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 Table of Contents  
LETTER TO EDITOR
Year : 2019  |  Volume : 33  |  Issue : 2  |  Page : 114-115

Penicillium marneffei pneumonia: A summary of Thai cases in 10-Year period (2009–2018) under universal coverage for antiretroviral therapy


1 TWS Medical Center, Bangkok, Thailand
2 Department of Biological Science, Joseph Ayo Babalola University, Ondo State, Nigeria

Date of Submission23-Feb-2019
Date of Acceptance04-Jul-2019
Date of Web Publication11-Feb-2020

Correspondence Address:
Pathum Sookaromdee
TWS Medical Center, Bangkok
Thailand
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jms.jms_12_19

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How to cite this article:
Sookaromdee P, Wiwanitkit V. Penicillium marneffei pneumonia: A summary of Thai cases in 10-Year period (2009–2018) under universal coverage for antiretroviral therapy. J Med Soc 2019;33:114-5

How to cite this URL:
Sookaromdee P, Wiwanitkit V. Penicillium marneffei pneumonia: A summary of Thai cases in 10-Year period (2009–2018) under universal coverage for antiretroviral therapy. J Med Soc [serial online] 2019 [cited 2020 May 27];33:114-5. Available from: http://www.jmedsoc.org/text.asp?2019/33/2/114/278077



Sir,

Penicilliosis is an important fungal infection due to pathogenic fungus, Penicillium marneffei. This infection is seen in immunocompromised host. Thailand is an endemic area of this disease. The P. marneffei pneumonia is the possible lung manifestation seen in penicilliosis. In Thailand, P. marneffei pneumonia has been reported for several years. The first report was from the medical center in the Northern region of Thailand. The cases are usually seen in the human immunodeficiency virus (HIV)-infected patients.[1],[2],[3] The infection is accepted as an important opportunistic infection among the Thai HIV-infected patients. Nevertheless, the infection can also be seen in the non-HIV-infected patients.[3]

The use of antiretroviral treatment becomes an important tool for the prevention of opportunistic infection among HIV-infected patients.[4] In Thailand, the implementation of universal coverage has been done for many years. After the polices development on universal coverage for antiretroviral treatment during 2001–2007, the free antiretroviral drug is given to all Thai HIV-infected patients.[5] The effects on the clinical epidemiology of important opportunistic infections among HIV-infected patients are expected.

Here, the authors summarize on the reports of Thai patients with P. marneffei pneumonia in a 10-year period (2009–2018) under universal coverage for antiretroviral therapy. The complete available clinical reports of P. marneffei pneumonia among Thai patients in the international (PubMed, Scopus, and Index Copernicus) and local (Thai Index Medicus) databases were searched, collected, and analyzed. According to the literature searching, there are at least three reports on three patients with P. marneffei pneumonia.[6],[7],[8] Of those three cases, two cases (66.7%) are non-HIV infected patients (one case with hypogammaglobulinemia and one case with hematological malignancy). All cases presented with fever and respiratory difficulties. The interstitial pneumonia is observable from chest X-ray. Pancytopenia is observed in a case with HIV infection. The final diagnosis is by sputum examination in all cases. Two from three cases have only lung infection whereas one case has disseminated penicilliosis. The case with disseminated penicilliosis is the HIV-infected patient. In the HIV-infected patient, the patient receives antiretroviral drug but not ate it.

Based on this study, the universal coverage for antiretroviral therapy for HIV-infected patients can significantly reduce the incidence of P. marneffei pneumonia, especially for the infection among the HIV-infected group. In the previous report from Thailand in the time, when there was no policies for universal coverage for antiretroviral therapy, 66.7% of P. marneffei pneumonia cases are HIV-infected patients. In the present study, the inversed ratio was seen; 66.7% of cases are non-HIV-infected patient.

Conclusively, the use of antiretroviral therapy is effective for reducing the incidence of P. marneffei pneumonia in our setting. Nevertheless, as an endemic area of pathogenic fungus, the P. marneffei pneumonia is still observable on other non-HIV-infected immunocompromised hosts.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Sirisanthana V, Sirisanthana T. Disseminated Penicillium marneffei infection in human immunodeficiency virus-infected children. Pediatr Infect Dis J 1995;14:935-40.  Back to cited text no. 1
    
2.
Watanabe H, Asoh N, Kobayashi S, Watanabe K, Oishi K, Kositsakulchai W, et al. Clinical and microbiological characteristics of community-acquired pneumonia among human immunodeficiency virus-infected patients in Northern Thailand. J Infect Chemother 2008;14:105-9.  Back to cited text no. 2
    
3.
Deesomchok A, Tanprawate S. A 12-case series of Penicillium marneffei pneumonia. J Med Assoc Thai 2006;89:441-7.  Back to cited text no. 3
    
4.
Nissapatorn V. Lessons learned about opportunistic infections in Southeast Asia. Southeast Asian J Trop Med Public Health 2008;39:625-41.  Back to cited text no. 4
    
5.
Tantivess S, Walt G. The role of state and non-state actors in the policy process: The contribution of policy networks to the scale-up of antiretroviral therapy in Thailand. Health Policy Plan 2008;23:328-38.  Back to cited text no. 5
    
6.
Sripa C, Mitchai J, Thongsri W, Sripa B. Diagnostic cytology and morphometry of Penicillium marneffei in the sputum of a hypogammaglobulinemia with hyper-igM patient. J Med Assoc Thai 2010;93 Suppl 3:S69-72.  Back to cited text no. 6
    
7.
Mingkwan W, Suwanpathumlert S. Disseminated penicilliosis in HIV patient. Uttaradit Hosp Med Bull 2009;24:102-5.  Back to cited text no. 7
    
8.
Apiwattanaporn A, Rojsanga P. Penicilliosis in non-HIV patient. Udonthani Hosp Med J 2013;1:183-16.  Back to cited text no. 8
    




 

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