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CASE REPORT

HIV-Negative Case of Talaromyces marneffei Pulmonary Infection with Liver Cirrhosis in China: A Case Report and Literature Review

ORCID Icon, , , , , , , & show all
Pages 1333-1343 | Received 09 Dec 2023, Accepted 19 Mar 2024, Published online: 04 Apr 2024

Figures & data

Table 1 Laboratory Findings at the First Presentation

Figure 1 Chest CT image. (A) A mixed ground glass (4.2*3.7 cm) in the posterior segment of the upper lobe of the right lung on admission (2023-2-28). (B) After effective antifungal therapy, the mixed ground glass opacity (2.5*1.4 cm) in the posterior segment of the upper lobe of the right lung was reduced on March 14, 2023. (C) After effective antifungal therapy, the nodule (11*7 mm) in the posterior segment of the upper lobe of the right lung continued to reduce on April 7, 2023. (D) The nodule (approximately 8 mm) in the posterior segment of the upper lobe of the right lung continued to reduce on April 22, 2023.

Figure 1 Chest CT image. (A) A mixed ground glass (4.2*3.7 cm) in the posterior segment of the upper lobe of the right lung on admission (2023-2-28). (B) After effective antifungal therapy, the mixed ground glass opacity (2.5*1.4 cm) in the posterior segment of the upper lobe of the right lung was reduced on March 14, 2023. (C) After effective antifungal therapy, the nodule (11*7 mm) in the posterior segment of the upper lobe of the right lung continued to reduce on April 7, 2023. (D) The nodule (approximately 8 mm) in the posterior segment of the upper lobe of the right lung continued to reduce on April 22, 2023.

Figure 2 Confirmation of TM specific amplification from lung tissue by NGS. (A) The reads mapped to TM derived from NGS data. A total of 51 reads were mapped to TM in the reference database, which contains approximately 2764 pathogen genomes and has a total coverage of 0.0127%. (B) The distribution of microbe sequences (N = 2764 reads) identified in patient plasma, including TM (N = 51; 1.85%), human gammaherpesvirus 4, Pseudomonas sp.R9.37 and others.

Figure 2 Confirmation of TM specific amplification from lung tissue by NGS. (A) The reads mapped to TM derived from NGS data. A total of 51 reads were mapped to TM in the reference database, which contains approximately 2764 pathogen genomes and has a total coverage of 0.0127%. (B) The distribution of microbe sequences (N = 2764 reads) identified in patient plasma, including TM (N = 51; 1.85%), human gammaherpesvirus 4, Pseudomonas sp.R9.37 and others.

Figure 3 Timeline of the patient with relevant data on the episodes and interventions.

Abbreviations: PVT portal vein thrombosis, LMWH low molecular weight heparin, TMF amitinofovir, NGS next generation sequencing, TM Talaromyces marneffei, Cr creatinine, AMPB amphotericin B liposomes, VRC voriconazole.
Figure 3 Timeline of the patient with relevant data on the episodes and interventions.

Figure 4 Gastroscopy: gastroesophageal varices (severe), portal hypertensive gastropathy.

Figure 4 Gastroscopy: gastroesophageal varices (severe), portal hypertensive gastropathy.

Table 2 Summary of HIV-Negative Adults with TM Infection