Talaromyces marneffei infection in an HIV infected patient with hematological malignancy - first report from Turkey

Talaromyces marneffei infection in an HIV infected patient with hematological malignancy - first report from Turkey

T.marneffei, encountered mostly in Southeast Asia, leads to a systemic infection, especially in immunocompromised individuals such as HIV-infected patients with low CD4 level. A 32-year-old male patient, residing in Hong Kong for the last two years, admitted with fever, cough, weakness, and weight l...

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Published in:The New microbiologica Vol. 46; no. 3; pp. 311 - 314
Main Authors: Kurt, Ahmet Furkan, Cicek, Ebru, Alhelou, Tamer Am, Mete, Bilgul, Karaali, Ridvan, Kuskucu, Mert Ahmet, Yazgan, Zeynep, Arsu, Hatice Yasar, Kaya, Sibel Yıldız, Aygun, Gokhan, Tabak, Fehmi
Format: Journal Article
Language:English
Published: Pavia Edizioni Medico Scientifiche 01-07-2023
Subjects:
Antibiotics
Antiretroviral agents
Antiretroviral therapy
CD4 antigen
Chemotherapy
Cough
Disseminated infection
Fever
Fungemia
Fungicides
HIV
Human immunodeficiency virus
Hyphae
Infections
Lymph nodes
Lymphoma
Malignancy
Red pigments
Sequence analysis
Weight loss
Turkey
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Summary:T.marneffei, encountered mostly in Southeast Asia, leads to a systemic infection, especially in immunocompromised individuals such as HIV-infected patients with low CD4 level. A 32-year-old male patient, residing in Hong Kong for the last two years, admitted with fever, cough, weakness, and weight loss. Physical examination revealed bilateral cervical and axillary multiple lymph nodes and hepatosplenomegaly. Screening of the pancytopenic patient revealed HIV infection. Histopathological examination of the cervical lymph node revealed plasmoblastic lymphoma. Blood and urine cultures remained sterile. Antiretroviral therapy was started. Fungal hyphae were detected in Gram staining of hemocultures taken in the third week due to ongoing fever, and antifungal therapy was started empirically. Red pigment around colonies on Sabouraud dextrose agar and microscopic appearance arose suspicion of Talaromyces spp. T.marneffei was identified by ITS 1-4 sequence analysis. Chemotherapy was started when fungemia was controlled. On the fifth day of chemotherapy, the patient's general condition deteriorated, broad-spectrum antibiotics were started and the patient was transferred to ICU. The cultures remained sterile and he expired five days later. In conclusion, although talaromycosis is not endemic in Turkey, it should be considered in patients with travel history to endemic regions and/or an underlying immunosuppressive disease such as HIV infection.
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ISSN:1121-7138