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Chen J, Zhang R, Shen Y, Liu L, Qi T, Wang Z, Song W, Tang Y, Lu H. Clinical Characteristics and Prognosis of Penicilliosis Among Human Immunodeficiency Virus-Infected Patients in Eastern China. Am J Trop Med Hyg 2017; 96:1350-1354. [PMID: 28719279 DOI: 10.4269/ajtmh.16-0521] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
AbstractTalaromyces marneffei infection is increasingly observed in people living with human immunodeficiency virus (HIV) in eastern China, a nonendemic area. This study aimed to draw the clinician's attention to this disease by presenting the clinical characteristics and prognosis of penicilliosis among HIV-infected patients from this region. We retrospectively analyzed HIV-infected patients with culture-proven T. marneffei infection admitted during January 1, 2014-December 31, 2015, at the Shanghai Public Health Clinical Center. A total of 48 patients with confirmed HIV infection and penicilliosis were enrolled, which accounted for a mean of 3.2% (95% confidence interval: 2.4-4.2%) of yearly HIV infection admissions among patients from eastern China. Symptoms included fever, cough, and gastrointestinal complaints, whereas the most common sign was skin lesions. Anemia occurred in 87.5% (42/48) of the patients. The overall mortality rate was 16.7%. Low CD4 T-cell count and hemoglobin level were correlated with mortality. Based on these results, we concluded that penicilliosis should be considered in HIV-infected patients from eastern China who present with fever, cutaneous lesions, and anemia. The clinical characters and the prognosis of patients with penicilliosis are similar to those in endemic areas. More attention should be paid to penicilliosis patients with low CD4 T-cell count and/or low hemoglobin level.
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Affiliation(s)
- Jun Chen
- Department of Infectious Diseases, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Renfang Zhang
- Department of Infectious Diseases, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Yinzhong Shen
- Department of Infectious Diseases, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Li Liu
- Department of Infectious Diseases, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Tangkai Qi
- Department of Infectious Diseases, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Zhenyan Wang
- Department of Infectious Diseases, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Wei Song
- Department of Infectious Diseases, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Yang Tang
- Department of Infectious Diseases, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Hongzhou Lu
- Department of Infectious Diseases, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
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Mukkada S, Kirby J, Apiwattanakul N, Hayden RT, Caniza MA. Use of Fungal Diagnostics and Therapy in Pediatric Cancer Patients in Resource-Limited Settings. CURRENT CLINICAL MICROBIOLOGY REPORTS 2016; 3:120-131. [PMID: 27672551 PMCID: PMC5034939 DOI: 10.1007/s40588-016-0038-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Fungal diseases are an important cause of mortality in immunocompromised hosts, and their incidence in pediatric cancer patients in low- to middle-income countries is underestimated. In this review, we present relevant, up-to-date information about the most common opportunistic and endemic fungal diseases among children with cancer, their geographic distribution, and recommended diagnostics and treatment. Efforts to improve the care of children with cancer and fungal disease must address the urgent need for sustainable and cost-effective solutions that improve training, fungal disease testing capability, and the use of available resources. We hope that the collective information presented here will be used to advise healthcare providers, regional and country health leaders, and policymakers of the current challenges in diagnosing and treating fungal infections in children with cancer in low- to middle-income countries.
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Affiliation(s)
- Sheena Mukkada
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN, USA
- Division of Infectious Diseases, Department of Pediatrics, University of Tennessee Health Sciences Center, Memphis, TN, USA
| | - Jeannette Kirby
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Nopporn Apiwattanakul
- Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Randall T. Hayden
- Department of Pathology, St. Jude Children’s Research Hospital, Memphis, TN, USA
| | - Miguela A. Caniza
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN, USA
- Department of Global Pediatric Medicine, St Jude Children’s Research Hospital, Memphis, TN, USA
- International Outreach Program, St. Jude Children's Research Hospital, Memphis, TN, USA
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Histoplasmosis infections worldwide: thinking outside of the Ohio River valley. CURRENT TROPICAL MEDICINE REPORTS 2015; 2:70-80. [PMID: 26279969 DOI: 10.1007/s40475-015-0044-0] [Citation(s) in RCA: 139] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
In the United States, histoplasmosis is generally thought to occur mainly in the Ohio and Mississippi River Valleys, and the classic map of histoplasmosis distribution reflecting this is second nature to many U.S. physicians. With the advent of the HIV pandemic reports of patients with progressive disseminated histoplasmosis and AIDS came from regions of known endemicity, as well as from regions not thought to be endemic for histoplasmosis throughout the world. In addition, our expanding armamentarium of immunosuppressive medications and biologics has increased the diagnosis of histoplasmosis worldwide. While our knowledge of areas in which histoplasmosis is endemic has improved, it is still incomplete. Our contention is that physicians should consider histoplasmosis with the right constellations of symptoms in any febrile patient with immune suppression, regardless of geographic location or travel history.
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Wang Y, Pan B, Wu J, Bi X, Liao W, Pan W, Gu J. Detection and phylogenetic characterization of a case of Histoplasma capsulatum infection in mainland China. Am J Trop Med Hyg 2014; 90:1180-3. [PMID: 24686744 DOI: 10.4269/ajtmh.14-0048] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Histoplasmosis usually occurs in specific endemic areas. Sporadic cases have also been reported in mainland China. Here, we described an indigenous case of disseminated histoplasmosis. Phylogenetic analysis revealed that the Histoplasma capsulatum isolated in our case belongs to the Australian clade. Combined with previous studies, it revealed high genetic diversity among Chinese H. capsulatum isolates.
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Affiliation(s)
- Ying Wang
- Department of Dermatology, Changhai Hospital, Second Military Medical University, Shanghai, People's Republic of China; Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai, People's Republic of China
| | - Bo Pan
- Department of Dermatology, Changhai Hospital, Second Military Medical University, Shanghai, People's Republic of China; Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai, People's Republic of China
| | - Jianhua Wu
- Department of Dermatology, Changhai Hospital, Second Military Medical University, Shanghai, People's Republic of China; Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai, People's Republic of China
| | - Xinling Bi
- Department of Dermatology, Changhai Hospital, Second Military Medical University, Shanghai, People's Republic of China; Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai, People's Republic of China
| | - Wanqing Liao
- Department of Dermatology, Changhai Hospital, Second Military Medical University, Shanghai, People's Republic of China; Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai, People's Republic of China
| | - Weihua Pan
- Department of Dermatology, Changhai Hospital, Second Military Medical University, Shanghai, People's Republic of China; Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai, People's Republic of China
| | - Jun Gu
- Department of Dermatology, Changhai Hospital, Second Military Medical University, Shanghai, People's Republic of China; Department of Dermatology, Changzheng Hospital, Second Military Medical University, Shanghai, People's Republic of China
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