AIDS-Associated Talaromyces marneffei Infection with Thoracic Spinal Cord Involvement Leading to Paraplegia: A Case Report and Literature Review

被引:0
作者
Guo, Yongzheng [1 ]
Song, Ying [2 ,3 ]
Peng, Xiaorong [1 ]
Zhou, Xiaotang [1 ]
Zhou, Hengjun [4 ]
Xu, Lijun [1 ]
Zhu, Biao [1 ]
机构
[1] Zhejiang Univ, State Key Lab Diag & Treatment Infect Dis, Natl Clin Res Ctr Infect Dis, Affiliated Hosp 1,Collaborat Innovat Ctr Diag & Tr, Hangzhou, Zhejiang, Peoples R China
[2] Southern Univ Sci & Technol, Peoples Hosp Shenzhen 3, Dept Infect Dis, Shenzhen, Guangdong, Peoples R China
[3] Southern Univ Sci & Technol, Affiliated Hosp 2, Shenzhen, Guangdong, Peoples R China
[4] Zhejiang Univ, Affiliated Hosp 1, Sch Med, Dept Neurosurg, Hangzhou, Zhejiang, Peoples R China
来源
INFECTION AND DRUG RESISTANCE | 2025年 / 18卷
关键词
Talaromyces marneffei; HIV; fungi; abscess; spinal cord; CENTRAL-NERVOUS-SYSTEM; FUNGAL-INFECTIONS; DIAGNOSIS; LYMPHOMA;
D O I
10.2147/IDR.S495568
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Background: Talaromyces marneffei is a common opportunistic infection in patients with acquired immune deficiency syndrome (AIDS) in South China. Spinal cord abscesses caused by T. marneffei are exceptionally rare and present with non-specific symptoms, which may result in delayed diagnosis and heightened adverse prognoses. Case Presentation: We report a case of a spinal cord abscess in a 30-year-old patient with AIDS that was caused by T. marneffei infection. The patient initially presented with T. marneffei septicemia and pleurisy. After initial antifungal treatment and combined antiretroviral therapy (cART), the patient's condition temporarily improved. However, he discontinued the antifungal treatment against medical advice and subsequently developed paraplegia, T. marneffei meningitis, and related intracranial and thoracic spinal cord lesions. Neurosurgical resection of the spinal cord lesion, combined with continued cART and antifungal treatment, resulted in the intracranial mass in the cerebellum resolving on MRI, but the patient remained non-ambulatory and incontinent during the last followup in August 2024. Conclusion: In patients with spinal cord abscesses and a history of disseminated T. marneffei infection, especially those with AIDS, talaromycosis should be considered as a potential differential diagnosis. Comprehensive management, encompassing adherence to treatment plans and effective follow-up, is crucial for improving prognosis.
引用
收藏
页码:1263 / 1269
页数:7
相关论文
共 22 条
  • [1] Fungal priority pathogens list to guide research, development, and public health action, (2022)
  • [2] Jiang J, Meng S, Huang S, Et al., Effects of Talaromyces marneffei infection on mortality of HIV/AIDS patients in southern China: a retrospective cohort study, Clin Microbiol Infect, 25, 2, pp. 233-241, (2019)
  • [3] Le T, Wolbers M, Chi NH, Et al., Epidemiology, seasonality, and predictors of outcome of AIDS-associated Penicillium marneffei infection in Ho Chi Minh City, Viet Nam Clin Infect Dis, 52, 7, pp. 945-952, (2011)
  • [4] Limper AH, Adenis A, Le T, Et al., Fungal infections in HIV/AIDS, Lancet Infect Dis, 17, 11, pp. e334-e43, (2017)
  • [5] Lino R, Guimaraes AR, Sousa E, Et al., Emerging fungal infections of the central nervous system in the past decade: a literature review, Infect Dis Rep, 16, 5, pp. 952-976, (2024)
  • [6] Zhu YM, Ai JW, Xu B, Et al., Rapid and precise diagnosis of disseminated T. marneffei infection assisted by high-throughput sequencing of multifarious specimens in a HIV-negative patient: a case report, BMC Infect Dis, 18, 1, (2018)
  • [7] Le T, Huu Chi N, Kim Cuc NT, Et al., AIDS-associated Penicillium marneffei infection of the central nervous system, Clin Infect Dis, 51, 12, pp. 1458-1462, (2010)
  • [8] Li YY, Dong RJ, Shrestha S, Et al., AIDS-associated Talaromyces marneffei central nervous system infection in patients of southwestern China, AIDS Res Ther, 17, 1, (2020)
  • [9] Wang Y, Mo X, Zhang J, Et al., Clinical features of Talaromyces marneffei infection in HIV-positive and HIV-negative individuals: a retrospective study in southern China, Med Mycol, 61, 8, (2023)
  • [10] Hu Y, Zhang J, Li X, Et al., Penicillium marneffei infection: an emerging disease in mainland China, Mycopathologia, 175, 1–2, pp. 57-67, (2013)