Chong Y B, Tan L P, Robinson S, Lim S K, Ng K P, Keng T C, Kamarulzaman A
Division of Nephrology, Department of Medicine, University Malaya Medical Centre, University of Malaya, Kuala Lumpur, Malaysia.
Trop Biomed. 2012 Jun;29(2):270-6.
Penicilliosis is a rare occurrence among non human immunodeficiency virus (HIV) infected patients. We report here two cases of Penicillium marneffei infection in patients with systemic lupus erythematosus (SLE). Both patients had a recent flare of lupus and were on immunosuppressive drugs when they presented with prolonged fever without an obvious foci of infection, unresponsive to broad-spectrum antibiotics. They were leucopaenic upon admission, with rapid deterioration during the course of the illness. Diagnosis of penicilliosis via fungal isolation from blood culture was delayed resulting in the late initiation of antifungal agents. While both patients ultimately recovered, the delay in diagnosis led to a prolonged hospital stay with increased morbidity. Clinicians should be aware of this uncommon but emerging fungal pathogen in SLE patients and maintain a high index of suspicion in diagnosing this potentially fatal but treatable disease.
马尔尼菲青霉病在未感染人类免疫缺陷病毒（HIV）的患者中较为罕见。我们在此报告两例系统性红斑狼疮（SLE）患者发生马尔尼菲青霉感染的病例。两名患者近期均有狼疮病情活动，在出现持续发热且无明显感染灶、对广谱抗生素治疗无效时，正在接受免疫抑制药物治疗。他们入院时白细胞减少，病程中病情迅速恶化。通过血培养分离真菌确诊马尔尼菲青霉病的时间延迟，导致抗真菌药物启动较晚。虽然两名患者最终康复，但诊断延迟导致住院时间延长且发病率增加。临床医生应意识到SLE患者中这种不常见但新出现的真菌病原体，并在诊断这种潜在致命但可治疗的疾病时保持高度警惕。
