Department of Dermatology, Shanghai Key Laboratory of Medical Mycology; The Center for Basic Research and Innovation of Medicine and Pharmacy (MOE), Shanghai Changzheng Hospital, Naval Medical University, Shanghai 200003, China.
Department of Dermatology, Linping District Traditional Chinese Medicine Hospital, Hangzhou 311103, China.
Med Mycol. 2024 Oct 4;62(10). doi: 10.1093/mmy/myae094.
Talaromyces marneffei (T. marneffei) stands out as the sole thermobiphasic fungus pathogenic to mammals, including humans, within the fungal community encompassing Ascomycota, Eurotium, Eurotiumles, Fungiaceae, and Cyanobacteria. Thriving as a saprophytic fungus in its natural habitat, it transitions into a pathogenic yeast phase at the mammalian physiological temperature of 37°C. Historically, talaromycosis has been predominantly associated with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), classified among the three primary opportunistic infections linked with AIDS, alongside tuberculosis and cryptococcosis. As advancements are made in HIV/AIDS treatment and control measures, the incidence of talaromycosis co-infection with HIV is declining annually, whereas the population of non-HIV-infected talaromycosis patients is steadily increasing. These patients exhibit diverse risk factors such as various types of immunodeficiency, malignant tumors, autoimmune diseases, and organ transplantation, among others. Yet, a limited number of retrospective studies have centered on the clinical characteristics and risk factors of HIV-negative talaromycosis patients, especially in children and patients with hematological malignancies, resulting in an inadequate understanding of this patient cohort. Consequently, we conducted a comprehensive review encompassing the epidemiology, pathogenesis, risk factors, clinical manifestations, diagnosis, treatment, and prognosis of HIV-negative talaromycosis patients, concluding with a prospectus of the disease's frontier research direction. The aim is to enhance comprehension, leading to advancements in the diagnosis and treatment rates for these patients, ultimately improving their prognosis.
马尔尼菲青霉（T. marneffei）是子囊菌门、曲霉目、青霉科、青霉属、蓝细菌中唯一一种对哺乳动物（包括人类）致病的嗜热双相真菌。它在其自然栖息地中作为腐生菌生长，在哺乳动物的生理温度 37°C 下转变为致病酵母相。历史上，马尔尼菲青霉病主要与人类免疫缺陷病毒（HIV）/获得性免疫缺陷综合征（AIDS）相关，是与 AIDS 相关的三种主要机会性感染之一，与结核病和隐球菌病并列。随着 HIV/AIDS 治疗和控制措施的进步，HIV 合并马尔尼菲青霉病的发病率逐年下降，而非 HIV 感染的马尔尼菲青霉病患者的数量却在稳步增加。这些患者具有多种不同的危险因素，如各种类型的免疫缺陷、恶性肿瘤、自身免疫性疾病和器官移植等。然而，针对非 HIV 感染的马尔尼菲青霉病患者的临床特征和危险因素的回顾性研究数量有限，特别是在儿童和血液恶性肿瘤患者中，因此对这一患者群体的认识不足。因此，我们对非 HIV 感染的马尔尼菲青霉病患者的流行病学、发病机制、危险因素、临床表现、诊断、治疗和预后进行了全面综述，并对该疾病的前沿研究方向进行了展望。目的是提高认识，提高这些患者的诊断和治疗率，最终改善他们的预后。
