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Penicillium marneffei is a rare human pathogen that often causes problems in clinical and histological diagnosis. A patient who presented with autoimmune haemolytic anaemia and hepatosplenomegaly, and was subsequently found to be suffering from disseminated Penicillium marneffei infection, is reported. The liver biopsy showed epithelioid cell granulomas only, and tuberculosis was initially considered the most likely diagnosis. The correct diagnosis became evident in a subsequent colonic biopsy, which showed extensive infiltration by penicillium-laden macrophages.

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We derived a 7-marker and 5-marker classifier using the Luminex assay and multiplex realtime PCR, respectively. The 5-protein panel assay was comprised of epidermal growth factor receptor 1, matrix metalloproteinase 7, KIT, and complement component 9. The 5-marker classifier resulted in 66.7% sensitivity with 92.2% specificity for whole stage, and 44.4% sensitivity with 92.2% specificity for stage I and II disease. Conclusion: We have developed a 5-protein biomarker panel using multiplex real-time PCR to accurately identify NSCLC. The panel displayed similar diagnostic performance compared to a 7-protein biomarker-based Luminex assay. The high specificity in patients with NSCLC might help differentiate non-malignant pulmonary nodules in low-dose chest computed tomography screening.

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