Penicillium Mushroom Is Hazardous

PENICILLIUM MUSHROOM DISEASE
contraception This is a binary fungus, intracellular parasite, attacks the endothelial system of normal and immunocompromised people. Currently, Penicillium marneffei becomes the third most important opportunistic infectious agent, after tuberculosis and Cryptococcus neoformans, in AIDS patients, in Southeast Asia.
1. Epidemiological characteristics
The disease is common in China, Thailand, Hong Kong, India, Malaysia, Indonesia, Laos, Cambodia, Vietnam .

.. Chiangmai Province (Thailand) and Guangxi (China) are important epidemiological areas. Many cases have been reported from European and American countries but these patients have a history of staying in Southeast Asia
P marneffei was first isolated in 1956 by Segretain in Da Lat from liver damage of the bamboo mouse Rhizomys sinensis, which is present in many Southeast Asian countries.



. Then, in 1959, the author determined the pathogenicity of the fungus when he accidentally injected P.marneffei into his finger.
Many subsequent surveys show that P.marneffei exists in the internal organs, especially the lungs and liver, of most bamboo rats Rhizomys spp. and Cannomys sp. although they have no pathological manifestations In addition, the fungus is also isolated from mouse droppings, from the soil in or around where rats live and travel However, the ecological cradle of P.marneffei remains controversial.
The infected person is probably inhaling fungal spores from the air.



. After entering the lungs, if macrophages are not killed, they enter the bloodstream and spread to other organs. The fungus that invades through scratched skin in people working in contact with soil has also been suggested by many authors; While exposure to bamboo rats or rodents has not been recognized as a risk factor.
In general, up to now, the exact mode of infection of P.marneffei has not been determined
P.marneffei has the ability to cause disease in normal people (20%), especially those living in epidemiological areas, as well as people with immunodeficiency (80%). People at high risk for P.marneffei infection include people with AIDS, Hodgkin, long-term crticoid treatment, cancer, diabetes ...



. Tuberculosis bacteria, Cryptococcus neoformans and P.marneffei, are the three agents of infection The association is leading among HIV (+) people, so it is important to detect Pmarneffei fungal disease in AIDS patients with prolonged fever. In AIDS patients, fungal infections usually attack when the CD4 count is <50 / mm3 of blood. 2. SYMPTOMS P.marneffei is thought to enter the human body through the respiratory tract, causing primary infection in the lungs, then spreading by blood to other endothelial retinal cells, usually lymph nodes, skin. , liver, spleen, intestines, bone marrow ...



In normal immunocompetent individuals, the disease may be localized or disseminated, sometimes with no clinical manifestations. Local forms of bronchitis, pneumonia with or without lymphadenopathy, chronic cervical lymphadenitis, etc. Destruction of tissue related to the inflammatory reaction forming granulomas containing giant multinuclear cells, lymphocytes and polymorphonuclear leukocytes, or purulent inflammatory reactions that form abscesses.
For immunocompromised individuals, the disease has spread throughout the body as soon as the symptoms are manifested and is often the result of necrotic reactions, diffuse infiltrates of macrophages filled with diffuse infection of the macrophages. Phagocytosis is full of fungi.
Clinical images include fever, weight loss, anemia accompanied by manifestations of damaged organs such as lymphadenopathy, skin lesions, liver, splenomegaly, pneumonia, enteritis, infectious arthritis, osteomyelitis ..
These manifestations, generally unspecific for P.marneffei infection except skin lesions, are relatively suggestive of the disease.



. Skin lesions are diverse, can be papules, central gangrene, acne acne, erythema ... often appear more on the body (face, body, hands), less common in the legs.
The characteristics of skin lesions are similar to those of Cryptococcus neoformans, which can be papules, central necrotic papules, acne-like pimples, erythematosus, etc. which often appear on the body (face, body, hands), less common in the legs
The characteristics of skin lesions are similar to those of Cryptococcus neoformans, Histoplasma spp., And Molluscum contagiosumplasma spp., And Molluscum contagiosum viruses on the skin, so a differential diagnosis is required for these agents.
The frequency of common clinical manifestations in n AIDS patients is as follows:
Clinical manifestations
Frequency
Fever
99%
Anemia
78%
Weight loss
76%
Skin lesions
71%
Systemic lymphadenopathy
58%
Gan big
51%
Manifestations in the lungs
49%
Diarrhea
thirty first%
Big spleen
16%
Lesions in the oral mucosa
4%
3.



. DIAGNOSTIC
Microbiological diagnosis
Direct visualization of a smear may show a fungal intracellular parasite, but sometimes it is difficult to distinguish P.marneffei from other parasites in endothelial retinal cells such as Histoplasma spp. Therefore, it is necessary to coordinate with the inoculation method to identify the fungus
Specimens may include skin lesions, pus, lymph nodes, bone marrow, blood,
Direct observation
Wet swab of specimens is not valid for pediatric diagnosis.

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