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马尔尼菲青霉足放线病菌感染患者的临床特征及病原菌的微生物学特点。

Clinical features of patients with talaromycosis marneffei and microbiological characteristics of the causative strains.

机构信息

School of Medicine, Ningbo University, Ningbo, China.

Department of Medical Laboratory, Ningbo First Hospital, Ningbo, China.

出版信息

J Clin Lab Anal. 2022 Nov;36(11):e24737. doi: 10.1002/jcla.24737. Epub 2022 Oct 21.

Abstract

BACKGROUND

Talaromyces marneffei (T. marneffei) is a temperature-dependent dimorphic fungus that is mainly prevalent in Southeast Asia and South China and often causes disseminated life-threatening infections. This study aimed to investigate the clinical features and improve the early diagnosis of talaromycosis marneffei in nonendemic areas.

METHODS

We retrospectively analyzed the medical records of six cases of T. marneffei infection. We describe the clinical manifestations, laboratory tests, and imaging manifestations of the six patients.

RESULTS

Talaromyces marneffei infection was confirmed by sputum culture, blood culture, tissue biopsy, and metagenomic next-generation sequencing (mNGS). In this study, there were five disseminated-type patients and two HIV patients. One patient died within 24 h, and the others demonstrated considerable improvement after definitive diagnosis.

CONCLUSIONS

Due to the lack of significant clinical presentations of talaromycosis marneffei, many cases may be easily misdiagnosed in nonendemic areas. It is particularly important to analyze the imaging manifestations and laboratory findings of infected patients. With the rapid development of molecular biology, mNGS may be a rapid and effective diagnostic method.

摘要

背景

马尔尼菲青霉(Talaromyces marneffei,T. marneffei)是一种温度依赖性的二相真菌,主要流行于东南亚和中国南方,常引起播散性、危及生命的感染。本研究旨在探讨非流行地区马尔尼菲青霉病的临床特征,提高早期诊断水平。

方法

我们回顾性分析了 6 例马尔尼菲青霉感染患者的病历。我们描述了 6 名患者的临床表现、实验室检查和影像学表现。

结果

通过痰培养、血培养、组织活检和宏基因组下一代测序(mNGS)证实了马尔尼菲青霉感染。本研究中,有 5 例为播散型患者,2 例为 HIV 患者。1 例患者在 24 小时内死亡,其余患者在明确诊断后均有明显改善。

结论

由于马尔尼菲青霉病的临床表现不明显,许多病例在非流行地区可能很容易被误诊。分析感染患者的影像学表现和实验室检查结果尤为重要。随着分子生物学的快速发展,mNGS 可能是一种快速有效的诊断方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7613/9701894/81e8bc0905a4/JCLA-36-e24737-g001.jpg

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