbidity and mortality in immunocompromised patients in endemic regions such as Southeast Asia. Improving the accuracy of diagnosing this disease would aid in reducing the mortality of associated infections. In this study, we developed a stable and reproducible murine pulmonary model that mimics human Penicilliosis marneffei using a nebulizer to deliver Talaromyces marneffei (SUMS0152) conidia to the lungs of BALB/c nude mice housed in exposure chamber. Using this model, we further revealed that nested PCR was sensitive and specific for detecting Talaromyces marneffei in bronchoalveolar lavage fluid and fresh tissues. This inhalation model may provide a more representative analysis tool for studying the development of Penicilliosis marneffei, in addition to revealing that nested PCR has a predictive value in reflecting pulmonary infection.