Rapid fatality of disseminated penicilliosis marneffei in a patient with acquired immunodeficiency syndrome

The incidence of penicilliosis marneffei a disseminated and progressive Penicillium marneffei infection, was reported to be markedly increased in Southeast Asia over the past decade, and P. marneffei has become 1 of the important opportunistic pathogens among patients with HIV infection in Taiwan over the previous 5 years. We report a white man who had stayed in Thailand for years before he developed fever for 1 week and present to our hospital with multiple skin papules with or without central necrosis over his face, trunk, and limbs. He died of septic shock and multiorgan failure on the second day of hospitalization. The subsequent blood cultures yielded P. marneffei, and serological assay proved that the patient had an underlying acquired immunodeficiency syndrome. Our report underscores the importance of a timely diagnosis and initiation of antifungal therapy for patients who have disseminated P. marneffei infection in immunocompromised patients.