Clinical Case Report: Hemophagocytic Syndrome in a Patient with Acquired Immunodeficiency Syndrome and Acute Disseminated Penicilliosis

Abstract. Penicilliosis marneffei, which is caused by the opportunistic fungus Penicillium marneffei, is one of the troublesome infections in patients infected with human immunodeficiency virus (HIV) in southeast Asia. We report an HIV-positive patient with acute disseminated penicilliosis marneffei that manifested as hemophagocytic syndrome. Numerous nucleated erythrocytes were also found in peripheral blood of the affected patient. Bone marrow aspirate histopathologically showed hemophagocytosis and abundant P. marneffei. The hemophagocytic syndrome and periph-eral nucleated erythrocytes improved after therapy with amphotericin B. Our report underscores the importance of recognition of this peculiar phenomenon in penicilliosis marneffei. This awareness may alert clinicians to potential penicilliosis marneffei in HIV-positive patients, therefore making early diagnosis and timely effective treatment of the infectious disease possible. Penicilliosis marneffei, an opportunistic infectious disease caused the dimorphic fungus Penicillium marneffei that grows as a mold at 25°C and as a yeast at 37°C. It is encountered in human immunodeficiency virus (HIV)–infected patients in southeast Asia,1 and is an emerging infectious disease among immunocompromised patients in Taiwan.2,3 The mortalit