Comparison of Talaromyces marneffei Infection in Human Immunodeficiency Virus-positive and Human Immunodeficiency Virus-negative Patients from Fujian, China
Background： Talaromyces （Penicillium） marneffei （TIM） is an emerging dimorphic human pathogenic fungus that is endemic to Southeast Asia. TM mostly occurs as an opportunistic infection in patients with human immunodeficiency virus （HIV）. The objective of this study was to compare the clinical and la...
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| Published in | Chinese medical journal Vol. 129; no. 9; pp. 1059 - 1065 |
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| Main Authors | , , , , , , , |
| Format | Journal Article |
| Language | English |
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China
Wolters Kluwer - Medknow Publications
05.05.2016
Medknow Publications and Media Pvt. Ltd Lippincott Williams & Wilkins Ovid Technologies Department of Respiratory and Critical Care Medicine%Department of Respiratory and Critical Care Medicine, Nanfang Hospital of Southern Medical University, Guangzhou, Guangdong 510515, China%Department of Respiratory and Critical Care Medicine, Fujian Provincial Hospital, Provincial Clinical Medical College of Fujian Medical University, Fuzhou, Fujian 350001, China Medknow Publications & Media Pvt Ltd Wolters Kluwer |
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| Abstract | Background： Talaromyces （Penicillium） marneffei （TIM） is an emerging dimorphic human pathogenic fungus that is endemic to Southeast Asia. TM mostly occurs as an opportunistic infection in patients with human immunodeficiency virus （HIV）. The objective of this study was to compare the clinical and laboratory parameters of patients with TM infections who were HIV-positive and HIV-negative and to assess therapies and outcomes. Methods： This was a retrospective analysis of 26 patients diagnosed with disseminated TM infection from September 2005 to April 2014 at Fujian Provincial Hospital, China. Results： Patients with TM infection tend to present with fever, weight loss, and anemia. The time from symptom onset to confirmed diagnosis was greater for HlV-negative patients （n 7; median： 60 days, range： 14-365 days） than for HIV-positive patients （n = 19; median： 30 days, range： 3-90 days, Mann-Whitney U= 31.50, P = 0.041）. HIV-negative patients were more likely to have dyspnea （57.1% vs. 5.3%, Z： = 8.86, P = 0.010）, low neutrophil count （Mann-Whitney U = 27.00, P = 0.029）, high CD4 count （Mann-Whitney U= 0.00, P 0.009）, and high lymphocyte count （Mann-Whitney U = 21.00, P = 0.009）. There were no significant differences in other demographic, clinical, or biochemical characteristics. Among all the patients, 12 HIV-positive patient and 1 HlV-negative patient received amphotericin and fluconazole treatment, 9 of whom improved, l died, 2 had kidney damage, 1 had hypokalemia due to exceeded doses. Conclusions： HIV-negative patients with TM infections tend to have a longer diagnostic interval, a higher percentage of dyspnea, higher levels of CD4 and lymphocytes, and lower neutrophil counts than TM infection in HIV-positive patients. Treatment programs with amphotericin and fluconazole are mostly effective. |
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| AbstractList | Background: Talaromyces (Penicillium) marneffei (TM) is an emerging dimorphic human pathogenic fungus that is endemic to Southeast Asia. TM mostly occurs as an opportunistic infection in patients with human immunodeficiency virus (HIV). The objective of this study was to compare the clinical and laboratory parameters of patients with TM infections who were HIV-positive and HIV-negative and to assess therapies and outcomes. Methods: This was a retrospective analysis of 26 patients diagnosed with disseminated TM infection from September 2005 to April 2014 at Fujian Provincial Hospital, China. Results: Patients with TM infection tend to present with fever, weight loss, and anemia. The time from symptom onset to confirmed diagnosis was greater for HIV-negative patients (n = 7; median: 60 days, range: 14-365 days) than for HIV-positive patients (n = 19; median: 30 days, range: 3-90 days, Mann-Whitney U = 31.50, P= 0.041). HIV-negative patients were more likely to have dyspnea (57.1% vs. 5.3%, χ2 = 8.86, P= 0.010), low neutrophil count (Mann-Whitney U = 27.00, P= 0.029), high CD4 count (Mann-Whitney U = 0.00, P= 0.009), and high lymphocyte count (Mann-Whitney U = 21.00, P= 0.009). There were no significant differences in other demographic, clinical, or biochemical characteristics. Among all the patients, 12 HIV-positive patient and 1 HIV-negative patient received amphotericin and fluconazole treatment, 9 of whom improved, 1 died, 2 had kidney damage, 1 had hypokalemia due to exceeded doses. Conclusions: HIV-negative patients with TM infections tend to have a longer diagnostic interval, a higher percentage of dyspnea, higher levels of CD4 and lymphocytes, and lower neutrophil counts than TM infection in HIV-positive patients. Treatment programs with amphotericin and fluconazole are mostly effective. Background: Talaromyces (Penicillium) marneffei (TM) is an emerging dimorphic human pathogenic fungus that is endemic to Southeast Asia. TM mostly occurs as an opportunistic infection in patients with human immunodeficiency virus (HIV). The objective of this study was to compare the clinical and laboratory parameters of patients with TM infections who were HIV-positive and HIV-negative and to assess therapies and outcomes. Methods: This was a retrospective analysis of 26 patients diagnosed with disseminated TM infection from September 2005 to April 2014 at Fujian Provincial Hospital, China. Results: Patients with TM infection tend to present with fever, weight loss, and anemia. The time from symptom onset to confirmed diagnosis was greater for HIV-negative patients (n = 7; median: 60 days, range: 14-365 days) than for HIV-positive patients (n = 19; median: 30 days, range: 3-90 days, Mann-Whitney U = 31.50, P= 0.041). HIV-negative patients were more likely to have dyspnea (57.1% vs. 5.3%, χ2 = 8.86, P= 0.010), low neutrophil count (Mann-Whitney U = 27.00, P= 0.029), high CD4 count (Mann-Whitney U = 0.00, P= 0.009), and high lymphocyte count (Mann-Whitney U = 21.00, P= 0.009). There were no significant differences in other demographic, clinical, or biochemical characteristics. Among all the patients, 12 HIV-positive patient and 1 HIV-negative patient received amphotericin and fluconazole treatment, 9 of whom improved, 1 died, 2 had kidney damage, 1 had hypokalemia due to exceeded doses. Conclusions: HIV-negative patients with TM infections tend to have a longer diagnostic interval, a higher percentage of dyspnea, higher levels of CD4 and lymphocytes, and lower neutrophil counts than TM infection in HIV-positive patients. Treatment programs with amphotericin and fluconazole are mostly effective. Background:Talaromyces (Penicillium) rnarneffei (TM) is an emerging dimorphic human pathogenic fungus that is endemic to Southeast Asia.TM mostly occurs as an opportunistic infection in patients with human immunodeficiency virus (HIV).The objective of this study was to compare the clinical and laboratory parameters of patients with TM infections who were HIV-positive and HIV-negative and to assess therapies and outcomes.Methods:This was a retrospective analysis of 26 patients diagnosed with disseminated TM infection from September 2005 to April 2014 at Fujian Provincial Hospital,China.Results:Patients with TM infection tend to present with fever,weight loss,and anemia.The time from symptom onset to confirmed diagnosis was greater for HIV-negative patients (n =7; median:60 days,range:14-365 days) than for HIV-positive patients (n =19; median:30 days,range:3-90 days,Mann Whitney U=31.50,P =0.041).HIV-negative patients were more likely to have dyspnea (57.1％ vs.5.3％,x2 =8.86,P =0.010),low neutrophil count (Mann-Whitney U =27.00,P =0.029),high CD4 count (Mann-Whitney U =0.00,P =0.009),and high lymphocyte count (Mann-Whitney U =21.00,P =0.009).There were no significant differences in other demographic,clinical,or biochemical characteristics.Among all the patients,12 HIV-positive patient and 1 HIV-negative patient received amphotericin and fluconazole treatment,9 of whom improved,1 died,2 had kidney damage,1 had hypokalemia due to exceeded doses.Conclusions:HIV-negative patients with TM infections tend to have a longer diagnostic interval,a higher percentage of dyspnea,higher levels of CD4 and lymphocytes,and lower neutrophil counts than TM infection in HIV-positive patients.Treatment programs with amphotericin and fluconazole are mostly effective. Background： Talaromyces （Penicillium） marneffei （TIM） is an emerging dimorphic human pathogenic fungus that is endemic to Southeast Asia. TM mostly occurs as an opportunistic infection in patients with human immunodeficiency virus （HIV）. The objective of this study was to compare the clinical and laboratory parameters of patients with TM infections who were HIV-positive and HIV-negative and to assess therapies and outcomes. Methods： This was a retrospective analysis of 26 patients diagnosed with disseminated TM infection from September 2005 to April 2014 at Fujian Provincial Hospital, China. Results： Patients with TM infection tend to present with fever, weight loss, and anemia. The time from symptom onset to confirmed diagnosis was greater for HlV-negative patients （n 7; median： 60 days, range： 14-365 days） than for HIV-positive patients （n = 19; median： 30 days, range： 3-90 days, Mann-Whitney U= 31.50, P = 0.041）. HIV-negative patients were more likely to have dyspnea （57.1% vs. 5.3%, Z： = 8.86, P = 0.010）, low neutrophil count （Mann-Whitney U = 27.00, P = 0.029）, high CD4 count （Mann-Whitney U= 0.00, P 0.009）, and high lymphocyte count （Mann-Whitney U = 21.00, P = 0.009）. There were no significant differences in other demographic, clinical, or biochemical characteristics. Among all the patients, 12 HIV-positive patient and 1 HlV-negative patient received amphotericin and fluconazole treatment, 9 of whom improved, l died, 2 had kidney damage, 1 had hypokalemia due to exceeded doses. Conclusions： HIV-negative patients with TM infections tend to have a longer diagnostic interval, a higher percentage of dyspnea, higher levels of CD4 and lymphocytes, and lower neutrophil counts than TM infection in HIV-positive patients. Treatment programs with amphotericin and fluconazole are mostly effective. BACKGROUNDTalaromyces (Penicillium) marneffei (TM) is an emerging dimorphic human pathogenic fungus that is endemic to Southeast Asia. TM mostly occurs as an opportunistic infection in patients with human immunodeficiency virus (HIV). The objective of this study was to compare the clinical and laboratory parameters of patients with TM infections who were HIV-positive and HIV-negative and to assess therapies and outcomes.METHODSThis was a retrospective analysis of 26 patients diagnosed with disseminated TM infection from September 2005 to April 2014 at Fujian Provincial Hospital, China.RESULTSPatients with TM infection tend to present with fever, weight loss, and anemia. The time from symptom onset to confirmed diagnosis was greater for HIV-negative patients (n = 7; median: 60 days, range: 14-365 days) than for HIV-positive patients (n = 19; median: 30 days, range: 3-90 days, Mann-Whitney U = 31.50, P= 0.041). HIV-negative patients were more likely to have dyspnea (57.1% vs. 5.3%, χ2 = 8.86, P= 0.010), low neutrophil count (Mann-Whitney U = 27.00, P= 0.029), high CD4 count (Mann-Whitney U = 0.00, P= 0.009), and high lymphocyte count (Mann-Whitney U = 21.00, P= 0.009). There were no significant differences in other demographic, clinical, or biochemical characteristics. Among all the patients, 12 HIV-positive patient and 1 HIV-negative patient received amphotericin and fluconazole treatment, 9 of whom improved, 1 died, 2 had kidney damage, 1 had hypokalemia due to exceeded doses.CONCLUSIONSHIV-negative patients with TM infections tend to have a longer diagnostic interval, a higher percentage of dyspnea, higher levels of CD4 and lymphocytes, and lower neutrophil counts than TM infection in HIV-positive patients. Treatment programs with amphotericin and fluconazole are mostly effective. Talaromyces (Penicillium) marneffei (TM) is an emerging dimorphic human pathogenic fungus that is endemic to Southeast Asia. TM mostly occurs as an opportunistic infection in patients with human immunodeficiency virus (HIV). The objective of this study was to compare the clinical and laboratory parameters of patients with TM infections who were HIV-positive and HIV-negative and to assess therapies and outcomes. This was a retrospective analysis of 26 patients diagnosed with disseminated TM infection from September 2005 to April 2014 at Fujian Provincial Hospital, China. Patients with TM infection tend to present with fever, weight loss, and anemia. The time from symptom onset to confirmed diagnosis was greater for HIV-negative patients (n = 7; median: 60 days, range: 14-365 days) than for HIV-positive patients (n = 19; median: 30 days, range: 3-90 days, Mann-Whitney U = 31.50, P= 0.041). HIV-negative patients were more likely to have dyspnea (57.1% vs. 5.3%, χ2 = 8.86, P= 0.010), low neutrophil count (Mann-Whitney U = 27.00, P= 0.029), high CD4 count (Mann-Whitney U = 0.00, P= 0.009), and high lymphocyte count (Mann-Whitney U = 21.00, P= 0.009). There were no significant differences in other demographic, clinical, or biochemical characteristics. Among all the patients, 12 HIV-positive patient and 1 HIV-negative patient received amphotericin and fluconazole treatment, 9 of whom improved, 1 died, 2 had kidney damage, 1 had hypokalemia due to exceeded doses. HIV-negative patients with TM infections tend to have a longer diagnostic interval, a higher percentage of dyspnea, higher levels of CD4 and lymphocytes, and lower neutrophil counts than TM infection in HIV-positive patients. Treatment programs with amphotericin and fluconazole are mostly effective. |
| Audience | Academic |
| Author | Hong-Ru Li Shao-Xi Cai Yu-Sheng Chen Mei-E Yu Neng-Luan Xu Bao-Song Xie Ming Lin Xin-Lan Hu |
| AuthorAffiliation | Department of Respiratory and Critical Care Medicine, Nanfang Hospital of Southern Medical University, Guangzhou, Guangdong 510515, China Department of Respiratory and Critical Care Medicine, Fujian Provincial Hospital, Provincial Clinical MedicalCollege of Fujian M~edical Universi＇ty, Fuzhou, Fujian 350001, China Department of Clinical Laboratory, Laboratory of Bacteriology, Fujian Provincial Hospital, Provincial Clinical Medical College of Fujian Medical University, Fuzhou, Fujian 350001, China |
| AuthorAffiliation_xml | – name: Department of Respiratory and Critical Care Medicine%Department of Respiratory and Critical Care Medicine, Nanfang Hospital of Southern Medical University, Guangzhou, Guangdong 510515, China%Department of Respiratory and Critical Care Medicine, Fujian Provincial Hospital, Provincial Clinical Medical College of Fujian Medical University, Fuzhou, Fujian 350001, China – name: 2 Department of Respiratory and Critical Care Medicine, Fujian Provincial Hospital, Provincial Clinical Medical College of Fujian Medical University, Fuzhou, Fujian 350001, China – name: 3 Department of Clinical Laboratory, Laboratory of Bacteriology, Fujian Provincial Hospital, Provincial Clinical Medical College of Fujian Medical University, Fuzhou, Fujian 350001, China – name: 1 Department of Respiratory and Critical Care Medicine, Nanfang Hospital of Southern Medical University, Guangzhou, Guangdong 510515, China |
| Author_xml | – sequence: 1 givenname: Hong-Ru surname: Li fullname: Li, Hong-Ru organization: Department of Respiratory and Critical Care Medicine, Nanfang Hospital of Southern Medical University, Guangzhou, Guangdong 510515; Department of Respiratory and Critical Care Medicine, Fujian Provincial Hospital, Provincial Clinical Medical College of Fujian Medical University, Fuzhou, Fujian 350001 – sequence: 2 givenname: Shao-Xi surname: Cai fullname: Cai, Shao-Xi organization: Department of Respiratory and Critical Care Medicine, Nanfang Hospital of Southern Medical University, Guangzhou, Guangdong 510515 – sequence: 3 givenname: Yu-Sheng surname: Chen fullname: Chen, Yu-Sheng organization: Department of Respiratory and Critical Care Medicine, Fujian Provincial Hospital, Provincial Clinical Medical College of Fujian Medical University, Fuzhou, Fujian 350001 – sequence: 4 givenname: Mei-E surname: Yu fullname: Yu, Mei-E organization: Department of Respiratory and Critical Care Medicine, Fujian Provincial Hospital, Provincial Clinical Medical College of Fujian Medical University, Fuzhou, Fujian 350001 – sequence: 5 givenname: Neng-Luan surname: Xu fullname: Xu, Neng-Luan organization: Department of Respiratory and Critical Care Medicine, Fujian Provincial Hospital, Provincial Clinical Medical College of Fujian Medical University, Fuzhou, Fujian 350001 – sequence: 6 givenname: Bao-Song surname: Xie fullname: Xie, Bao-Song organization: Department of Respiratory and Critical Care Medicine, Fujian Provincial Hospital, Provincial Clinical Medical College of Fujian Medical University, Fuzhou, Fujian 350001 – sequence: 7 givenname: Ming surname: Lin fullname: Lin, Ming organization: Department of Respiratory and Critical Care Medicine, Fujian Provincial Hospital, Provincial Clinical Medical College of Fujian Medical University, Fuzhou, Fujian 350001 – sequence: 8 givenname: Xin-Lan surname: Hu fullname: Hu, Xin-Lan organization: Department of Clinical Laboratory, Laboratory of Bacteriology, Fujian Provincial Hospital, Provincial Clinical Medical College of Fujian Medical University, Fuzhou, Fujian 350001 |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/27098791$$D View this record in MEDLINE/PubMed |
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| Keywords | Human Immunodeficiency Virus Talaromyces marneffei Clinical Characteristics |
| Language | English |
| License | http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. |
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| Notes | Clinical Characteristics; Human lmmunodeficiency Virus; Talaromyces marneffei 11-2154/R Background： Talaromyces （Penicillium） marneffei （TIM） is an emerging dimorphic human pathogenic fungus that is endemic to Southeast Asia. TM mostly occurs as an opportunistic infection in patients with human immunodeficiency virus （HIV）. The objective of this study was to compare the clinical and laboratory parameters of patients with TM infections who were HIV-positive and HIV-negative and to assess therapies and outcomes. Methods： This was a retrospective analysis of 26 patients diagnosed with disseminated TM infection from September 2005 to April 2014 at Fujian Provincial Hospital, China. Results： Patients with TM infection tend to present with fever, weight loss, and anemia. The time from symptom onset to confirmed diagnosis was greater for HlV-negative patients （n 7; median： 60 days, range： 14-365 days） than for HIV-positive patients （n = 19; median： 30 days, range： 3-90 days, Mann-Whitney U= 31.50, P = 0.041）. HIV-negative patients were more likely to have dyspnea （57.1% vs. 5.3%, Z： = 8.86, P = 0.010）, low neutrophil count （Mann-Whitney U = 27.00, P = 0.029）, high CD4 count （Mann-Whitney U= 0.00, P 0.009）, and high lymphocyte count （Mann-Whitney U = 21.00, P = 0.009）. There were no significant differences in other demographic, clinical, or biochemical characteristics. Among all the patients, 12 HIV-positive patient and 1 HlV-negative patient received amphotericin and fluconazole treatment, 9 of whom improved, l died, 2 had kidney damage, 1 had hypokalemia due to exceeded doses. Conclusions： HIV-negative patients with TM infections tend to have a longer diagnostic interval, a higher percentage of dyspnea, higher levels of CD4 and lymphocytes, and lower neutrophil counts than TM infection in HIV-positive patients. Treatment programs with amphotericin and fluconazole are mostly effective. ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
| OpenAccessLink | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4852673/ |
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| PublicationCentury | 2000 |
| PublicationDate | 2016-05-05 |
| PublicationDateYYYYMMDD | 2016-05-05 |
| PublicationDate_xml | – month: 05 year: 2016 text: 2016-05-05 day: 05 |
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| PublicationPlace | China |
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| PublicationTitle | Chinese medical journal |
| PublicationTitleAlternate | Chinese Medical Journal |
| PublicationTitle_FL | Chinese Medical Journal |
| PublicationYear | 2016 |
| Publisher | Wolters Kluwer - Medknow Publications Medknow Publications and Media Pvt. Ltd Lippincott Williams & Wilkins Ovid Technologies Department of Respiratory and Critical Care Medicine%Department of Respiratory and Critical Care Medicine, Nanfang Hospital of Southern Medical University, Guangzhou, Guangdong 510515, China%Department of Respiratory and Critical Care Medicine, Fujian Provincial Hospital, Provincial Clinical Medical College of Fujian Medical University, Fuzhou, Fujian 350001, China Medknow Publications & Media Pvt Ltd Wolters Kluwer |
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| Snippet | Background： Talaromyces （Penicillium） marneffei （TIM） is an emerging dimorphic human pathogenic fungus that is endemic to Southeast Asia. TM mostly occurs as... Background: Talaromyces (Penicillium) marneffei (TM) is an emerging dimorphic human pathogenic fungus that is endemic to Southeast Asia. TM mostly occurs as an... Talaromyces (Penicillium) marneffei (TM) is an emerging dimorphic human pathogenic fungus that is endemic to Southeast Asia. TM mostly occurs as an... BACKGROUNDTalaromyces (Penicillium) marneffei (TM) is an emerging dimorphic human pathogenic fungus that is endemic to Southeast Asia. TM mostly occurs as an... Background:Talaromyces (Penicillium) rnarneffei (TM) is an emerging dimorphic human pathogenic fungus that is endemic to Southeast Asia.TM mostly occurs as an... |
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| SubjectTerms | Acquired immune deficiency syndrome Adult Aged AIDS Amphotericin B Antiretroviral drugs Blood Bone marrow CD4 Lymphocyte Count Clinical Characteristics; Human Immunodeficiency Virus; Talaromyces marneffei Critical care Disease control Disease prevention Dosage and administration Epidemiology Female Fever Fluconazole Health aspects HIV HIV infections HIV Infections - complications HIV patients Hospitals Human immunodeficiency virus Humans Infections Infectious diseases Laboratories Male Medical diagnosis Medicine Middle Aged Mycoses - diagnosis Mycoses - drug therapy Mycoses - immunology Original Retrospective Studies Risk factors Talaromyces - drug effects 人类免疫缺陷病毒 患者 病毒感染 福建省 阳性 阴性 青霉菌 黄色 |
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| Title | Comparison of Talaromyces marneffei Infection in Human Immunodeficiency Virus-positive and Human Immunodeficiency Virus-negative Patients from Fujian, China |
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