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Article: Penicilliosis in children without HIV infection-are they immunodeficient?
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TitlePenicilliosis in children without HIV infection-are they immunodeficient?
 
AuthorsLee, PPW1
Chan, KW1
Lee, TL1
Ho, MHK1
Chen, XY2
Li, CH3
Chu, KM1
Zeng, HS2
Lau, YL1 4
 
Issue Date2012
 
PublisherOxford University Press. The Journal's web site is located at http://www.oxfordjournals.org/our_journals/cid/
 
CitationClinical Infectious Diseases, 2012, v. 54 n. 2, p. e8-e19 [How to Cite?]
DOI: http://dx.doi.org/10.1093/cid/cir754
 
AbstractBackground. Penicillium marneffei infection is indigenous to Southeast Asia. Majority of penicilliosis occurs in patients with AIDS, and less commonly with secondary immunodeficiencies. Penicilliosis is rare in otherwise healthy persons, but information on their immunological status is often lacking.Methods.From 1996 to 2009, we diagnosed penicilliosis in 5 children. Their clinical features, immunological findings, and genetic studies were analyzed. A systematic review of the English and Chinese literature was performed. Case reports/series on patients <18 years with penicilliosis were included, and patients stated to be human immunodeficiency virus (HIV)-positive excluded. Results. All of our 5 patients were HIV negative. Presentations included fungemia (n = 2), multifocal lymphadenopathy (n = 2), and necrotizing pneumonia (n = 1). Four patients had recurrent mucocutaneous candidiasis. Hyperimmunoglobin E syndrome was diagnosed in 1 patient, while another had functional defect in interleukin-12/interferon-γ axis. Three patients were lymphopenic with low natural killer cell counts, but a specific immune defect was not identified. Systematic review of 509 reports on human penicilliosis identified 32 patients aged 3 months to 16 years with no known HIV infection. Twenty-four patients (75%) had disseminated disease, and 55% died of penicilliosis. Eight patients had primary immunodeficiencies or blood disorders, while 4 others had abnormal immune functions. Immune evaluations of the remaining patients were unstated.Conclusion.Penicilliosis is a severe disease causing high mortality in children. As an AIDS-defining illness, penicilliosis should be regarded as an indicator for underlying immunodeficiency in HIV-negative individuals. Immunological investigations should be performed, especially in those with recurrent infections. Multicentered collaborative studies are needed to collect information on long-term prognosis and define immune defects underlying penicilliosis. © 2011 The Author.
 
ISSN1058-4838
2013 Impact Factor: 9.416
 
DOIhttp://dx.doi.org/10.1093/cid/cir754
 
ISI Accession Number IDWOS:000298383700001
 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorLee, PPW
 
dc.contributor.authorChan, KW
 
dc.contributor.authorLee, TL
 
dc.contributor.authorHo, MHK
 
dc.contributor.authorChen, XY
 
dc.contributor.authorLi, CH
 
dc.contributor.authorChu, KM
 
dc.contributor.authorZeng, HS
 
dc.contributor.authorLau, YL
 
dc.date.accessioned2012-10-30T06:09:09Z
 
dc.date.available2012-10-30T06:09:09Z
 
dc.date.issued2012
 
dc.description.abstractBackground. Penicillium marneffei infection is indigenous to Southeast Asia. Majority of penicilliosis occurs in patients with AIDS, and less commonly with secondary immunodeficiencies. Penicilliosis is rare in otherwise healthy persons, but information on their immunological status is often lacking.Methods.From 1996 to 2009, we diagnosed penicilliosis in 5 children. Their clinical features, immunological findings, and genetic studies were analyzed. A systematic review of the English and Chinese literature was performed. Case reports/series on patients <18 years with penicilliosis were included, and patients stated to be human immunodeficiency virus (HIV)-positive excluded. Results. All of our 5 patients were HIV negative. Presentations included fungemia (n = 2), multifocal lymphadenopathy (n = 2), and necrotizing pneumonia (n = 1). Four patients had recurrent mucocutaneous candidiasis. Hyperimmunoglobin E syndrome was diagnosed in 1 patient, while another had functional defect in interleukin-12/interferon-γ axis. Three patients were lymphopenic with low natural killer cell counts, but a specific immune defect was not identified. Systematic review of 509 reports on human penicilliosis identified 32 patients aged 3 months to 16 years with no known HIV infection. Twenty-four patients (75%) had disseminated disease, and 55% died of penicilliosis. Eight patients had primary immunodeficiencies or blood disorders, while 4 others had abnormal immune functions. Immune evaluations of the remaining patients were unstated.Conclusion.Penicilliosis is a severe disease causing high mortality in children. As an AIDS-defining illness, penicilliosis should be regarded as an indicator for underlying immunodeficiency in HIV-negative individuals. Immunological investigations should be performed, especially in those with recurrent infections. Multicentered collaborative studies are needed to collect information on long-term prognosis and define immune defects underlying penicilliosis. © 2011 The Author.
 
dc.description.naturelink_to_OA_fulltext
 
dc.identifier.citationClinical Infectious Diseases, 2012, v. 54 n. 2, p. e8-e19 [How to Cite?]
DOI: http://dx.doi.org/10.1093/cid/cir754
 
dc.identifier.doihttp://dx.doi.org/10.1093/cid/cir754
 
dc.identifier.eissn1537-6591
 
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2013 Impact Factor: 9.416
 
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dc.identifier.urihttp://hdl.handle.net/10722/170462
 
dc.identifier.volume54
 
dc.languageeng
 
dc.publisherOxford University Press. The Journal's web site is located at http://www.oxfordjournals.org/our_journals/cid/
 
dc.publisher.placeUnited States
 
dc.relation.ispartofClinical Infectious Diseases
 
dc.relation.referencesReferences in Scopus
 
dc.titlePenicilliosis in children without HIV infection-are they immunodeficient?
 
dc.typeArticle
 
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Author Affiliations
  1. The University of Hong Kong Li Ka Shing Faculty of Medicine
  2. Guangzhou Children's Hospital
  3. Tuen Mun Hospital
  4. Queen Mary Hospital Hong Kong