Department of Respiratory and Critical Care Medicine, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, Zhejiang, P. R. China.
General Medical Ward (9A), East Branch, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai, Zhejiang, P. R. China.
J Infect Dev Ctries. 2024 Aug 31;18(8):1296-1300. doi: 10.3855/jidc.19061.
Talaromyces marneffei (T. marneffei), a kind of endemic opportunistic pathogen, was previously thought to occur in HIV-positive individuals and non-HIV hosts with impaired immune function. However, the infection of T. marneffei in patient with normal immune function was rarely reported.
We report a case of severe pneumonia caused by T. marneffei in an immunocompetent and HIV-negative patient, which was rapidly confirmed by metagenomics next-generation sequencing (mNGS) and treated successfully. The patient was a previously healthy 63-year-old male, who was admitted to hospital with fever for 11 days, cough and sputum for 1 week, and chest distress for 4 days. The infection of T. marneffei was quickly determined by alveolar lavage under bedside bronchoscope and mNGS test.
Patient's condition improved rapidly after voriconazole treatment, and he was evaluated as a HIV-negative case of T. marneffei infection with normal immune function. This is a sporadic case of T. marneffei in non-endemic areas, and mNGS played a very important role in the treatment of the disease. The patient's immune function was relatively normal which was rare in clinical practice.
马尔尼菲青霉（Talaromyces marneffei，T. marneffei）是一种地方性机会致病菌，以前被认为仅发生于 HIV 阳性和免疫功能受损的非 HIV 宿主。然而，免疫功能正常的患者感染马尔尼菲青霉的情况很少见报道。
我们报告了一例免疫功能正常且 HIV 阴性的患者发生严重的马尔尼菲青霉肺炎的病例，该病例通过宏基因组下一代测序（mNGS）快速确诊，并成功进行了治疗。该患者为一名 63 岁的既往健康男性，因发热 11 天、咳嗽咳痰 1 周、胸闷 4 天而入院。床边支气管镜肺泡灌洗和 mNGS 检测迅速确定了马尔尼菲青霉的感染。
患者经伏立康唑治疗后病情迅速改善，评估为免疫功能正常的非地方性马尔尼菲青霉感染的 HIV 阴性病例。这是一例罕见的非流行地区散发性马尔尼菲青霉感染病例，mNGS 在疾病治疗中发挥了非常重要的作用。患者的免疫功能相对正常，这在临床实践中较为少见。
