Talaromyces marneffei infection in a lung cancer patient: a rare case report

Lin, Fanhai; Qiu, Ye; Zeng, Wen; Liang, Yi; Zhang, Jianquan

doi:10.1186/s12879-019-3968-5

Cited by 12 publications

(6 citation statements)

References 8 publications

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“…Only the yeast phase has pathogenicity. In addition, a mulberry-shaped cell mass, sausage-shaped cells, and a transverse wall are the three main morphological characteristics of T. marneffei growth in tissue, 11 which were also found in our case.…”

Section: Discussionsupporting

confidence: 84%

Rapid and precise diagnosis of T. marneffei pulmonary infection in a HIV-negative patient with autosomal-dominant STAT3 mutation: a case report

Zhang

Qiu

et al. 2020

Ther Adv Respir Dis

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Background: Talaromyces marneffei, also named Penicillium marneffei, is an opportunistic pathogen that can cause systemic or limited infection in human beings. This infection is especially common in human immunodeficiency virus (HIV)-infected hosts; however, it has also been recently reported in HIV-negative hosts. Here, we report a very rarely seen case of T. marneffei pulmonary infection in a non-HIV-infected patient with signal transducer and activator of transcription 3 ( STAT3) mutation. Case presentation: A 34-year-old woman was admitted to our hospital for uncontrollable nonproductive cough and dyspnea with exercise. She had been immunocompromised since infancy. Computerized tomography scan showed multiple ground glass opacities with multiple bullae in both lungs. Next generation sequencing (NGS) of the bronchoalveolar lavage fluid identified T. marneffei nucleotide sequences. Culture of bronchoscopy specimens further verified the results. The patient was HIV negative, and blood gene detection indicated STAT3 mutation. To date, following the application of itraconazole, the patient has recovered satisfactorily. Conclusion: In clinical practice, T. marneffei infection among HIV-negative individuals is relatively rare, and we found that patients who are congenitally immunocompromised due to STAT3 mutation may be potential hosts. Early diagnosis and timely treatment are expected to improve the prognosis of T. marneffei infection. NGS is a powerful technique that may play an important role in this progress. The reviews of this paper are available via the supplemental material section.

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Section: Discussionsupporting

confidence: 84%

Rapid and precise diagnosis of T. marneffei pulmonary infection in a HIV-negative patient with autosomal-dominant STAT3 mutation: a case report

Zhang

Qiu

et al. 2020

Ther Adv Respir Dis

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“…Our literature review identified few cases of lung cancer with Talaromycosis (8,11). Lung cancer will impair the immune system, but whether this is an important cause of Talaromycosis remains to be confirmed by future studies.…”

Section: Discussionmentioning

confidence: 99%

Pneumonia caused by Talaromyces marneffei in an epidermal growth factor receptor (EGFR) mutation-positive advanced lung adenocarcinoma patient: a case report

Liu

Lin

et al. 2021

Ann Palliat Med

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Talaromyces marneffei (T. marneffei) is a pathogenic, thermally dimorphic fungus that can cause invasive infection and significant morbidity in immunocompromised patients, especially those with human immunodeficiency virus (HIV) or other immune defects. Currently, T. marneffei infection is understood to be not limited only to immunodeficient patients, as cases of immunocompromised patients or immunocompetent patients associated with T. marneffei infection have been increasingly reported in recent years. The exact mechanism is not yet clear. This study reports a case of an advanced lung adenocarcinoma patient with T. marneffei infection. The patient is a 59-year-old female with a 3-month history of coughing, expectoration, and progressive dyspnea. Computed tomography (CT) scans showed a mass in the left lower lung, multiple plaques and nodules in both lungs, and left pleural effusion. The patient was diagnosed with T. marneffei infection, as T. marneffei was found in both the bronchoalveolar lavage fluid (BALF) and the sputum. According to the pathology of the left lung lesion by transbronchial lung biopsy (TBLB) and contrast-enhanced brain magnetic resonance imaging (MRI), the patient was diagnosed with epidermal growth factor receptor (EGFR) mutation-positive stage Ⅳ lung adenocarcinoma (T4N3M1c). She received intravenous liposomal amphotericin B and oral itraconazole as anti-fungal treatments, meanwhile, icotinib was used as an anti-tumor treatment. Following treatment, CT re-examination showed that the mass was remarkably absorbed, and some of the lung nodules had disappeared. No relapse of T. marneffei infection was found during the follow-up. This case indicates that patients with malignant lung tumors may possibly become infected with T. marneffei. Sequential treatment of amphotericin liposome B followed by itraconazole is effective for lung cancer patients with T. marneffei infection.

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“…For TSM patients presenting with multiple osteolysis and/or swollen lymph nodes, hematologic malignancies should be considered if active antifungal therapy proves to be ineffective. For patients with cancer, such as hematological malignancies and lung cancer [ 9 ], the presence of TM should be ascertained before or after chemotherapy. The final diagnosis primarily relies on multiple pathological examinations and the pathogenic culture of lymph nodes and bone marrow tissue.…”

Section: Discussionmentioning

confidence: 99%

Rare incidence of non-secretory myeloma with talaromycosis: a case report

et al. 2021

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Background Talaromyces marneffei (TM) primarily infects patients with co-morbidities that cause immunodeficiency, but non-secretory myeloma (NSMM) is rare. TSM and NSMM are associated with fever, osteolysis, and swollen lymph nodes, thereby making it difficult for clinicians to make differential diagnosis. In this case, we describe TM infection coexisting with NSMM. Case presentation We retrospectively reviewed the case of a male (without human immunodeficiency virus infection) with fever, thoracalgia, swollen lymph nodes, and subcutaneous nodules who presented to the First Affiliated Hospital of Guangxi Medical University in February 2014. Chest computed tomography revealed patchy infiltration and positron emission tomography/computed tomography showed increased metabolic activity in the lower-right lung, lymph nodes, left ninth rib, and right ilium. Pathological examination of the lung, lymph nodes, subcutaneous nodules, and bone marrow showed no malignancy, he was diagnosed with community-acquired pneumonia. His clinical symptoms did not improve after anti-bacterial, anti-Mycobacterium tuberculosis, and anti-non-M. tuberculosis treatment. Later, etiological culture and pathological examination of the subcutaneous nodule proved TM infection, and the patient was re-diagnosed with disseminated TSM, which involved the lungs, lymph nodes, skin, bone, and subcutaneous tissue. After antifungal treatment, the patient showed significant improvement, except for the pain in his bones. Imaging showed aggravated osteolysis, and bone marrow biopsy and immunohistochemistry indicated NSMM. Thus, we conclusively diagnosed the case as NSMM with TSM (involving the lungs, lymph nodes, skin, and subcutaneous tissue). His condition improved after chemotherapy, and he was symptom-free for 7 years. Conclusion TM infection is rare in individual with NSMM. Since they have clinical manifestation in common, easily causing misdiagnosis and missed diagnosis, multiple pathological examinations and tissue cultures are essential to provide a differential diagnosis.

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Talaromyces marneffei infection in a lung cancer patient: a rare case report

Cited by 12 publications

References 8 publications

Rapid and precise diagnosis of T. marneffei pulmonary infection in a HIV-negative patient with autosomal-dominant STAT3 mutation: a case report

Rapid and precise diagnosis of T. marneffei pulmonary infection in a HIV-negative patient with autosomal-dominant STAT3 mutation: a case report

Pneumonia caused by Talaromyces marneffei in an epidermal growth factor receptor (EGFR) mutation-positive advanced lung adenocarcinoma patient: a case report

Rare incidence of non-secretory myeloma with talaromycosis: a case report

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