Clinical characteristics of 14 cases of HIV negative Talaromyces marneffei infection

LIU Jinzhu; RENG Dongcheng; ZHANG Xiaonan

doi:10.3969/j.issn.1007-8134.2024.05.009

Abstract：Objective To analyze the clinical characteristics of HIV negative patients with Marneffei basket disease and improve their understanding of the disease.Methods A total of 14 cases of HIV negative Marneffe's disease admitted to the Third People's Hospital of Shenzhen from January 2016 to January 2022 were analyzed and summarized.The clinical characteristics of HIV negative Marneffe's disease patients were analyzed and summarized.Results The majority of HIV negative patients with Marneffei basket form bacteria with an age of(46.71±18.93)years.Diagnosis methods:bl ood culture in 2 cases,sputum culture in 4 cases,pus or tissue culture of lesions in 3 cases,and metagenomic second-generation sequencing technology in 5 cases.The median time from onset to definitive diagnosis in patients is 30 days,with a diagnosis median time of 180 days for patients with bone destruction.Main clinical features:10 cases of fever,10 cases of pulmonary infection,7 cases of cough and phlegm,10 cases of anemia,7 cases of emaciation,5 cases of inflammatory papules or ulcers and other skin lesions,4 cases of hepatosplenomegaly,2 cases of mycosis,and 3 cases of bone destruction.Two patients were misdiagnosed as bone tuberculosis,and five patients were misdiagnosed as pulmonary tuberculosis and received anti tuberculosis treatment,with a misdiagnosis rate of 50%.After antifungal treatment,3 patients died.Conclusions There is no significant specificity in the clinical manifestations of HIV negative and HIV positive Marneffe's disease patients.The incidence of hepatosplenomegaly and mycosis is relatively low,and patients without underlying diseases are prone to bone destruction,which can lead to misdiagnosis or delayed diagnosis.The second-generation sequencing technology of metagenes can serve as an important tool for auxiliary diagnosis.