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Disseminated Infections with Talaromyces marneffei in Non-AIDS Patients Given Monoclonal Antibodies against CD20 and Kinase Inhibitors.

Chan JF, Chan TS, Gill H, Lam FY, Trendell-Smith NJ, Sridhar S, Tse H, Lau SK, Hung IF, Yuen KY, Woo PC - Emerging Infect. Dis. (2015)

Bottom Line: Infections with the fungus Talaromyces (formerly Penicillium) marneffei are rare in patients who do not have AIDS.We report disseminated T. marneffei infection in 4 hematology patients without AIDS who received targeted therapy with monoclonal antibodies against CD20 or kinase inhibitors during the past 2 years.Clinicians should be aware of this emerging complication, especially in patients from disease-endemic regions.

View Article: PubMed Central - PubMed

ABSTRACT
Infections with the fungus Talaromyces (formerly Penicillium) marneffei are rare in patients who do not have AIDS. We report disseminated T. marneffei infection in 4 hematology patients without AIDS who received targeted therapy with monoclonal antibodies against CD20 or kinase inhibitors during the past 2 years. Clinicians should be aware of this emerging complication, especially in patients from disease-endemic regions.

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Nasopharyngeal biopsy specimen from case-patient 1, who had a disseminated infection with Talaromyces marneffei. A) Grocott silver staining showing abundant yeast cells (arrows) with central septa 4–5 µm in diameter. B) Hematoxylin and eosin staining showing necrotic material admixed with blood and fibrin with aggregates of foamy macrophages (arrow). Scale bars indicate 5 μm.
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Figure 2: Nasopharyngeal biopsy specimen from case-patient 1, who had a disseminated infection with Talaromyces marneffei. A) Grocott silver staining showing abundant yeast cells (arrows) with central septa 4–5 µm in diameter. B) Hematoxylin and eosin staining showing necrotic material admixed with blood and fibrin with aggregates of foamy macrophages (arrow). Scale bars indicate 5 μm.

Mentions: A colonoscopy showed multiple shallow ulcers at the terminal ileum (Figure 1). Histologic analysis of an ulcer biopsy specimen showed slough of an acutely inflamed ulcer but no microorganisms. However, histologic analysis of a specimen from a nasopharyngeal biopsy performed for persistent left facial pain showed abundant yeast cells engulfed by foamy macrophages (Figure 2). Culture of terminal ileal ulcer biopsy specimens, stool samples, and nasopharyngeal biopsy specimens yielded T. marneffei. A contrast-enhanced cranial computed tomography (CT) scan showed 2 lesions (3–4-mm) with rim enhancement and perifocal edema at the right occipital and left parieto-occipital lobes. A thoracic CT scan showed 2 cavitary lesions (4–8 mm) in the right upper and lower lobes.


Disseminated Infections with Talaromyces marneffei in Non-AIDS Patients Given Monoclonal Antibodies against CD20 and Kinase Inhibitors.

Chan JF, Chan TS, Gill H, Lam FY, Trendell-Smith NJ, Sridhar S, Tse H, Lau SK, Hung IF, Yuen KY, Woo PC - Emerging Infect. Dis. (2015)

Nasopharyngeal biopsy specimen from case-patient 1, who had a disseminated infection with Talaromyces marneffei. A) Grocott silver staining showing abundant yeast cells (arrows) with central septa 4–5 µm in diameter. B) Hematoxylin and eosin staining showing necrotic material admixed with blood and fibrin with aggregates of foamy macrophages (arrow). Scale bars indicate 5 μm.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4816330&req=5

Figure 2: Nasopharyngeal biopsy specimen from case-patient 1, who had a disseminated infection with Talaromyces marneffei. A) Grocott silver staining showing abundant yeast cells (arrows) with central septa 4–5 µm in diameter. B) Hematoxylin and eosin staining showing necrotic material admixed with blood and fibrin with aggregates of foamy macrophages (arrow). Scale bars indicate 5 μm.
Mentions: A colonoscopy showed multiple shallow ulcers at the terminal ileum (Figure 1). Histologic analysis of an ulcer biopsy specimen showed slough of an acutely inflamed ulcer but no microorganisms. However, histologic analysis of a specimen from a nasopharyngeal biopsy performed for persistent left facial pain showed abundant yeast cells engulfed by foamy macrophages (Figure 2). Culture of terminal ileal ulcer biopsy specimens, stool samples, and nasopharyngeal biopsy specimens yielded T. marneffei. A contrast-enhanced cranial computed tomography (CT) scan showed 2 lesions (3–4-mm) with rim enhancement and perifocal edema at the right occipital and left parieto-occipital lobes. A thoracic CT scan showed 2 cavitary lesions (4–8 mm) in the right upper and lower lobes.

Bottom Line: Infections with the fungus Talaromyces (formerly Penicillium) marneffei are rare in patients who do not have AIDS.We report disseminated T. marneffei infection in 4 hematology patients without AIDS who received targeted therapy with monoclonal antibodies against CD20 or kinase inhibitors during the past 2 years.Clinicians should be aware of this emerging complication, especially in patients from disease-endemic regions.

View Article: PubMed Central - PubMed

ABSTRACT
Infections with the fungus Talaromyces (formerly Penicillium) marneffei are rare in patients who do not have AIDS. We report disseminated T. marneffei infection in 4 hematology patients without AIDS who received targeted therapy with monoclonal antibodies against CD20 or kinase inhibitors during the past 2 years. Clinicians should be aware of this emerging complication, especially in patients from disease-endemic regions.

Show MeSH
Related in: MedlinePlus