Penicillium marneffei presenting as an immune reconstitution inflammatory syndrome (IRIS) in a patient with advanced HIV
Autor: | Hiten Thaker, Rachel Hajjawi, Peter J. Moss, Charlotte Hall, Gavin Barlow, Kate Adams |
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Rok vydání: | 2013 |
Předmět: |
Male
Antifungal Agents Context (language use) HIV Infections Article Diagnosis Differential Penicilliosis Acquired immunodeficiency syndrome (AIDS) Immune reconstitution inflammatory syndrome Immune Reconstitution Inflammatory Syndrome Medicine Humans Lymphatic Diseases biology business.industry Penicillium General Medicine Middle Aged medicine.disease biology.organism_classification Mycoses Immunology Splenomegaly Penicillium marneffei business Viral load Dimorphic fungus Rare disease |
Zdroj: | BMJ case reports. 2013 |
ISSN: | 1757-790X |
Popis: | A 62-year-old British man with advanced HIV was established on antiretroviral therapy and treatment for disseminated Mycobacterium avium complex and Cytomegalovirus infections. One month later he re-presented with epigastric pain, an epigastric mass and skin lesions. Abdominal imaging revealed large volume lymphadenopathy, which was not present on previous imaging. Blood cultures yielded Penicillium marneffei, a dimorphic fungus endemic to South-east Asia. The patient had spent several years travelling in Thailand prior to the diagnosis of HIV. Penicilliosis is a common AIDS-defining illness in endemic areas, but remains rare in Europe. In this case, it presented in the context of a rapidly decreasing viral load as an immune reconstitution inflammatory syndrome. The challenges of management in the context of multiple comorbidities and polypharmacy are discussed. |
Databáze: | OpenAIRE |
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