Disseminated talaromycosis in an HIV-infected patient

Chang, Chee Yik; Wahid, Adrena Abdul; Ong, Edmund

doi:10.1590/0037-8682-0896-2020

Cited by 1 publication

(1 citation statement)

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“…Human infection results from inhalation of fungal spores following disruption of the soil [ 94 ]. The clinical features are non-specific and are indistinguishable from those of disseminated tuberculosis and other systemic mycoses, with disseminated infection involving multiple organ systems as the most common manifestation in patients with advanced HIV disease [ 94 , 96 ]. In addition, T. marneffei infection of the respiratory system is often misdiagnosed as TB, with fatal complications.…”

Section: Resultsmentioning

confidence: 99%

Pulmonary and Extrapulmonary Manifestations of Fungal Infections Misdiagnosed as Tuberculosis: The Need for Prompt Diagnosis and Management

Ekeng

Davies

Osaigbovo

et al. 2022

JoF

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Fungal infections commonly present with myriad symptoms that mimic other clinical entities, notable amongst which is tuberculosis. Besides histoplasmosis and chronic pulmonary aspergillosis, which can mimic TB, this review has identified several other fungal infections which also do. A total of 80 individual cases misdiagnosed as TB are highlighted: aspergillosis (n = 18, 22.5%), histoplasmosis (n = 16, 20%), blastomycosis (n = 14, 17.5%), cryptococcosis (n = 11, 13.8%), talaromycosis (n = 7, 8.8%), coccidioidomycosis (n = 5, 6.3%), mucormycosis (n = 4, 5%), sporotrichosis (n = 3, 3.8%), phaeohyphomycosis (n = 1, 1.3%) and chromoblastomycosis (n = 1, 1.3%). Case series from India and Pakistan reported over 100 cases of chronic and allergic bronchopulmonary aspergillosis had received anti-TB therapy before the correct diagnosis was made. Forty-five cases (56.3%) had favorable outcomes, and 25 (33.8%) died, outcome was unclear in the remainder. Seventeen (21.3%) cases were infected with human immunodeficiency virus (HIV). Diagnostic modalities were histopathology (n = 46, 57.5%), culture (n = 42, 52.5%), serology (n = 18, 22.5%), cytology (n = 2, 2.5%), gene sequencing (n = 5, 6.3%) and microscopy (n = 10, 12.5%) including Gram stain, India ink preparation, bone marrow smear and KOH mount. We conclude that the above fungal infections should always be considered or ruled out whenever a patient presents with symptoms suggestive of tuberculosis which is unconfirmed thereby reducing prolonged hospital stay and mortalities associated with a delayed or incorrect diagnosis of fungal infections.

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Section: Resultsmentioning

confidence: 99%