Fatal Talaromyces marneffei Infection in a Patient with Autoimmune Hepatitis
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Talaromyces marneffei, previously known as Penicillium marneffei, is the most important pathogenic thermally dimorphic fungus causing systemic mycosis in Southeast Asia. Traditionally, T. marneffei infection in human was mainly associated with acquired immunodeficiency syndrome caused by HIV infection. In recent years, there has been an increasing number of T. marneffei infections reported in non-HIV-infected patients with other immunocompromised conditions, including autoantibodies against interferon-gamma, systemic lupus erythematosis, solid organ transplantation, Job’s syndrome, hematological malignancies, and use of novel targeted therapies. In this article, we describe the first case of fatal T. marneffei infection in a patient with underlying autoimmune hepatitis, presented as fever without localizing features. The diagnosis of talaromycosis was confirmed with the identification of the fungi isolated from the blood culture specimen by conventional methods and using matrix-assisted laser desorption–ionization time-of-flight mass spectrometer. This case shows the importance of a high index of suspicion, particularly for such a highly fatal but potentially treatable fungal infection.
KeywordsTalaromyces marneffei Fatal infection Autoimmune hepatitis Matrix-assisted laser desorption–ionization time-of-flight mass spectrometer
This work was partly supported by the Health and Medical Research Fund [No. HKM-15-M07 (commissioned project)], Food and Health Bureau, Government of the Hong Kong Special Administrative Region, Hong Kong, and the Strategic Research Theme Fund of The University of Hong Kong.
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Conflict of interest
The authors declare that they have no conflict of interest.
- 4.Capponi M, Segretain G, Sureau P. Penicillosis from Rhizomys sinensis. Bull Soc Pathol Exot. 1956;49:418–21.Google Scholar
- 11.Chan JF, Chan TS, Gill H, Lam FY, Trendell-Smith NJ, Sridhar S, Tse H, Lau SK, Hung IF, Yuen KY, Woo PC. Disseminated infections with Talaromyces marneffei in non-AIDS patients given monoclonal antibodies against CD20 and kinase inhibitors. Emerg Infect Dis. 2015;21(7):1101–6.CrossRefPubMedPubMedCentralGoogle Scholar
- 17.Lau SK, Lam CS, Ngan AH, Chow WN, Wu AK, Tsang DN, Tse CW, Que TL, Tang BS, Woo PC. Matrix-assisted laser desorption ionization time-of-flight mass spectrometry for rapid identification of mold and yeast cultures of Penicillium marneffei. BMC Microbiol. 2016;16(1):36.CrossRefPubMedPubMedCentralGoogle Scholar
- 18.Le T, Wolbers M, Chi NH, Quang VM, Chinh NT, Lan NP, Lam PS, Kozal MJ, Shikuma CM, Day JN, Farrar J. Epidemiology, seasonality, and predictors of outcome of AIDS-associated Penicillium marneffei infection in Ho Chi Minh City, Viet Nam. Clin Infect Dis. 2011;52(7):945–52.CrossRefPubMedPubMedCentralGoogle Scholar