{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T08:40:04Z","timestamp":1756370404733,"version":"3.44.0"},"reference-count":20,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,12,21]]},"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:p>We report a retroviral positive patient who presented to us with recurrent skin lesions along with intermittent, colicky periumbilical abdominal pain associated with non-projectile, postprandial vomiting. Contrast-enhanced CT (CECT) of abdomen and pelvis was suggestive of proximal jejunal obstruction. Double balloon enteroscopy done which showed extensive deep ulceration with surrounding nodular surface and friable mucosa at 60\u2009cm from pylorus with luminal narrowing. The biopsy from this region as well as the skin lesion on the forehead grew <jats:italic>Talaromyces marneffei<\/jats:italic>. She was initially treated with liposomal amphotericin B for 2\u2009weeks following which she received itraconazole for 3\u2009weeks for disseminated talaromycosis infection. She had already been started on antiretroviral therapy (ART) 1\u2009year back however her cluster of differentiation 4 (CD4) counts did not show any improvement. Proximal bowel obstruction leading to poor nutritional status compounded with ineffective ART therapy due to suboptimal absorption, dictated the staged management of her condition. Feeding jejunostomy was done with a plan to offer her resection and anastomosis of affected jejunal segment, should she require one, after optimising her nutritional and immunological status.<\/jats:p>","DOI":"10.1136\/bcr-2019-230121","type":"journal-article","created":{"date-parts":[[2020,2,14]],"date-time":"2020-02-14T04:25:14Z","timestamp":1581654314000},"page":"e230121","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Opportunistic penicilliosis infection causing intestinal obstruction in people living with HIV complicating antiretroviral therapy"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6794-4944","authenticated-orcid":false,"given":"Rajeevan","family":"Philip Sridhar","sequence":"first","affiliation":[{"name":"General Surgery, Christian Medical College and Hospital, Vellore, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victor Vijay","family":"Coelho","sequence":"additional","affiliation":[{"name":"General Surgery, Christian Medical College and Hospital, Vellore, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beulah","family":"Roopavathana","sequence":"additional","affiliation":[{"name":"General Surgery, Christian Medical College and Hospital, Vellore, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suchita","family":"Chase","sequence":"additional","affiliation":[{"name":"General Surgery, Christian Medical College and Hospital, Vellore, Tamil Nadu, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,2,13]]},"reference":[{"key":"2025082801150432000_13.2.e230121.1","doi-asserted-by":"crossref","first-page":"1350","DOI":"10.4269\/ajtmh.16-0521","article-title":"Clinical characteristics and prognosis of penicilliosis among human immunodeficiency Virus\u2013Infected patients in eastern China","volume":"96","author":"Chen","year":"2017","journal-title":"Am J Trop Med Hyg"},{"key":"2025082801150432000_13.2.e230121.2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4061\/2011\/247923","article-title":"Human immunodeficiency virus-associated gastrointestinal disease: common endoscopic biopsy diagnoses","volume":"2011","author":"Bhaijee","year":"2011","journal-title":"Patholog Res Int"},{"key":"2025082801150432000_13.2.e230121.3","article-title":"Kaposi's sarcoma presenting as acute small bowel obstruction diagnosed on multidetector computed tomography with histopathological correlation","volume":"2015","author":"Halankar","year":"2015","journal-title":"Case Rep Radiol"},{"key":"2025082801150432000_13.2.e230121.4","doi-asserted-by":"publisher","DOI":"10.1309\/AJCPWVBQCW13DJLO"},{"key":"2025082801150432000_13.2.e230121.5","doi-asserted-by":"publisher","DOI":"10.1258\/jrsm.98.11.513"},{"key":"2025082801150432000_13.2.e230121.6","unstructured":"Talaromycosis (formerly penicilliosis) | fungal diseases | CDC, 2019. 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