Disseminated Penicillium marneffei mimicking paradoxical response and relapse in a non-HIV patient with pulmonary tuberculosis
Journal
Journal of the Chinese Medical Association
Journal Volume
78
Journal Issue
4
Pages
258-260
Date Issued
2015
Author(s)
Abstract
Clinical deterioration during the treatment of tuberculosis remains a diagnostic challenge. We describe the case of a 46-year-old man with a history of oral cancer status after a radical operation who had pulmonary tuberculosis with pleura and neck lymph node involvement. The clinical condition improved after antituberculosis therapy. However, the patient suffered from low-grade fever, progressive dyspnea, and cough after 7weeks of the therapy. The findings of chest plain films were relapse and progression of left lung haziness. The deterioration was caused by disseminated Penicillium marneffei infection. Disseminated P. marneffei in a non-HIV patient with tuberculosis is rarely seen, and the manifestations are similar to a paradoxical response and relapse of pulmonary tuberculosis, thereby making it difficult to establish a diagnosis. ? 2015.
SDGs
Other Subjects
amphotericin B; amphotericin B lipid complex; ethambutol; isoniazid; itraconazole; pyrazinamide; rifampicin; adult; Article; case report; cervical lymph node; coughing; differential diagnosis; directly observed therapy; drug withdrawal; dyspnea; fever; human; human tissue; lung tuberculosis; male; middle aged; optic neuritis; penicilliosis; relapse; skin biopsy; thorax radiography; treatment response; complication; Mycoses; Penicillium; recurrent disease; Tuberculosis, Pulmonary; Amphotericin B; Humans; Male; Middle Aged; Mycoses; Penicillium; Recurrence; Tuberculosis, Pulmonary
Publisher
Elsevier Ltd
Type
journal article