Surviving Mardi Gras in an Intensive Care Unit

Penicilliosis is a life threatening fungal infection caused by Penicillium marneffei (PM). It has a high mortality rate if not picked up in time and treated appropriately. Making an early diagnosis is a key in improving outcomes. It is endemic in Southeast Asia and causes disseminated disease in the immunocompromised host especially in the human immunodeficiency virus (HIV) infected population. We describe a HIV patient who presented with an altered sensorium. After admission he developed gastrointestinal bleeding, respiratory failure and septic shock. Blood cultures revealed yeast with high suspicion for PM. Intravenous amphotericin B was promptly initiated resulting in marked improvement of overall condition. The learning objective of this report is to illustrate the increasing variability of clinical manifestations and absence of “typical” skin lesions making an early diagnosis difficult. In endemic regions the immunocompetent are equally susceptible. A high index of suspicion, early recognition and treatment is required to improve patient outcomes. J Microbiol Infect Dis 2017; 7(1): 46-50