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Article: Penicilliosis in children without HIV infection-are they immunodeficient?

TitlePenicilliosis in children without HIV infection-are they immunodeficient?
Authors
Issue Date2012
PublisherOxford University Press. The Journal's web site is located at http://www.oxfordjournals.org/our_journals/cid/
Citation
Clinical Infectious Diseases, 2012, v. 54 n. 2, p. e8-e19 How to Cite?
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.
Persistent Identifierhttp://hdl.handle.net/10722/170462
ISSN
2023 Impact Factor: 8.2
2023 SCImago Journal Rankings: 3.308
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLee, PPWen_US
dc.contributor.authorChan, KWen_US
dc.contributor.authorLee, TLen_US
dc.contributor.authorHo, MHKen_US
dc.contributor.authorChen, XYen_US
dc.contributor.authorLi, CHen_US
dc.contributor.authorChu, KMen_US
dc.contributor.authorZeng, HSen_US
dc.contributor.authorLau, YLen_US
dc.date.accessioned2012-10-30T06:09:09Z-
dc.date.available2012-10-30T06:09:09Z-
dc.date.issued2012en_US
dc.identifier.citationClinical Infectious Diseases, 2012, v. 54 n. 2, p. e8-e19en_US
dc.identifier.issn1058-4838en_US
dc.identifier.urihttp://hdl.handle.net/10722/170462-
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.en_US
dc.languageengen_US
dc.publisherOxford University Press. The Journal's web site is located at http://www.oxfordjournals.org/our_journals/cid/en_US
dc.relation.ispartofClinical Infectious Diseasesen_US
dc.titlePenicilliosis in children without HIV infection-are they immunodeficient?en_US
dc.typeArticleen_US
dc.identifier.emailLee, PPW:ppwlee@hku.hken_US
dc.identifier.emailLau, YL:lauylung@hkucc.hku.hken_US
dc.identifier.authorityLee, PPW=rp00462en_US
dc.identifier.authorityLau, YL=rp00361en_US
dc.description.naturelink_to_OA_fulltexten_US
dc.identifier.doi10.1093/cid/cir754en_US
dc.identifier.pmid22065867-
dc.identifier.scopuseid_2-s2.0-84555204801en_US
dc.identifier.hkuros200685-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-84555204801&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume54en_US
dc.identifier.issue2en_US
dc.identifier.spagee8en_US
dc.identifier.epagee19en_US
dc.identifier.eissn1537-6591-
dc.identifier.isiWOS:000298383700001-
dc.publisher.placeUnited Statesen_US
dc.identifier.f100013437005-
dc.identifier.scopusauthoridLee, PPW=14048822200en_US
dc.identifier.scopusauthoridChan, KW=8587755300en_US
dc.identifier.scopusauthoridLee, TL=35573927500en_US
dc.identifier.scopusauthoridHo, MHK=8925896400en_US
dc.identifier.scopusauthoridChen, XY=35195524300en_US
dc.identifier.scopusauthoridLi, CH=8354475100en_US
dc.identifier.scopusauthoridChu, KM=7402452751en_US
dc.identifier.scopusauthoridZeng, HS=53364836500en_US
dc.identifier.scopusauthoridLau, YL=7201403380en_US
dc.identifier.issnl1058-4838-

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