Clinical characteristics and outcomes of 20 non-HIV-infected patients with dis-seminated Talaromycosis marneffei
10.3969/j.issn.1002-2694.2025.00.157
- VernacularTitle:20例非HIV感染播散性马尔尼菲篮状菌病临床特征及转归的分析
- Author:
Xianlan ZHANG
1
;
Ning SU
;
Chaoxia LI
;
Yun JIN
;
Huiyi HUANG
;
Zhihao HUANG
Author Information
1. 广州市胸科医院综合内科,广州 510095
- Publication Type:Journal Article
- Keywords:
Talaromycosis marneffei;
HIV;
clinical manifestations;
prognosis
- From:
Chinese Journal of Zoonoses
2025;41(10):1081-1088
- CountryChina
- Language:Chinese
-
Abstract:
This study analyzed the clinical characteristics,diagnosis,treatment,and outcomes of disseminated Tsalaromycosis marneffei(DTSM)in non-HIV-infected patients.A retrospective analysis was conducted on 20 cases of non-HIV-infected DTSM treated at Guangzhou Chest Hospital between January 2015 and December 2021.Clinical data,including demographic characteris-tics,time to diagnosis,clinical manifestations,comorbidities,treatment details,and outcomes,were collected and analyzed.Among the 20 cases,9 were in males,and 11 were in females;the median age was 46(range:1-70)years.The median time from symptom onset to definitive diagnosis was 12(range:1-24)months,and 16 cases were initially misdiagnosed with mycobacterial disease.More than half the patients exhibited four major clinical features:fever,lymphadenopathy,skin lesions,and bone lesions.Pulmonary imag-ing abnormalities were observed in 19 cases,and an average of(3.6±1.6)lung lobes were involved.The positive detection rate of multi-sample cultures(70%,14/20)was significantly higher than that identified through histopathological examination(25%,5/20)(χ2=8.120,P=0.004).Findings for all five patients with positive next-generation sequencing(NGS)results were further confirmed through pathogen culture or histopathology.After antifungal treatment,14 patients showed clinical improvement and were discharged.In conclusion,non-HIV-infected DTSM is characterized by complex clinical manifestations and extensive pulmonary involvement,thus leading to frequent misdiagnosis and diagnostic delays.Pathogen detection methods,such as multi-sample cultures and NGS,demonstrate superior diagnostic accuracy to histopathological examination.Early identification and standardized antifungal therapy are critical factors in determining patient outcomes.
