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Rose Alligator Strap Pattern Chain Shoulder Women Bag Donalworld Penicillium marneffei infection is a systemic fungal infection that causes morbidity and mortality in immunosuppressed patients resident in or having visited Southeast Asia, northeastern India, southern China, Hong Kong and Taiwan.

This systemic fungal infection was commonly diagnosed prior to the era of potent antiretroviral therapy (ART). The widespread use of ART has led to a significant decline of opportunistic infections (OIs), including P. marneffei infection in the highly endemic areas. However, despite the wide availability of ART in Thailand, P. marneffei infection continues to cause considerable morbidity and mortality in AIDS patients who are either unaware of their HIV infection, who do not have access to ART, or who have suboptimal responses to HIV therapy.

Humans and bamboo rats are the only known animal hosts. Although the geographic habitats of these bamboo rats correspond with the regional areas where human cases of P. marneffei infection have been found, definite proof of an environmental reservoir for P. marneffeia Handbag Women Pretty Blue Gift Party As Bridal Evening Twill Envelope Clutch Frosted Purse Wedding Rhinestone 7wRqAxF7p, within the soil or other substrates, is still lacking.

P. marneffei infection usually occurs late in the course of HIV infection. The majority of cases are observed in patients who have a CD4+ cell count of <100 cells/mm3. Papular skin lesions provide a clue for diagnosis. Other clinical manifestations are less specific, i.e., fever, weight loss, nonproductive cough, hepatosplenomegaly and generalized lymphadenopathy.

Diagnosis is made by isolation of the fungus from clinical specimens or identifi cation of organisms in tissue sections. Presumptive diagnosis can be quickly made through microscopic examination of Wright-stained samples of skin scrapings, bone marrow aspirate, or lymph node biopsy specimens. The organism can also be identified on blood smears of patients with heavy fungemia.

Mortality is high in delayed or untreated patients. Antifungal therapy with amphotericin B and itraconazole is effective in most cases. After induction therapy, lifelong maintenance therapy is necessary; treatment can be discontinued if immune recovery occurs.

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