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Sex Transm Infect 83:249-250 doi:10.1136/sti.2006.023408
  • Letters to the editor

Genital ulcer caused by Penicillium marneffei in an HIV-infected patient

  1. Vamseedhar Annam1,
  2. Arun C Inamadar2,
  3. Aparna Palit2,
  4. Mallikarjun Koppad3,
  5. B V Peerapur3,
  6. B R Yelikar4
  1. 1Department of Pathology, BLDEA’s SBMP Medical College, Hospital & Research Centre, Bijapur, Karnataka, India
  2. 2Department of Dermatology, Venereology & Leprosy, BLDEA’s SBMP Medical College, Hospital & Research Centre, Bijapur, Karnataka, India
  3. 3Department of Microbiology, BLDEA’s SBMP Medical College, Hospital & Research Centre, Bijapur, Karnataka, India
  4. 4Department of Pathology, BLDEA’s SBMP Medical College, Hospital & Research Centre, Bijapur, Karnataka, India
  1. Correspondence to:
 Dr A C Inamadar
 Department of Dermatology, Venereology & Leprosy, BLDEA’s SBMP Medical College, Hospital & Research Centre, Ashram Road, Bijapur 586103, Karnataka, India; aruninamadar{at}rediffmail.com
  • Accepted 15 December 2006

Infection by Penicillium marneffei is an emerging systemic illness among HIV-infected patients. Most reports of this infection are from south-east Asia, where this is considered as the third most common AIDS-defining illness after tuberculosis and cryptococcosis.1 The most common initial site of infection is the reticuloendothelial system, and skin involvement is a part of disseminated infection.2 The usual cutaneous manifestations include molluscum contagiosum-like papular eruptions involving predominantly the face and neck3; necrotic papule, pustules or nodules may also be seen.3 Inhalation of airborne conidia is the most probable mode of entry of P marneffei into the body.2 Inoculation is a rare mode of acquiring this infection, which may occur in laboratory workers. The first documented case of human infection by P marneffei was by accidental puncture of the finger of Gabriel Segretain, one of the research workers who gave the initial description of this pathogenic fungus.2 This mode of infection gives rise to nodule formation at the site of inoculation. Here, we report the unusual presentation of an HIV-infected Indian patient with genital ulcers caused by P marneffei followed by dissemination.

A 50-year-old truck driver presented with genital ulcers of 2 months’ duration. The lesions started on the shaft of the penis as tender nodules, which suppurated to form ulcers. In the past, he had had multiple unprotected exposures to commercial sex workers, the last being 3 months previously. Before presentation, …