Wong Stephenie Y N, Wong K F
Department of Pathology, Queen Elizabeth Hospital, 30 Gascoigne Road, Kowloon, Hong Kong.
Patholog Res Int. 2011 Feb 10;2011:764293. doi: 10.4061/2011/764293.
Penicillium marneffei is a dimorphic fungus which is endemic in Southeast Asia. It is an opportunistic pathogen which has emerged to become an AIDS-defining illness in the endemic areas. Early diagnosis with prompt initiation of treatment is crucial for its management. Prompt diagnosis can often be established through careful cytological and histological examination of clinical specimens although microbiological culture remains the gold standard for its diagnosis. Standard antifungal treatment for AIDS patients with penicilliosis is well established. Highly active antiretroviral therapy should be started early together with the antifungal treatment. Special attention should be paid to potential drug interaction between antiretroviral and antifungal treatments. Secondary prophylaxis may be discontinued with a low risk of relapse of the infection once the immune dysfunction has improved.
马尔尼菲青霉是一种双相真菌,在东南亚地区流行。它是一种机会性病原体,在流行地区已成为一种艾滋病界定疾病。早期诊断并迅速开始治疗对其管理至关重要。尽管微生物培养仍是其诊断的金标准,但通过对临床标本进行仔细的细胞学和组织学检查通常可以迅速做出诊断。艾滋病合并马尔尼菲青霉病患者的标准抗真菌治疗方法已确立。应在开始抗真菌治疗的同时尽早启动高效抗逆转录病毒治疗。应特别注意抗逆转录病毒治疗和抗真菌治疗之间的潜在药物相互作用。一旦免疫功能障碍有所改善,感染复发风险较低时,二级预防可以停用。