Talaromyces marneffei fungemia after travel to China in a Canadian patient with AIDS

Abstract

A 62-year-old man was admitted to the general medicine service with a 2-month history of odynophagia, fevers, rigors, a 22-kg unintentional weight loss and watery diarrhea. He had moved to Canada 25 years earlier from Guangzhou, China (Guangdong Province) and had last visited China

An Overview of Diagnostic and Management Strategies for Talaromycosis, an Underrated Disease

“…It is known that patients may develop talaromycosis some years after T. marneffei exposure [ 26 , 62 , 63 ]. In other words, T. marneffei may remain latent within the host and may reactivate at a later stage.…”

“…Although talaromycosis is endemic to the preceding areas and settings, its threat is not limited to specific countries or geographical regions, particularly in this era where the number of international travelers and instances of large population movements are increasing. It is known that travelers who visit areas of endemicity are also potentially vulnerable [ 8 , 25 , 26 , 27 , 28 ]. Furthermore, talaromycosis tends to predominantly affect young people during the peak years of their economic productivity [ 8 , 13 , 14 ].…”

Talaromyces marneffei Infection: Virulence, Intracellular Lifestyle and Host Defense Mechanisms

“…The reticuloendothelial system (RES) associated to internal organs such as lung, liver, lymph nodes, spleen, and bone marrow are commonly involved in disseminated talaromycosis [14]. Instead of acutely causing disease, T. marneffei can also become latent with subsequent reactivation, which is clearly evidenced by patients developing talaromycosis years after spending time in an endemic area [35][36][37][38]. The progression and severity of the disease seems to depend on the robustness of the host's immune status especially in individuals with a low level of CD4 T helper lymphocytes [6,39] or in the presence of neutralizing anti-IFN-γ autoantibodies [40][41][42].…”

A global view on fungal infections in humans and animals: infections caused by dimorphic fungi and dermatophytoses

“…Talaromycoses are geographically restricted to southeast Asia, especially Hong Kong, Thailand, Vietnam, Taiwan, China, Laos, Cambodia, Malaysia and Myanmar (Chariyalertsak et al 1996;Ranjana et al 2002;Le et al 2011;Chan et al 2016) The clinical features of disseminated T. marneffei infection may include fever, lymphadenopathy, weight loss, hepatomegaly, splenomegaly, respiratory and gastrointestinal abnormalities, and skin lesions (Larsson et al 2012;Limper et al 2017). The skin lesions are present in 70% of cases and are classically described as necrotic papules, although they may vary in appearance (Table 1) (Waters et al 2020). Since the other symptoms are nonspecific, the skin lesions may play an important role in prompting consideration of this diagnosis (Jiang et al 2019).…”

“…However, there is little evidence of direct rat-to-human transmission. Although the mode of transmission of T. marneffei remains unknown, environmental exposure is likely, with inhalation of T. marneffei conidia from such environments as soil or plants where bamboo rat faeces may be present (Chariyalertsak et al 1997;Waters et al 2020). Indeed, an environmental study conducted with molecular methods detected T. marneffei in soil samples collected outside the habitats of bamboo rats, including a bat cave, an elephant camp and dogs (Pryce-Miller et al 2008;Chaiwun et al 2011;Headley et al 2017).…”