Sripa Chongrak, Mitchai Jumphol, Thongsri Warin, Sripa Banchob
Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
J Med Assoc Thai. 2010 Mar;93 Suppl 3:S69-72.
Penicillosis caused by Penicillium marneffei is endemic in Asia and is a highly fatal disease in HIV-AIDS patients. Reports, however; in other immunocompromized diseases are scanty. This report describes the cytological diagnosis of P. marneffei infection from the sputum of a pediatric patient with hypogammaglobulinemia with hyper IgM and severe pneumonia. In this case, rapid, differential identification of the characteristic septated structure of P. marneffei in the macrophages, bronchial epithelium and also extracellularly allowed prompt and proper treatment. In addition, morphometry of P. marneffei obtained from the clinical specimen was reported. This report demonstrated the fungus was not only in the phagocytes, a phenomenon that is well recognized, but also in epithelial cells. Moreover, it also highlights the need for awareness of penicillosis in non-AIDS immunocompromized patients living in, or persons traveling to, P. marneffei-endemic areas.
马尔尼菲青霉引起的马尔尼菲青霉病在亚洲呈地方性流行，在艾滋病患者中是一种高致死性疾病。然而，关于其他免疫功能低下疾病的报道却很少。本报告描述了一名患有低丙种球蛋白血症伴高IgM和严重肺炎的儿科患者痰液中马尔尼菲青霉感染的细胞学诊断。在该病例中，通过快速、鉴别性地识别巨噬细胞、支气管上皮细胞以及细胞外马尔尼菲青霉的特征性分隔结构，得以迅速进行恰当治疗。此外，还报告了从临床标本中获取的马尔尼菲青霉的形态测量结果。本报告表明，该真菌不仅存在于吞噬细胞中（这是一种广为人知的现象），也存在于上皮细胞中。此外，它还强调了生活在马尔尼菲青霉流行地区或前往该地区旅行的非艾滋病免疫功能低下患者需要提高对马尔尼菲青霉病的认识。
