Allergic bronchopulmonary mycosis due to Talaromyces marneffei: The first case report

Abstract

Allergic bronchopulmonary mycosis (ABPM) is a hypersensitivity disease of the lower airways caused by environmental fungi. While Aspergillus fumigatus is the most common pathogen, there has been a gradual increase in the occurrence of ABPM caused by other fungi in the past 20 years. This case report presents the first case of ABPM associated with Talaromyces marneffei (TM). The patient had positive TM results on bronchoalveolar lavage fluid (BALF) culture and multiple metagenomic next-generation sequencing (mNGS), a total IgE level of 1155 IU/ml, an IgG antibody to Aspergillus level (> 500 AU/ml) that was considerably higher than normal, and CT with central bronchiectasis and mucous embolus. Combined with the patient's clinical symptoms, the diagnosis was TM-related ABPM. Subsequently, the patient achieved favourable therapeutic effects through oral corticosteroid treatment. This case shows us the possibility of noninvasive infection of TM in the lower respiratory tract, improves our understanding of ABPM, and provides a reference for the clinical diagnosis and treatment of the disease.