Intestinal <i>Penicillium marneffei</i>: An unusual cause of chronic diarrhea in an AIDS patient

Hung, Hiu-Gong; Lok, Ka–Ho

doi:10.1111/j.1751-2980.2010.00435.x

Cited by 9 publications

(2 citation statements)

References 11 publications

(29 reference statements)

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“…Although gastrointestinal symptoms (e.g., diarrhea) are relatively common with a prevalence of approximately 25% [6], the prevalence of colonic involvement caused by Talaromyces marneffei infection is only 1.9% [7]. Including the present case, prominent abdominal involvement from Talaromyces marneffei infection has been reported in a total of 14 patients (Table 1) [4][5][6][7][8][9][10][11][12][13]. The main macroscopic pathological changes include multiple gastrointestinal ulcers and mesenteric lymphadenitis.…”

Section: Discussionmentioning

confidence: 88%

Gastrointestinal manifestations of Talaromyces marneffei infection in an HIV-infected patient rapidly verified by metagenomic next-generation sequencing: a case report

2021

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Background The manifestation of Talaromyces marneffei infection in some HIV-infected patients may be atypical. Cases with gastrointestinal involvement have rarely been reported. It is hard to make a diagnosis when patients are lacking the characteristic rash and positive blood culture. Case presentation Here, we described a patient living with HIV who complained of fever and abdominal pain, and was rapidly diagnosed with Talaromyces marneffei infection by metagenomic next-generation sequencing (mNGS) using formalin-fixation and paraffin-embedded (FFPE) samples of omentum majus tissue. We also reviewed reported related cases. Conclusions Talaromyces marneffei is an unusual cause of clinical presentations involving obvious abdominal pain and lower gastrointestinal bleeding, but can be included in the differential diagnosis. As an important diagnostic tool, the significance of mNGS using FFPE samples of lesions provides a more targeted diagnosis.

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Section: Discussionmentioning

confidence: 88%

Gastrointestinal manifestations of Talaromyces marneffei infection in an HIV-infected patient rapidly verified by metagenomic next-generation sequencing: a case report

2021

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“…[ 8 ] A patient with gastric mucosal erosions and intestinal ulcers combined with TM infection presented with diarrhea, weight loss, fever, and a CD4 + T-lymphocyte count of 11 cells/µL. [ 9 ] Our patient’s presentation was somewhat different, as he had a low CD4 + T-lymphocyte count and weight loss but no abdominal pain, fever, or diarrhea; he did have abdominal distension, poor appetite, and skin lesions. Atypical gastrointestinal symptoms may lead clinicians to misdiagnose TM infection as a common digestive tract disease, leading to delays in treatment.…”

Section: Discussionmentioning

confidence: 99%

Gastrointestinal Talaromyces marneffei infection in a man with AIDS: A case report

Peng

Mou

et al. 2023

Medicine

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Rationale: Reports of intestinal Talaromyces marneffei infection have increased year by year, but those of gastric infection remain rare. Here, we report disseminated talaromycosis with gastric and intestinal ulcers in an AIDS patient who was treated by antifungal agents and a proton pump inhibitor and achieved a satisfactory outcome. Patient concerns: A 49-year-old man developed a gastrointestinal illness with main abdominal distension, poor appetite and a positive HIV infection to our AIDS clinical treatment center. Diagnoses: Electronic gastrointestinal endoscopy showed that the patient had multiple ulcers in the gastric angle, gastric antrum and large intestine. Gastric Helicobacter pylori infection was ruled out by paraulcerative histopathological analysis and a C14 urea breath test. The diagnosis was confirmed by gastroenteroscopic biopsy and metagenomic next-generation sequencing of gastric ulcer tissue. Interventions: Symptomatic and supportive treatments [a proton pump inhibitor and gastrointestinal motility promotion] were initiated. The patient was prescribed sequential antifungal therapy with amphotericin B (0.5 mg/kg·d, 2 weeks) and itraconazole (200 mg, q12h, 10 weeks), and then followed with itraconazole for long-term secondary prevention (200 mg, qd). Outcomes: The combined use of antifungal agents and a proton pump inhibitor improved the patient’s condition, and he was discharged home 20 days later. He had no gastrointestinal symptom during 1 year of telephone-based follow-up. Lessons: In endemic areas, clinicians should be alert to the possibility of Talaromyces marneffei infection presenting with gastric ulcers in patients with AIDS, after excluding Helicobacter pylori infection.

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The Mycobiome in Health and Disease: Emerging Concepts, Methodologies and Challenges

et al. 2020

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Fungal disease is an increasingly recognised global clinical challenge associated with high mortality. Early diagnosis of fungal infection remains problematic due to the poor sensitivity and specificity of current diagnostic modalities. Advances in sequencing technologies hold promise in addressing these shortcomings and for improved fungal detection and identification. To translate such emerging approaches into mainstream clinical care will require refinement of current sequencing and analytical platforms, ensuring standardisation and consistency through robust clinical benchmarking and its validation across a range of patient populations. In this stateof-the-art review, we discuss current diagnostic and therapeutic challenges associated with fungal disease and provide key examples where the application of sequencing technologies has potential diagnostic application in assessing the human 'mycobiome'. We assess how ready access to fungal sequencing may be exploited in broadening our insight into hostfungal interaction, providing scope for clinical diagnostics and the translation of emerging mycobiome research into clinical practice.

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Intestinal Penicillium marneffei: An unusual cause of chronic diarrhea in an AIDS patient

Cited by 9 publications

References 11 publications

Gastrointestinal manifestations of Talaromyces marneffei infection in an HIV-infected patient rapidly verified by metagenomic next-generation sequencing: a case report

Gastrointestinal manifestations of Talaromyces marneffei infection in an HIV-infected patient rapidly verified by metagenomic next-generation sequencing: a case report

Gastrointestinal Talaromyces marneffei infection in a man with AIDS: A case report

The Mycobiome in Health and Disease: Emerging Concepts, Methodologies and Challenges

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