Penicillium marneffeipresenting as an obstructing endobronchial lesion in an immunocompetent host

Abstract

To the Editors: Penicillium marneffei was first isolated in 1956 from the liver of the Vietnamese bamboo rat [1]. It is recognised as an emerging infection among HIV-infected patients in South East Asia, where it typically presents as cutaneous lesions, fever, lymphadenopathy and hepatosplenomegaly [2]. Indeed, in this population, it is now the third most common opportunistic infection [3]. Penicilliosis is a rare disease in immunocompetent hosts. It has been previously described in patients with comorbid conditions such as connective tissue diseases and haematological malignancies. Although inhalation of the conidia is thought to lead to disseminated infection, a primary pulmonary presentation is unusual. We describe a unique presentation of systemic P. marneffei infection in an immunocompetent host presenting with an endobronchial tumour-like lesion and post-obstructive pneumonia. A 45-yr-old, previously well male was referred to our hospital for further investigation of fevers, lymphadenopathy …