A Case Report of Talaromyces marneffei Infection Repeatedly Misdiagnosed as Tuberculosis in an HIV-Negative Patient

Kaisu Pan, Gaoling Zhao, Wenjie Fang, Chunquan Sheng, Qingjie Zhao, Yongsheng He, Amanda Juan Chen, Wanqing Liao, Dongyan Zheng, Keya Cai, Weihua Pan, Cunwei Cao

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¹ Department of Dermatology and Venereology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530022, Guangxi Zhuang Autonomous Region, China,

² Autobio Diagnostics Co., Ltd., Zhengzhou 450016, Henan Province, China,

³ Department of Dermatology, Shanghai Key Laboratory of Medical Mycology, Changzheng Hospital, Naval Medical University, Shanghai 200003, China,

⁴ School of Pharmacy, Second Military Medical University, Shanghai 200433, China,

⁵ Organic Chemistry Group, College of Pharmacy, Naval Medical University, Shanghai 200433, China,

⁶ Tianjin Era Biology Technology Co., Ltd., Tianjin 300457, China,

⁷ Microbiome Research Center, Moon (Guangzhou) Biotech Ltd., Guangzhou 510535, China,

⁸ Department of Dermatology, Shanghai Key Laboratory of Medical Mycology, Changzheng Hospital, Naval Medical University, Shanghai 200003, China,

⁹ Fangchenggang Wanqing Institute of Mycosis Prevention and Control, Fangchenggang 538000, China,

¹⁰ Autobio Diagnostics Co., Ltd., Zhengzhou 450016, Henan Province, China,

¹¹ Department of Dermatology, Shanghai Key Laboratory of Medical Mycology, Changzheng Hospital, Naval Medical University, Shanghai 200003, China,

¹² Department of Dermatology and Venereology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530022, Guangxi Zhuang Autonomous Region, China,

DH 2023 , 1(3), 9–16; https://doi.org/10.26689/dh.v1i3.5852

© 2023 by the Authors. Licensee Whioce Publishing, Singapore. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )

Abstract

Talaromycosis is the most common opportunistic fungal infection in AIDS (acquired immunodeficiency syndrome) patients and its causative agent, Talaromyces marneffei, is endemic in Southeast Asia and southern China. However, in recent years, there has been an increasing number of reports of Talaromyces marneffei infection in nonendemic areas around the world, and incidences of infection in HIV (human immunodeficiency virus)-negative patients have also seen an upward trend. Mycobacterium tuberculosis, which causes human tuberculosis, not only invades the lungs but can travel with cells and lymph, and subsequently invade the whole body. Tuberculosis and Talaromyces marneffei share similar clinical manifestations, making them prone to being overlooked or misdiagnosed. This article reports a case of an HIV-negative patient who was repeatedly misdiagnosed with cervical lymph node tuberculosis and pulmonary tuberculosis. The symptoms did not improve after several months of treatment. After a series of diagnostic methods such as matrix-assisted laser desorption ionization time-of-flight (MALDI-TOF) mass spectrometry, galactomannan (GM) test, fungal microscopy, and fungal culture, the patient was finally diagnosed with Talaromyces marneffei infection. This case report is intended to serve as a reference for clinicians to reduce missed diagnoses and misdiagnoses.

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