Annals of Laboratory Medicine

Korean Society for Laboratory Medicine (대한진단검사의학회)
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A Case of Disseminated Penicillium marneffei Infection in a Liver Transplant Recipient

  • Seo, Ja-Young (Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Ma, Young-Eun (Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Lee, Jang-Ho (Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Lee, Seung-Tae (Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Ki, Chang-Seok (Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Lee, Nam-Yong (Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • Received : 2010.04.09
  • Accepted : 2010.07.26
  • Published : 2010.08.31
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Abstract

Penicillium marneffei is the only dimorphic fungus among Penicillium spp. that can cause a fatal infection in immunocompromised patients. P. marneffei is endemic in Southeast Asia and eastern China. P. marneffei infection is an AIDS-defining illness and the third most common opportunistic infection in the endemic regions. Here, the authors report a case of disseminated P. marneffei infection in a patient who underwent liver transplantation in China. During the hospital stay, the mold form of the fungus that produced a red wine-colored pigment on the agar plate was isolated from the patient's urine, transtracheal aspirate, and blood. The fungus was identified as P. marneffei by direct sequencing of the D1-D2 and ITS regions. Thermal dimorphism was also confirmed by subculturing the colony at $37^{\circ}C$. To the best of our knowledge, this is the first Korean case of disseminated P. marneffei infection in a liver transplant recipient.

Penicillium marneffei는 Penicillium species 중에서 유일한 이형성 진균으로 주로 면역 기능이 저하된 환자에서 치명적인 감염을 일으킨다. 이 균은 동남아시아 일부 국가와 중국 남부에 분포하며 호발 지역에서는 AIDS 정의 질환 중 하나로 AIDS 환자에서 세 번째로 흔한 기회 감염균이다. 본 저자들은 중국에서 간이식을 받은 환자에서 발생한 파종성 P. marneffei 감염 1예를 경험하였다. 증례의 환자는 호흡 곤란, 저산소증 등으로 중환자실에 입원하여 경과 관찰하던 중 소변, 경기관지 흡인액, 혈액 배양에서 배지에 적갈색 색소를 생성하는 사상균 집락이 관찰되었다. 이에 분리된 균주에 대하여 D1-D2 및 ITS 구역에 대한 직접염기서열 분석을 통하여 P. marneffei로 동정되었으며 $37^{\circ}C$에서 배양한 결과 효모형 집락으로 자라는 것을 확인하였으므로 본 저자들은 간이식 환자에서 발생한 파종성 P. marneffei 감염 사례를 한국에서는 최초로 보고하는 바이다.

Keywords

References

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