Department of Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, Hubei, China.
Front Cell Infect Microbiol. 2024 Mar 11;14:1347677. doi: 10.3389/fcimb.2024.1347677. eCollection 2024.
Talaromycosis is a serious opportunistic infectious disease caused by , which mostly occurs in immunocompromised patients. The disease is mainly prevalent in tropical countries and regions of Southeast Asia and South Asia, but non-endemic areas also have patients with Talaromycosis. The disease has no characteristic clinical manifestations and is difficult to diagnose. Delayed diagnosis often leads to death.
Both patients had cellular immunodeficiency. Case 1 had a history of acquired immune deficiency syndrome, and case 2 had a history of renal transplantation and glucose-6-phosphate dehydrogenase deficiency. They all had fever, anemia, fatigue, and skin lesions. Case 1 had gastrointestinal bleeding, enlarged lymph nodes, and hepatosplenomegaly. Case 2 had cough and dyspnea. Both patients had thrombocytopenia and hypoalbuminemia; an increased neutrophil ratio, procalcitonin, and C-reactive protein; and abnormal liver function and coagulation dysfunction. Case 1 sputum culture, blood culture, and bronchoalveolar lavage fluid were positive for . was detected in the blood culture of case 2, with infection of and . Chest computed tomography scan mainly showed pulmonary exudative lesions. Although these two patients were actively treated, they died of poor efficacy.
Talaromycosis has an insidious onset, long course, atypical clinical symptoms, imaging performance and laboratory results, difficult diagnosis, and high mortality. Therefore, it is important to promptly consider and treat Talaromycosis in immunocompromised patients upon infection in order to reduce mortality.
足放线病菌病是一种由 引起的严重机会性感染性疾病，主要发生于免疫功能低下的患者。该病主要流行于东南亚和南亚的热带国家和地区，但非流行地区也有足放线病菌病患者。该病无特征性临床表现，诊断困难，延误诊断常导致死亡。
两名患者均存在细胞免疫缺陷。例 1 有获得性免疫缺陷综合征病史，例 2 有肾移植和葡萄糖-6-磷酸脱氢酶缺乏病史。两人均有发热、贫血、乏力和皮肤损伤。例 1 有胃肠道出血、淋巴结肿大、肝脾肿大。例 2 有咳嗽和呼吸困难。两名患者均有血小板减少和低蛋白血症；中性粒细胞比例、降钙素原和 C 反应蛋白升高；肝功能和凝血功能异常。例 1 痰培养、血培养和支气管肺泡灌洗液均为阳性。例 2 血培养检测到 ，合并感染 和 。胸部计算机断层扫描主要显示肺部渗出性病变。尽管这两名患者接受了积极治疗，但疗效不佳而死亡。
足放线病菌病起病隐匿，病程长，临床表现、影像学表现和实验室结果不典型，诊断困难，死亡率高。因此，对于免疫功能低下患者在感染后，及时考虑和治疗足放线病菌病，对于降低死亡率非常重要。
