Multiple Nodular Pulmonary Lesions in a Human Immunodeficiency Virus-Infected Patient: An Unusual Manifestation of Invasive Penicillium Marneffei Infection

Abstract

Penicillium marneffel is endemic in southeastern Asian countries. In northern Thailand, it is the third most common opportunistic infection following tuberculosis and cryptococcosis in human immunodeficiency virus (HIV)-infected patients with acquired immunodeficiency syndrome (AIDS). The chest roentgenograms in such cases usually show mixed alveolar and interstitial infiltrates. We report a 60-year-old male HIV-infected patient with P. marneffei infection whose chest film initially presented with multiple nodular lesions. Generally, HIV patients with multiple pulmonary nodules should be considered as having pulmonary tuberculosis, Pneumocystis carinii pneumonia (PCP), cryptococcal pneumonia, Kaposi's sarcoma, or metastatic carcinoma. This case presented an unusual manifestation of invasive P. marneffei infection with multiple nodular pulmonary lesions. Thus, when HIV-infected patients present with multiple pulmonary nodules, P. marneffei infection should be considered.