该病例报告了一名HIV阴性的中年男性患者,最初被误诊为肺结核,但最终被诊断为播散的马尔尼菲塔拉霉素(T。马内菲)通过下一代测序感染。病人出现呼吸道症状,复发性骨痛,以皮下肿块为主要症状。经过一年的抗真菌治疗,症状明显改善,但停药两周后症状复发,再次服用抗真菌药物后症状缓解。该报告强调,对于结核病感染诊断基础不足或对抗结核药物反应不佳的患者,需要使用宏基因组下一代测序(mNGS)快速评估真菌感染。此外,需要长期随访以观察播散性马尼菲感染患者的疾病复发.
This case reports a middle-aged male patient who was HIV-negative and initially misdiagnosed as pulmonary tuberculosis but was eventually diagnosed with disseminated Talaromyces marneffei (T. marneffei) infection by next-generation sequencing. The patient presented with respiratory symptoms, recurrent bone pain, and subcutaneous masses as the main symptoms. After one year of antifungal treatment, the symptoms improved obviously, but the symptoms recurred after two weeks of drug withdrawal, and the symptoms were relieved after re-administration of antifungal drugs again. This report highlights the need for the rapid evaluation of fungal infections with metagenomic next-generation sequencing (mNGS) in patients with an inadequate diagnostic basis for tuberculosis infection or a poor response to antituberculosis drugs. In addition, long-term follow-up is needed to observe disease recurrence in patients with disseminated T. marneffei infection.