PDF(Pubmed)
Abstract：
UNASSIGNED: Talaromycosis is a serious opportunistic infectious disease caused by Talaromyces marneffei, which mostly occurs in immunocompromised patients. The disease is mainly prevalent in tropical countries and regions of Southeast Asia and South Asia, but non-endemic areas also have patients with Talaromycosis. The disease has no characteristic clinical manifestations and is difficult to diagnose. Delayed diagnosis often leads to death.
UNASSIGNED: Both patients had cellular immunodeficiency. Case 1 had a history of acquired immune deficiency syndrome, and case 2 had a history of renal transplantation and glucose-6-phosphate dehydrogenase deficiency. They all had fever, anemia, fatigue, and skin lesions. Case 1 had gastrointestinal bleeding, enlarged lymph nodes, and hepatosplenomegaly. Case 2 had cough and dyspnea. Both patients had thrombocytopenia and hypoalbuminemia; an increased neutrophil ratio, procalcitonin, and C-reactive protein; and abnormal liver function and coagulation dysfunction. Case 1 sputum culture, blood culture, and bronchoalveolar lavage fluid were positive for T. marneffei. T. marneffei was detected in the blood culture of case 2, with infection of Candida parapsilosis and Pneumocystis jirovecii. Chest computed tomography scan mainly showed pulmonary exudative lesions. Although these two patients were actively treated, they died of poor efficacy.
UNASSIGNED: Talaromycosis has an insidious onset, long course, atypical clinical symptoms, imaging performance and laboratory results, difficult diagnosis, and high mortality. Therefore, it is important to promptly consider and treat Talaromycosis in immunocompromised patients upon infection in order to reduce mortality.
UNASSIGNED: Both patients had cellular immunodeficiency. Case 1 had a history of acquired immune deficiency syndrome, and case 2 had a history of renal transplantation and glucose-6-phosphate dehydrogenase deficiency. They all had fever, anemia, fatigue, and skin lesions. Case 1 had gastrointestinal bleeding, enlarged lymph nodes, and hepatosplenomegaly. Case 2 had cough and dyspnea. Both patients had thrombocytopenia and hypoalbuminemia; an increased neutrophil ratio, procalcitonin, and C-reactive protein; and abnormal liver function and coagulation dysfunction. Case 1 sputum culture, blood culture, and bronchoalveolar lavage fluid were positive for T. marneffei. T. marneffei was detected in the blood culture of case 2, with infection of Candida parapsilosis and Pneumocystis jirovecii. Chest computed tomography scan mainly showed pulmonary exudative lesions. Although these two patients were actively treated, they died of poor efficacy.
UNASSIGNED: Talaromycosis has an insidious onset, long course, atypical clinical symptoms, imaging performance and laboratory results, difficult diagnosis, and high mortality. Therefore, it is important to promptly consider and treat Talaromycosis in immunocompromised patients upon infection in order to reduce mortality.
摘要：
■塔拉真菌病是由马尔尼菲塔拉真菌病引起的一种严重的机会性传染病，主要发生在免疫功能低下的患者。该病主要流行于东南亚和南亚的热带国家和地区,但非流行地区也有塔拉真菌病患者。本病无特征性临床表现，诊断困难。延迟诊断通常会导致死亡。
■两名患者均有细胞免疫缺陷。病例1有获得性免疫缺陷综合征病史，病例2有肾移植史和葡萄糖-6-磷酸脱氢酶缺乏症。他们都发烧了,贫血,疲劳,和皮肤损伤。病例1有消化道出血,淋巴结肿大,和肝脾肿大.病例2有咳嗽和呼吸困难。两名患者均有血小板减少症和低白蛋白血症；中性粒细胞比率增加，降钙素原,和C反应蛋白；肝功能异常和凝血功能障碍。病例1痰培养,血培养,支气管肺泡灌洗液为马尔尼菲氏杆菌阳性。在病例2的血液培养中检测到马尔尼菲T.Marneffei，并感染了近叶念珠菌和肺孢子虫。胸部CT扫描主要表现为肺渗出性病变。尽管这两名患者得到了积极的治疗，他们死于疗效不佳。
■塔拉真菌病发病隐匿,漫长的课程，不典型的临床症状，成像性能和实验室结果，诊断困难,和高死亡率。因此,重要的是要及时考虑和治疗感染后免疫功能低下患者的塔拉真菌病，以降低死亡率。
■两名患者均有细胞免疫缺陷。病例1有获得性免疫缺陷综合征病史，病例2有肾移植史和葡萄糖-6-磷酸脱氢酶缺乏症。他们都发烧了,贫血,疲劳,和皮肤损伤。病例1有消化道出血,淋巴结肿大,和肝脾肿大.病例2有咳嗽和呼吸困难。两名患者均有血小板减少症和低白蛋白血症；中性粒细胞比率增加，降钙素原,和C反应蛋白；肝功能异常和凝血功能障碍。病例1痰培养,血培养,支气管肺泡灌洗液为马尔尼菲氏杆菌阳性。在病例2的血液培养中检测到马尔尼菲T.Marneffei，并感染了近叶念珠菌和肺孢子虫。胸部CT扫描主要表现为肺渗出性病变。尽管这两名患者得到了积极的治疗，他们死于疗效不佳。
■塔拉真菌病发病隐匿,漫长的课程，不典型的临床症状，成像性能和实验室结果，诊断困难,和高死亡率。因此,重要的是要及时考虑和治疗感染后免疫功能低下患者的塔拉真菌病，以降低死亡率。
