Penicilliosis

This page is about clinical aspects of the disease.  For microbiologic aspects of the causative organism(s), see Penicillium marneffei.

For patient information click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Synonyms and keywords:

Penicilliosis is an infection caused by Penicillium marneffei. Once considered rare, its occurrence has increased due to AIDS. It is now the third most common opportunistic infection (after extrapulmonary tuberculosis and cryptococcosis) in HIV-positive individuals within the endemic area of Southeast Asia.

Diagnosis is usually made by identification of the fungi from clinical specimens. Biopsies of skin lesions, lymph nodes, and bone marrow demonstrate the presence of organisms on histopathology.

The most common symptoms are fever, skin lesions, anemia, generalized lymphadenopathy, and hepatomegaly.

Penicillium marneffei demonstrates in vitro susceptibility to multiple antifungal agents including ketoconazole, itraconazole, miconazole, flucytosine, and amphotericin B. Without treatment patients have a poor prognosis.

Treatment

Antimicrobial Regimen

• Penicillium marneffei

• Preferred regimen: Amphotericin B 0.5–1 mg/kg per day for 2 weeks followed by Itraconazole 400 mg/day for 10 weeks followed by 200 mg/day PO

• Alternative regimen: Itraconazole 200 mg PO tid for 3 days, then 200 mg PO bid for 12 weeks, then 200 mg PO q24h in less sick patients.

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