Fungal infections identified in patients with AIDS

S. Dobiasova¹, J. Kolcakova², A. Kubatova³

¹Department of Clinical Mycology, Regional Institute of Public Health, Partyzanske nam.7, 702 00 Ostrava, Czech Republic,
²Department of Infectious Diseases, University Hospital, 17.listopadu 1790, 708 52 Ostrava, Czech Republic,
³Department of Botany, Faculty of Science, Charles University, Benatska 2, Prague 2, Czech Republic

The aim of this paper is to report five cases of severe fungal infections identified in AIDS patients in Czech Republic. Patients were treated in Center of Infectious Diseases of the University Hospital in Ostrava. The study was performed between January 1999 and April 2003. During this period 44 patients (out of them 6 women) were investigated. We report first case of Penicillium marneffei infection in Czech Republic, identified in 26 year-old man, originating from Vietnam. Furthermore are reported three cases of human infection by Pneumocystis jiroveci and one case of esophageal candidiasis caused by Candida glabrata and Candida albicans.

• One case of Penicillium marneffei infection identified in AIDS patient in Czech Republic:
  case of a 26 year-old man, Vietnamese refugee (CD4 lymphocytes 14/µl, the viral load (VL) 1468,825 copies/ml of plasma).
  The fungus was isolated from blood and identified on the basis of cultural and microscopic features. The strain (CCF 3217) is deposited at the Culture Collection of fungi (CCF), Department of Botany, Charles University, Prague. This record is considered to be the first in the Czech Republic.
  Fluconazole was effective in the treatment of this case.
• Three cases of human infection by Pneumocystis jiroveci:
  case of a 31 year-old man (CD4 79, VL 252,894)
  case of a 22 year-old man (CD4 59, VL 244,754)
  case of a 43 year-old man (CD4 45, VL 89,000)
  Samples of bronchoalveolar lavage fluid were stained by Giemsa and Gram-Weigert stain and imunofluorescence stain (MONOFLUOKIT P.CARINII, BIO-RAD). All three patients were treated with co-trimoxazole and survived.
• One case of oesophageal candidiasis:
  case of a 37 year-old man (CD4 5, VL 48,800 ).
  The isolates of Candida glabrata recovered from the oral cavity were resistant either to itraconazole or to fluconazole. Patient was treated with fluconazole, itraconazole and amphotericin B. Patient died twoo years after the start of therapy. The isolates of C. glabrata and C. albicans were found in esophagus, pectoral cavity and in the upper palate.

In: Congress of the European Confederation of Medical Mycology /9./ and Trends in Invasive Fungal infections (7.). - Amsterdam, - 2003. - S.166.
[Congress of the European Confederation of Medical Mycology /9./ and Trends in Invasive Fungal infections /7./. Amsterdam (NL), 03.09.28-03.10.01]

Full text: Dobiasova S., Kolcakova J., Kubatova A.: Fungal infections identified in AIDS patients. Proceedings of the 9th Congress of the ECMM and 7th Trends in IFI. -Bologna, Monduzzi editore 2003. - S. 193-196 ISBN 88-323-3154-3