Acute Disseminated Talaromyces marneffei in An Immunocompetent Patient

• DOI: 10.1007/s11046-017-0127-7
• Publication Date: 2017-03-27T00:59:08Z
• Authors: Pingli Wang; Youfei Chen; Hao Xu; Liren Ding; Zuqun Wu; Zhijiang Xu; Kai Wang
• Keywords: Male; 0301 basic medicine; Antifungal Agents; Asia; Brain; Middle Aged; Magnetic Resonance Imaging; 3. Good health; Leukocyte Count; 03 medical and health sciences; C-Reactive Protein; Treatment Outcome; Talaromyces; Humans; Voriconazole; Thoracic Wall; Tomography, X-Ray Computed; Fungemia; Neck

Talaromyces marneffei (also called Penicilliosis Marneffei or T. marneffei) is a rare fungal disease that is prevalent mainly in Southeast Asia and commonly seen in immunocompromised hosts. It was rarely observed in immunocompetent hosts. We report a case of acute disseminated T. marneffei in an immunocompetent patient in the non-prevalent region. This patient had never visited the endemic area. The patient experienced a persistent fever. Brain CT and magnetic resonance imaging (MRI) showed a mass in the right frontal with osteolytic damage. Excessive white blood cell (WBC) count and C-reactive protein content were observed. Antibiotics including meropenem and linezolid could not play an effect, and another two hard masses appeared in his right neck and front chest wall. The aspirates from the right frontal mass and bone marrow were cultured. The final diagnose of this infection was disseminated T. marneffei. After voriconazole treatment, all symptoms improved gradually. We present this case and aim to promote more clinicians and microbiologists in the non-endemic region to recognize this rare disease.