Norwegian scabies coinfected with disseminated Talaromyces marneffei – a dual challenge in HIV immunodeficiency: A case report
Year: 2025
Type: article
Study design: Case Report
Abstract: RATIONALE: Norwegian scabies (crusted scabies) is an extreme manifestation of Sarcoptes scabiei infestation, primarily affecting immunocompromised populations such as HIV-positive individuals. This condition is characterized by a severe mite burden and high transmissibility, often accompanied by pathognomonic hyperkeratotic plaques. PATIENT CONCERNS: A 46-year-old male patient diagnosed with HIV presented with persistent fever and progressive cutaneous desquamation, along with lymphadenopathy and worsening rash, initially misdiagnosed as atopic dermatitis. DIAGNOSES: Microscopic examination of skin scrapings confirmed a diagnosis of Norwegian scabies. Blood cultures and lymph node puncture revealed disseminated Talaromyces marneffei infection. The patient's cluster of differentiation 4 cell count was extremely low, and immunoglobulin E levels were significantly elevated. INTERVENTIONS: The patient received a comprehensive treatment regimen including topical sulfur ointment, oral ivermectin, and voriconazole, in addition to antiretroviral therapy. Supportive care included methylprednisolone and immunoglobulin therapy. OUTCOMES: After 1 month of treatment, the patient's skin symptoms completely resolved, and he was discharged. LESSONS: For immunocompromised HIV patients, routine microscopic examination of skin scrapings is recommended to promptly identify Norwegian scabies, preventing misdiagnosis and potential infectious complications.
Source: Medicine
Authors: Yan Zhang, Xiaojin Ding, Jing Wu, Wenyan Yu, Kenv Pan, Aifang Xu
Institutions: Zhejiang Chinese Medical University, Hangzhou Xixi hospital
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,950
OpenAlex ID: W4413110774