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Int J Infect Dis. 2016 Oct;51:78-80. doi: 10.1016/j.ijid.2016.08.026. Epub 2016 Sep 3.

Disseminated penicilliosis due to Penicillium chrysogenum in a pediatric patient with Henoch-Schönlein syndrome.

Author information

1
Department of Infectious Diseases, Hospital Infantil de México Federico Gómez, Dr. Márquez #162, Col. Doctores, Cuauhtémoc, 06720 Mexico City, Mexico. Electronic address: marmtom@hotmail.com.
2
Department of Infectious Diseases, Hospital Infantil de México Federico Gómez, Dr. Márquez #162, Col. Doctores, Cuauhtémoc, 06720 Mexico City, Mexico.
3
Laboratory of Mycology, Hospital Infantil de México Federico Gómez, Mexico City, Mexico.
4
Department of Microbiology, ENCB, Instituto Politécnico Nacional, Mexico City, Mexico.
5
Department of Pediatrics, Centro Medico Dalinde, Mexico City, Mexico.

Abstract

A case of disseminated infection caused by Penicillium chrysogenum in a 10-year-old boy with a history of Henoch-Schönlein purpura and proliferative glomerulonephritis, treated with immunosuppressors, is reported herein. The patient had a clinical picture of 2 weeks of fever that did not respond to treatment with broad-spectrum antibiotics and amphotericin B. Computed tomography imaging showed diffuse cotton-like infiltrates in the lungs, hepatomegaly, mesenteric lymphadenopathy, and multiple well-defined round hypodense lesions in the spleen. His treatment was changed to caspofungin, followed by voriconazole. One month later, a splenic biopsy revealed hyaline septate hyphae of >1μm in diameter. Fungal growth was negative. However, molecular analysis showed 99% identity with P. chrysogenum. A therapeutic splenectomy was performed, and treatment was changed to amphotericin B lipid complex and caspofungin. The patient completed 2 months of treatment with resolution of the infection. P. chrysogenum is a rare causative agent of invasive fungal infections in immunocompromised patients, and its diagnosis is necessary to initiate the appropriate antifungal treatment.

KEYWORDS:

Disseminated penicilliosis; Hyalohyphomycosis; Penicilliosis; Penicillium chrysogenum

PMID:
27596684
DOI:
10.1016/j.ijid.2016.08.026
[Indexed for MEDLINE]
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