Two cases of HIV-negative adults with disseminated Talaromyces marneffei infections and literature review
10.3760/cma.j.cn431274-20240508-00761
- VernacularTitle:HIV阴性的成人播散性马尔尼菲篮状菌感染2例并文献复习
- Author:
Xiufang CHEN
1
;
Shan ZHAO
;
Ziying CHEN
;
Jiao WANG
;
Guiying ZHANG
Author Information
1. 长沙市中心医院皮肤性病科，长沙 410004
- Publication Type:Journal Article
- Keywords:
Mycoses;
Talaromyces marneffei;
HIV-negative
- From:
Journal of Chinese Physician
2025;27(4):568-572
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical characteristics and treatment of human immunodeficiency virus (HIV) negative adult disseminated Talaromyces marneffei (TSM) infection, so as to improve the diagnosis and treatment of this disease.Methods:While two HIV-negative adult patients with disseminated T. Marneffei infection were reported, papers published between 1970 and February 2024 were collected from CNKI, Wanfang and Chongqing Weipu databases, and patient data meeting diagnostic criteria were collected. A total of 34 HIV-negative adults with disseminated T. Marneffei infection were collected. The data of 34 patients with this disease were retrospectively analyzed, and the demographic distribution, systematic signs, examination results, complications, diagnosis and treatment plan and effect of this disease were summarized.Results:Among the 34 patients, the ratio of male to female patients was 21∶13. The median age of onset was 51 years, ranging from 24 to 70 years. The incidence area was more common in the south of China. The most common clinical manifestation was fever. 70.6%(24/34) of patients were misdiagnosed, most often with tuberculosis. The methods of diagnosis were as follows: 26 cases were diagnosed by fungal culture, 5 cases by high-throughput sequencing and 3 cases by direct microscopy. 32 patients received antifungal therapy, 9 were cured, 10 improved, 2 died, 4 relapsed, 4 patients were effective (but the outcome was unknown), 2 patients had poor effect, and 1 patient had unknown effect. Two patients died soon after admission due to rapid disease progression.Conclusions:The symptoms of HIV negative adults infected with T. Marneffei are varied and may involve multiple systems. Infection is often misdiagnosed. Early identification and fungal culture can improve the detection rate. High-throughput sequencing is a relatively mature diagnostic technology.
