Tsui W M, Ma K F, Tsang D N
Institute of Pathology, Queen Elizabeth Hospital, Hong Kong.
Histopathology. 1992 Apr;20(4):287-93. doi: 10.1111/j.1365-2559.1992.tb00985.x.
Penicillium marneffei is a rare human pathogen predominantly affecting residents of South-east Asia. We report four fatal cases from Hong Kong in human immunodeficiency virus-infected patients. The diagnosis was established by histological examination and confirmed by isolation of the fungus. The infection was disseminated with involvement of lymph nodes, liver, spleen, lung, intestine and bone marrow. The involved organs showed an exclusively anergic tissue reaction characterized by a diffuse infiltrate of fungi-laden macrophages, multiple co-existing opportunistic infections and lymphoid cell depletion. This organism has to be distinguished from Histoplasma capsulatum and Pneumocystis carinii. Establishment of the diagnosis is important not only because this infection is potentially curable, but also it is a likely indicator disease of AIDS in South-east Asia. Penicilliosis marneffei should be suspected in any symptomatic HIV-positive patient who comes from or has visited endemic areas of South-east Asia.
马尔尼菲青霉菌是一种罕见的人类病原体，主要影响东南亚居民。我们报告了香港4例人类免疫缺陷病毒感染患者的死亡病例。诊断通过组织学检查确立，并经真菌分离确诊。感染呈播散性，累及淋巴结、肝脏、脾脏、肺、肠道和骨髓。受累器官呈现出一种独特的无反应性组织反应，其特征为充满真菌的巨噬细胞弥漫性浸润、多种并存的机会性感染以及淋巴细胞耗竭。这种病原体必须与荚膜组织胞浆菌和卡氏肺孢子菌相鉴别。确立诊断很重要，不仅因为这种感染有可能治愈，而且它可能是东南亚艾滋病的指示性疾病。对于任何来自或曾访问过东南亚疫区且有症状的HIV阳性患者，都应怀疑马尔尼菲青霉病。
