Epidemiological and clinical features of talaromycosis (Penicilliosis) marneffei among human immunodeficiency virus-infected patients in Malaysia
The AIDS epidemic in Southeast Asia has led to a marked rise in the incidence of talaromycosis (penicilliosis) marneffei. The aim of this cross-sectional study was to determine the clinico-epidemiological features and outcome predictors of talaromycosis in Malaysia. We identified Talaromycosis...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Pusat Perubatan Universiti Kebangsaan Malaysia
2018
|
| Online Access: | http://journalarticle.ukm.my/20611/1/10_ms406_pdf_17905.pdf http://journalarticle.ukm.my/20611/ https://www.medicineandhealthukm.com/toc/13/2 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Summary: | The AIDS epidemic in Southeast Asia has led to a marked rise in the incidence
of talaromycosis (penicilliosis) marneffei. The aim of this cross-sectional study
was to determine the clinico-epidemiological features and outcome predictors
of talaromycosis in Malaysia. We identified Talaromycosis marneffei cases from
cultures of sterile specimens from 191 human immunodeficiency virus (HIV)-
infected patients. Talaromycosis increased from 20-25 (2010-2011) to 45-50 cases
per year (2012-2014). Talaromycosis was the HIV-presenting illness in 117 (61.3%)
patients. The incidence of talaromycosis as HIV-presenting illness showed an
increasing trend from 10.7 (2010) to 26.4 (2014) cases per 1000 new HIV patients.
The patients were between 19 and 74 of age (mean 37.2+9.4 years) and the male to
female ratio was 7.7:1. Malay (73, 38.2%) and Chinese (70, 36.3%) were the most
prevalent ethnic groups. Common clinical manifestations included loss of weight
(85.9%), fever (84.8%) and cough (67%), while skin lesions were only present
in 42.9% cases. Common concurrent infections were oral candidiasis (79.6%),
tuberculosis (36.1%) and hepatitis C infection (20.9%). Most patients (93.7%)
were anaemic with mean haemoglobin level of 9.9+2.3 g/dL, 39% had impaired
liver function, and 18.8% were neutropaenic. Median CD4 cell count was 16
cells/L. Most patients (70.4%) received intravenous amphotericin B followed by
itraconazole. At 8-month follow up, 148 (81.8%) patients were alive while 33
(18.2%) had died. Intravenous drug abuse, concurrent toxoplasma encephalitis
and concurrent Pneumocystis jiroveci pneumonia independently predicted death
outcome in both univariate and multivariate logistic regression analyses. |
|---|