Fungemia caused by Penicillium marneffei in an immunocompetent patient with COPD: A unique case report.

Rationale: This report describes a rare case in Wenzhou city of Zhejiang province that a non-HIV infected male recovering from fungemia caused by Penicillium marneffei (P. marneffei). Interestingly, it's very easy to misdiagnose with aspergillosis, a fungal disease prevalent in Wenzhou, during the whole procedure. Patient concerns: An 80-year-old Chinese male subject with pre-existing chronic obstructive pulmonary disease (COPD) presented with symptoms of chest tightness and high fever for a month. Diagnoses: Fungal culture from the blood isolated P marneffei. Naturally, the patient was diagnosed with P marneffei fungemia. However, he was proven serologically to be negative for human immunodeficiency virus (HIV). Interventions: The patient was treated with voriconazole at 200mg/dL every 12 hours via intravenous administration. Outcomes: The fever returned to normal and chest tightness disappeared gradually after a week of voriconazole treatment. Lessons: A high level of clinical suspicion and awareness is necessary for early diagnosis of P marneffei fungemia, especially in elder patients with underlying diseases.