Immune reconstitution inflammatory syndrome from Penicillium marneffei in an HIV-infected child: A case report and review of literature
Backgrounds: Disseminated Penicillium marneffei infection is one of the most common HIV-related opportunistic infections in Southeast Asia. Immune reconstitution inflammatory syndrome (IRIS) is a complication related to antiretroviral therapy (ART)-induced immune restoration. The aim of this report...
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th-cmuir.6653943832-519462018-09-04T06:12:12Z Immune reconstitution inflammatory syndrome from Penicillium marneffei in an HIV-infected child: A case report and review of literature Tavitiya Sudjaritruk Thira Sirisanthana Virat Sirisanthana Medicine Backgrounds: Disseminated Penicillium marneffei infection is one of the most common HIV-related opportunistic infections in Southeast Asia. Immune reconstitution inflammatory syndrome (IRIS) is a complication related to antiretroviral therapy (ART)-induced immune restoration. The aim of this report is to present a case of HIV-infected child who developed an unmasking type of IRIS caused by disseminated P. marneffei infection after ART initiation.Case presentation: A 14-year-old Thai HIV-infected girl presented with high-grade fever, multiple painful ulcerated oral lesions, generalized non-pruritic erythrematous skin papules and nodules with central umbilication, and multiple swollen, warm, and tender joints 8 weeks after ART initiation. At that time, her CD4 + cell count was 7.2% or 39 cells/mm 3. On admission, her repeated CD4 + cell count was 11% or 51 cells/mm 3 and her plasma HIV-RNA level was < 50 copies/mL. Her skin biopsy showed necrotizing histiocytic granuloma formation with neutrophilic infiltration in the upper and reticular dermis. Tissue sections stained with hematoxylin and eosin (H&E), periodic acid-Schiff (PAS), and Grocott methenamine silver (GMS) stain revealed numerous intracellular and extracellular, round to oval, elongated, thin-walled yeast cells with central septation. The hemoculture, bone marrow culture, and skin culture revealed no growth of fungus or bacteria. Our patient responded well to intravenous amphotericin B followed by oral itraconazole. She fully recovered after 4-month antifungal treatment without evidence of recurrence of disease.Conclusions: IRIS from P. marneffei in HIV-infected people is rare. Appropriate recognition and properly treatment is important for a good prognosis. © 2012 Sudjaritruk et al; licensee BioMed Central Ltd. 2018-09-04T06:12:12Z 2018-09-04T06:12:12Z 2012-01-31 Journal 14712334 2-s2.0-84856323291 10.1186/1471-2334-12-28 https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84856323291&origin=inward http://cmuir.cmu.ac.th/jspui/handle/6653943832/51946 |
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Medicine Tavitiya Sudjaritruk Thira Sirisanthana Virat Sirisanthana Immune reconstitution inflammatory syndrome from Penicillium marneffei in an HIV-infected child: A case report and review of literature |
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Backgrounds: Disseminated Penicillium marneffei infection is one of the most common HIV-related opportunistic infections in Southeast Asia. Immune reconstitution inflammatory syndrome (IRIS) is a complication related to antiretroviral therapy (ART)-induced immune restoration. The aim of this report is to present a case of HIV-infected child who developed an unmasking type of IRIS caused by disseminated P. marneffei infection after ART initiation.Case presentation: A 14-year-old Thai HIV-infected girl presented with high-grade fever, multiple painful ulcerated oral lesions, generalized non-pruritic erythrematous skin papules and nodules with central umbilication, and multiple swollen, warm, and tender joints 8 weeks after ART initiation. At that time, her CD4 + cell count was 7.2% or 39 cells/mm 3. On admission, her repeated CD4 + cell count was 11% or 51 cells/mm 3 and her plasma HIV-RNA level was < 50 copies/mL. Her skin biopsy showed necrotizing histiocytic granuloma formation with neutrophilic infiltration in the upper and reticular dermis. Tissue sections stained with hematoxylin and eosin (H&E), periodic acid-Schiff (PAS), and Grocott methenamine silver (GMS) stain revealed numerous intracellular and extracellular, round to oval, elongated, thin-walled yeast cells with central septation. The hemoculture, bone marrow culture, and skin culture revealed no growth of fungus or bacteria. Our patient responded well to intravenous amphotericin B followed by oral itraconazole. She fully recovered after 4-month antifungal treatment without evidence of recurrence of disease.Conclusions: IRIS from P. marneffei in HIV-infected people is rare. Appropriate recognition and properly treatment is important for a good prognosis. © 2012 Sudjaritruk et al; licensee BioMed Central Ltd. |
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Journal |
author |
Tavitiya Sudjaritruk Thira Sirisanthana Virat Sirisanthana |
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Tavitiya Sudjaritruk Thira Sirisanthana Virat Sirisanthana |
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Tavitiya Sudjaritruk |
title |
Immune reconstitution inflammatory syndrome from Penicillium marneffei in an HIV-infected child: A case report and review of literature |
title_short |
Immune reconstitution inflammatory syndrome from Penicillium marneffei in an HIV-infected child: A case report and review of literature |
title_full |
Immune reconstitution inflammatory syndrome from Penicillium marneffei in an HIV-infected child: A case report and review of literature |
title_fullStr |
Immune reconstitution inflammatory syndrome from Penicillium marneffei in an HIV-infected child: A case report and review of literature |
title_full_unstemmed |
Immune reconstitution inflammatory syndrome from Penicillium marneffei in an HIV-infected child: A case report and review of literature |
title_sort |
immune reconstitution inflammatory syndrome from penicillium marneffei in an hiv-infected child: a case report and review of literature |
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2018 |
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https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84856323291&origin=inward http://cmuir.cmu.ac.th/jspui/handle/6653943832/51946 |
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