Penicilliosis

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Penicilliosis
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Penicilliosis (also known as penicillosis and talaromycosis) is an infection caused by Penicillium marneffei . [1]

Infection invasion of a host by disease-causing organisms

Infection is the invasion of an organism's body tissues by disease-causing agents, their multiplication, and the reaction of host tissues to the infectious agents and the toxins they produce. Infectious disease, also known as transmissible disease or communicable disease, is illness resulting from an infection.

<i>Penicillium marneffei</i> species of fungus

Penicillium species are usually regarded as unimportant in terms of causing human disease. Penicillium marneffei, now called Talaromyces marneffei, discovered in 1956, is an exception. It is now regarded as one of the world's ten most feared fungi. This is the only known thermally dimorphic species of Penicillium, and it can cause a lethal systemic infection (penicilliosis) with fever and anaemia similar to disseminated cryptococcosis.

Contents

It is a dimorphic fungus. [2] [3]

Symptoms

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

Fever common medical sign characterized by elevated body temperature

Fever, also known as pyrexia and febrile response, is defined as having a temperature above the normal range due to an increase in the body's temperature set point. There is not a single agreed-upon upper limit for normal temperature with sources using values between 37.5 and 38.3 °C. The increase in set point triggers increased muscle contractions and causes a feeling of cold. This results in greater heat production and efforts to conserve heat. When the set point temperature returns to normal, a person feels hot, becomes flushed, and may begin to sweat. Rarely a fever may trigger a febrile seizure. This is more common in young children. Fevers do not typically go higher than 41 to 42 °C.

Anemia Decrease in the total number of red blood cells or amount of hemoglobin in the blood, or lowered ability of the blood to carry oxygen

Anemia is a decrease in the total amount of red blood cells (RBCs) or hemoglobin in the blood, or a lowered ability of the blood to carry oxygen. When anemia comes on slowly, the symptoms are often vague and may include feeling tired, weakness, shortness of breath or a poor ability to exercise. Anemia that comes on quickly often has greater symptoms, which may include confusion, feeling like one is going to pass out, loss of consciousness, or increased thirst. Anemia must be significant before a person becomes noticeably pale. Additional symptoms may occur depending on the underlying cause.

Lymphadenopathy disorder of lymph nodes

Lymphadenopathy or adenopathy is disease of the lymph nodes, in which they are abnormal in size or consistency. Lymphadenopathy of an inflammatory type is lymphadenitis, producing swollen or enlarged lymph nodes. In clinical practice, the distinction between lymphadenopathy and lymphadenitis is rarely made and the words are usually treated as synonymous. Inflammation of the lymphatic vessels is known as lymphangitis. Infectious lymphadenitis affecting lymph nodes in the neck is often called scrofula.

Diagnosis

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.

Fungus Any member of the eukaryotic kingdom that includes organisms such as yeasts, molds and mushrooms

A fungus is any member of the group of eukaryotic organisms that includes microorganisms such as yeasts and molds, as well as the more familiar mushrooms. These organisms are classified as a kingdom, fungi, which is separate from the other eukaryotic life kingdoms of plants and animals.

Lymph node organ of the lymphatic system

A lymph node or lymph gland is an ovoid or kidney-shaped organ of the lymphatic system, and of the adaptive immune system, that is widely present throughout the body. They are linked by the lymphatic vessels as a part of the circulatory system. Lymph nodes are major sites of B and T lymphocytes, and other white blood cells. Lymph nodes are important for the proper functioning of the immune system, acting as filters for foreign particles and cancer cells. Lymph nodes do not have a detoxification function, which is primarily dealt with by the liver and kidneys.

Bone marrow is a semi-solid tissue which may be found within the spongy or cancellous portions of bones. In birds and mammals, bone marrow is the primary site of new blood cell production or hematopoiesis. It is composed of hematopoietic cells, marrow adipose tissue, and supportive stromal cells. In adult humans, bone marrow is primarily located in the ribs, vertebrae, sternum, and bones of the pelvis. On average, bone marrow constitutes 4% of the total body mass of humans; in an adult having 65 kilograms of mass, bone marrow typically accounts for approximately 2.6 kilograms (5.7 lb).

Treatment

Penicillium marneffei demonstrates in vitro susceptibility to multiple antifungal agents including ketoconazole, itraconazole, [4] miconazole, flucytosine, and amphotericin B. Without treatment patients have a poor prognosis; death occur by liver failure as the fungus releases toxins in the bloodstream. The elevation of liver enzyme in the blood helps to establish a diagnosis.

<i>In vitro</i> test-tube experiments

In vitro studies are performed with microorganisms, cells, or biological molecules outside their normal biological context. Colloquially called "test-tube experiments", these studies in biology and its subdisciplines are traditionally done in labware such as test tubes, flasks, Petri dishes, and microtiter plates. Studies conducted using components of an organism that have been isolated from their usual biological surroundings permit a more detailed or more convenient analysis than can be done with whole organisms; however, results obtained from in vitro experiments may not fully or accurately predict the effects on a whole organism. In contrast to in vitro experiments, in vivo studies are those conducted in animals, including humans, and whole plants.

Ketoconazole chemical compound

Ketoconazole is an antifungal medication used to treat a number of fungal infections. Applied to the skin it is used for fungal skin infections such as tinea, cutaneous candidiasis, pityriasis versicolor, dandruff, and seborrhoeic dermatitis. Taken by mouth it is a less preferred option and only recommended for severe infections when other agents cannot be used. Other uses include excessive hair growth and Cushing’s syndrome.

Itraconazole chemical compound

Itraconazole is an antifungal medication used to treat a number of fungal infections. This includes aspergillosis, blastomycosis, coccidioidomycosis, histoplasmosis, and paracoccidioidomycosis. It may be given by mouth or intravenously.

Epidemiology

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.

Opportunistic infection

An opportunistic infection is an infection caused by pathogens that take advantage of an opportunity not normally available, such as a host with a weakened immune system, an altered microbiota, or breached integumentary barriers. Many of these pathogens do not cause disease in a healthy host that has a normal immune system. However, a compromised immune system, which is seriously debilitated and has lowered resistance to infection, a penetrating injury, or a lack of competition from normal commensals presents an opportunity for the pathogen to infect.

Tuberculosis Infectious disease caused by the bacterium Mycobacterium tuberculosis

Tuberculosis (TB) is an infectious disease usually caused by Mycobacterium tuberculosis (MTB) bacteria. Tuberculosis generally affects the lungs, but can also affect other parts of the body. Most infections do not have symptoms, in which case it is known as latent tuberculosis. About 10% of latent infections progress to active disease which, if left untreated, kills about half of those affected. The classic symptoms of active TB are a chronic cough with blood-containing sputum, fever, night sweats, and weight loss. It was historically called "consumption" due to the weight loss. Infection of other organs can cause a wide range of symptoms.

Cryptococcosis opportunistic mycosis that results in fungal infection and has material basis in Cryptococcus neoformans or Cryptococcus gattii.

Cryptococcosis, also known as cryptococcal disease, is a potentially fatal fungal disease. It is caused by one of two species; Cryptococcus neoformans and Cryptococcus gattii. These were all previously thought to be subspecies of C. neoformans but have now been identified as distinct species.

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<i>Sporothrix schenckii</i> species of fungus

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Shunt nephritis

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<i>Microsporum gypseum</i> species of fungus

Microsporum gypseum is a soil-associated dermatophyte that occasionally is known to infect the upper dead layers of the skin of mammals. The name refers to an asexual "form-taxon" that has been associated with four related biological species of fungi: the pathogenic taxa Arthroderma incurvatum, A. gypsea, A. fulva and the non-pathogenic saprotroph A. corniculata. More recent studies have restricted M. gypseum to two teleomorphic species A. gypseum and A. incurvatum. The conidial states of A. fulva and A. corniculata have been assigned to M. fulvum and M. boullardii. Because the anamorphic states of these fungi are so similar, they can be identified reliably only by mating. Two mating strains have been discovered, "+" and "–". The classification of this species has been based on the characteristically rough-walled, blunt, club-shaped, multicelled macroconidia. Synonyms include Achorion gypseum, Microsporum flavescens, M. scorteum, and M. xanthodes. There has been past nomenclatural confusion in the usage of the generic names Microsporum and Microsporon.

<i>Microsporum canis</i> species of fungus

Microsporum canis is a pathogenic, asexual fungus in the phylum Ascomycota that infects the upper, dead layers of skin on domesticated cats, and occasionally dogs and humans. The species has a worldwide distribution.

The stages of HIV infection are acute infection, latency and AIDS. Acute infection lasts for several weeks and may include symptoms such as fever, swollen lymph nodes, inflammation of the throat, rash, muscle pain, malaise, and mouth and esophageal sores. The latency stage involves few or no symptoms and can last anywhere from two weeks to twenty years or more, depending on the individual. AIDS, the final stage of HIV infection, is defined by low CD4+ T cell counts, various opportunistic infections, cancers and other conditions.

<i>Apophysomyces variabilis</i> species of fungus

Apophysomyces variabilis is an emerging fungal pathogen that can cause serious and sometimes fatal infection in humans. This fungus is a soil-dwelling saprobe with tropical to subtropical distribution. It is a zygomycete that causes mucormycosis, an infection in humans brought about by fungi in the order Mucorales. Infectious cases have been reported globally in locations including the Americas, Southeast Asia, India, and Australia. Apophysomyces variabilis infections are not transmissible from person to person.

Phaeohyphomycosis is a heterogeneous group of mycotic infections caused by dematiaceous fungi whose morphologic characteristics in tissue include hyphae, yeast-like cells, or a combination of these. It can be associated an array of darkly-pigmented hyphomycetes including Alternaria species,Exophiala jeanselmei, and Rhinocladiella mackenziei.

<i>Epidermophyton floccosum</i> anthropophilic dermatophyte

Epidermophyton floccosum is a filamentous fungus that causes skin and nail infections in humans. This anthropophilic dermatophyte can lead to diseases such as tinea pedis, tinea cruris, tinea corporis and onychomycosis. Diagnostic approaches of the fungal infection include physical examination, culture testing, and molecular detection. Topical antifungal treatment, such as the use of terbinafine, itraconazole, voriconazole, and ketoconazole, is often effective.

References

  1. Desakorn V, Smith MD, Walsh AL, et al. (January 1999). "Diagnosis of Penicillium marneffei infection by quantitation of urinary antigen by using an enzyme immunoassay". Journal of Clinical Microbiology. 37 (1): 117–21. PMC   84182 . PMID   9854074.
  2. Pautler KB, Padhye AA, Ajello L (1984). "Imported penicilliosis marneffei in the United States: report of a second human infection". Sabouraudia. 22 (5): 433–8. doi:10.1080/00362178485380691. PMID   6505916.
  3. Sirisanthana T, Supparatpinyo K (1998). "Epidemiology and management of penicilliosis in human immunodeficiency virus-infected patients". Int. J. Infect. Dis. 3 (1): 48–53. doi:10.1016/S1201-9712(98)90095-9. PMID   9831676.
  4. Wu TC, Chan JW, Ng CK, Tsang DN, Lee MP, Li PC (April 2008). "Clinical presentations and outcomes of Penicillium marneffei infections: a series from 1994 to 2004". Hong Kong Med J. 14 (2): 103–9. PMID   18382016.
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