Xu Zhiping,Yan Li,Peng Li,Feng Yanmei,Jia Jinwei,Li Yishi.Penicilliosis marneffei misdiagnosed as tuberculosis in china: 2 cases of reports and literature review[J].J Amry Med Univ (J Third Mil Med Univ),2016,38(14):1686-1690.
Xu Zhiping,Yan Li,Peng Li,Feng Yanmei,Jia Jinwei,Li Yishi.Penicilliosis marneffei misdiagnosed as tuberculosis in china: 2 cases of reports and literature review[J].J Amry Med Univ (J Third Mil Med Univ),2016,38(14):1686-1690.DOI:
Penicilliosis marneffei misdiagnosed as tuberculosis in china: 2 cases of reports and literature review
Objective To report 2 cases of penicilliosis marneffei that was misdiagnosed as tuberculosis for a long time
and analysis relevant manifestations by literature review. Methods Two cases of disseminated penicilliosis marneffei in immunocompetent hosts from our hospital were presented
and the relevant manifestations by literature review were analyzed. Results The first case is a 32-year-old male
who was admitted with recurrent episodes of fever
productive cough and hemoptysis
and had accepted ineffective anti-infection and anti-tuberculosis treatment. Bronchoscopy showed that tracheas and bronchia mucosal epithelia were attached with white necrosis. Disseminated penicilliosis marneffei was diagnosed by fungal culture of tracheas necrosis and bronchoalveolar lavage fluid. The second case is a 28-year-old female
who was admitted with high temperature
cough
and sputum
had mass shadow with atelectasis in the upper lobe of left lung in her chest CT
and had accepted ineffective anti-tuberculosis treatment for a long time. Multiple subcutaneous abscess and osteolytic destruction appeared at the same time. Finally
penicilliosis marneffei was confirmed by fungal culture of crown mass puncture pus. Moreover
based on relevant literatures from 1980 to 2014
1 826 cases in CNKI and 471 cases in PUBMED had been reported. 78.3%-91.7% of these patients were HIV-infected
more than 90% with fever
about 50% with cough
anemia and skin lesions
about 60% with lung infiltration shadows
and approximately 40% with hepatosplenomegaly and lymphadenopathy. Conclusion Penicilliosis marneffei is more common in the patients with HIV infection
and it may also occur in the persons with normal immune function. It has different symptoms and easy to be misdiagnosed as tuberculosis. When general anti-infection or anti-tuberculosis treatment is ineffective in the immunocompetent patients
penicilliosis marneffei should be highly considered. Early diagnosis and treatment is the key for good prognosis of penicilliosis marneffei.
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