Disseminated talaromycosis complicated by recurrent gastrointestinal bleeding and hemorrhagic shock: a case report

Abstract

Background Gastrointestinal involvement is not uncommon in patients with disseminated talaromycosis, but successful management of massive gastrointestinal bleeding and hemorrhagic shock secondary to talaromycosis is rarely reported. Clinical management strategies for these patients have not been well documented. Case presentation Here, we reported a case of disseminated talaromycosis with recurrent gastrointestinal bleeding and hemorrhagic shock who was successfully alleviated solely with medical treatment. Conclusions Early diagnosis and treatment for Talaromyces marneffei, intravenous fluid resuscitation, hemostatic therapy and blood transfusion are all essential for talaromycosis complicated with gastrointestinal bleeding and hemorrhagic shock. It is also necessary to warn about the possibility of bleeding induced or aggravated by endoscopic biopsy trauma.

Disseminated Talaromyces marneffei infection initially presenting as cutaneous and subcutaneous lesion in an HIV-Negative renal transplant recipient: a case report and literature review

“…Although gastrointestinal ulcers and erosion are common in T. marneffei -infected patients (∼ 31%), gastrointestinal bleeding is very rare. It is worth noting that even among the most common HIV-positive patients with T. marneffei infection, though about a third of these patients have symptoms such as ulcers, only 2 cases of gastrointestinal bleeding could be officially searched using the Pubmed electronic database [ 44 , 45 ]. However, among 11 T. marneffei -infected kidney transplant patients, including the patient described in the current case, 3 patients had gastrointestinal bleeding [ 30 , 32 ], accounting for 27.3%, which is much higher than the proportion of gastrointestinal bleeding in HIV patients.…”

“…Conventional surgical treatment is not ideal, and bleeding may still occur in other parts of the intestines after surgery. Additionally, endoscopic hemostasis treatment carries the risk of causing or exacerbating bleeding, which often proves fatal if it leads to hemorrhagic shock [ 30 , 44 ]. Therefore, early diagnosis and timely treatment are necessary for kidney transplant patients suspected of having T. marneffei infection.…”

Disseminated Talaromyces marneffei infection after renal transplantation: A case report and literature review

“…The mortality rate of gastrointestinal bleeding caused by T. marneffei infection in HIV patients is extremely high, and the successful management experience is not much ( Cui et al., 2022 ). Due to the lack of guidelines for T. marneffei infection in organ transplant patients, as well as the concurrent severe impairment of liver and kidney function in our patient, voriconazole was used for induction therapy as recommended by the Centers for Disease Control and Prevention ( Masur et al., 2014 ).…”

Gastrointestinal Talaromyces marneffei infection in a patient with AIDS: A case report and systematic review

“…From 1988 to 2022, in addition to the review, only 28 other cases of T. marneffei infection identified via abdominal symptoms, intestinal lesions, and histopathology involving the digestive tract were observed in the existing literature, with the detailed information provided. According to the report, GI symptoms account for approximately 18.8%-31% of T. marneffei infection, but the proportion does not match the morbidity of actual confirmed GI infections with T. marneffei (4,11,20,28). For example, in a retrospective analysis, only three of 33 T. marneffei infections with GI symptoms were diagnosed as T. marneffei GI system infections (20).…”