Pneumonia caused by Talaromyces marneffei in an epidermal growth factor receptor (EGFR) mutation-positive advanced lung adenocarcinoma patient: a case report

被引：3

作者：

Liu, Wei ^{[1
]}

Xu, Jinhe ^{[2
]}

Lin, Baoquan ^{[3
]}

Zhang, Yabin ^{[4
]}

Xie, Feilai ^{[5
]}

Zhou, Chengzhi ^{[6
]}

Lai, Guoxiang ^{[1
]}

Zhang, Lei ^{[1
]}

Yu, Zongyang ^{[1
]}

机构：

[1] Fujian Med Univ, Hosp Joint Logist Support Force 900, Fuzhou Gen Hosp,PLA, Xiamen Univ,Dongfang Hosp,Dept Resp & Crit Care M, Fuzhou, Peoples R China

[2] Fujian Med Univ, Grad Coll, Fuzhou, Peoples R China

[3] Fujian Med Univ, Xiamen Univ, Hosp Joint Logist Support Force 900,PLA, Dept Cardiothorac Surg,Dongfang Hosp,Fuzhou Gen H, Fuzhou, Peoples R China

[4] Fujian Med Univ, Xiamen Univ, Hosp Joint Logist Support Force 900, Inst Lab Med,Dongfang Hosp,Fuzhou Gen Hosp,PLA, Fuzhou, Peoples R China

[5] Fujian Med Univ, Xiamen Univ, Hosp Joint Logist Support Force 900, Pathol Dept,Fuzhou Gen Hosp,Dongfang Hosp,PLA, Fuzhou, Peoples R China

[6] Guangzhou Med Univ, Natl Clin Res Ctr Resp Dis, Guangzhou Inst Resp Hlth, State Key Lab Resp Dis,Affiliated Hosp 1, Guangzhou, Peoples R China

来源：

ANNALS OF PALLIATIVE MEDICINE | 2021年 / 10卷 / 01期

关键词：

Case report; Talaromyces marneffei (T. marneffei); human immunodeficiency virus-negative (HIV-negative); lung adenocarcinoma; PENICILLIOSIS; INFECTION;

D O I：

10.21037/apm-20-2137

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

Talaromyces marneffei (T. marneffei) is a pathogenic, thermally dimorphic fungus that can cause invasive infection and significant morbidity in immunocompromised patients, especially those with human immunodeficiency virus (HIV) or other immune defects. Currently, T. marneffei infection is understood to be not limited only to immunodeficient patients, as cases of immunocompromised patients or immunocompetent patients associated with T. marneffei infection have been increasingly reported in recent years. The exact mechanism is not yet clear. This study reports a case of an advanced lung adenocarcinoma patient with T. marneffei infection. The patient is a 59-year-old female with a 3-month history of coughing, expectoration, and progressive dyspnea. Computed tomography (CT) scans showed a mass in the left lower lung, multiple plaques and nodules in both lungs, and left pleural effusion. The patient was diagnosed with T. marneffei infection, as T. marneffei was found in both the bronchoalveolar lavage fluid (BALF) and the sputum. According to the pathology of the left lung lesion by transbronchial lung biopsy (TBLB) and contrast-enhanced brain magnetic resonance imaging (MRI), the patient was diagnosed with epidermal growth factor receptor (EGFR) mutation-positive stage IV lung adenocarcinoma (T4N3M1c). She received intravenous liposomal amphotericin B and oral itraconazole as anti-fungal treatments, meanwhile, icotinib was used as an anti-tumor treatment. Following treatment, CT re-examination showed that the mass was remarkably absorbed, and some of the lung nodules had disappeared. No relapse of T. marneffei infection was found during the follow-up. This case indicates that patients with malignant lung tumors may possibly become infected with T. marneffei. Sequential treatment of amphotericin liposome B followed by itraconazole is effective for lung cancer patients with T. marneffei infection.

引用

页码：759 / 766

页数：8

共 13 条

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