A new case of imported disseminated infection with penicillium marneffei revealed by isolated fever

Disseminated infection with Penicillium marneffei common in patients infected with human immunodeficiency virus (HIV) in Southeast Asia but few imported cases have been reported in Europe. We report one case of P. marneffei in a patient infected with HIV who had lived in endemic rural areas of Thailand as bambou worker. The patient presented unspecific signs (isolated fever, weight loss and deep abdominal lymphadenopathy), confirmed by abdominal lymph mode and hepatic biopsies, as well as blood and bone marrow cultures. He was treated with amphotericin B for 3 weeks followed by itraconazole 400 mg daily, for 4 months with rapid clinical improvement. After 4 months, maintenance therapy with itraconazole was administered at 200 mg daily and no relapse was observed after 7 months follow-up. In this patient, itraconazole in association with antiretroviral therapy was effective for treatment of P. marneffei.