Case of <i>Penicillium marneffei</i> infection in a non‐<scp>AIDS</scp> patient

Phuong, Hoang T.; Tran, Van Cuong; Nguyen, Thuong Vu; Nguyen, Sau Huu; Le, Doanh H.; Truong, T.; Nguyen, Hoa L.; Sugawara, Koji; Tsuruta, Daisuke

doi:10.1111/1346-8138.14181

Cited by 3 publications

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“…In recent years, it has been reported that an increasing number and proportion of cases in non-HIV-infected patients who had some form of immunodeficiency (hypogammaglobulinemia, CD4 lymphopenia) or underlying diseases with immunocompromised condition, including hematologic malignancies or autoimmune diseases, were receiving treatments that could impair their cellular immunity, such as antineoplastic or corticosteroid agents [ 8 , 9 ]. However, some researchers have recommended that T. marneffei infection also occur in persons with normal immunity [ 4 , 8 , 10 – 12 ]. Here, we report an unusual case of disseminated T. marneffei infection in non-HIV, non-immunosuppressed and non-endemic conditions.…”

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confidence: 99%

Unusual disseminated Talaromyces marneffei infection mimicking lymphoma in a non-immunosuppressed patient in East China: a case report and review of the literature

et al. 2020

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Background Talaromyces marneffei infection is an important opportunistic infection associated with acquired immune deficiency syndrome (AIDS). However, it is unusual in patients with non-AIDS and other non-immunosuppressed conditions. We report a case of delayed diagnosis of disseminated T. marneffei infection in non-AIDS, non-immunosuppressive and non-endemic conditions. Case presentation We describe a previously healthy 24-year-old man who complained of a 3-month history of intermittent diarrhea and a recent week of uncontrollable high fever. The HIV antibody test was negative. Enhanced abdominal computed tomography (CT) and integrated 18F-2-deoxy-2-fluoro-D-glucose position emission tomography/computed tomography (FDG PET/CT) both suspected malignant lymphoma. However, a large number of yeast-like cells were found in macrophages in cervical lymph node samples by hematoxylin and eosin stain and silver hexamine stain. Subsequent blood culture suggested T. marneffei infection. Metagenomic Next Generation Sequencing (mNGS) results suggested T. marneffei as the dominant pathogen. Unfortunately, the patient continued to develop acute liver failure and died due to adverse events associated with amphotericin B. Conclusions Early diagnosis in HIV-negative patients who are otherwise not immunosuppressed and endemic poses a serious challenge. T. marneffei infection is an FDG-avid nonmalignant condition that may lead to false-positive FDG PET/CT scans. Nevertheless, integrated FDG PET/CT is necessary in patients with fever of unknown origin in the early period to perform earlier biopsy for histopathology and culture in highly avid sites and to avoid delays in diagnosis and treatment.

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