A case of Talaromyces marneffei infection that required differentiation from Pneumocystis pneumonia
Mieko Tokano,
Norihito Tarumoto,
Kazuo Imai,
Jun Sakai,
Masahiro Kodana,
Erika Naito,
Yoshitaka Uchida,
Makoto Nagata,
Shigefumi Maesaki
Affiliations
Mieko Tokano
Department of Infectious Disease and Infection Control, Saitama Medical University, 38 Morohongo, Moroyamamachi, Irumagun, Saitama 350-0495, Japan; Departments of Allergy and Immunology, Faculty of Medicine, Saitama Medical University, 38 Morohongo, Moroyamamachi, Irumagun, Saitama 350-0495, Japan
Norihito Tarumoto
Department of Infectious Disease and Infection Control, Saitama Medical University, 38 Morohongo, Moroyamamachi, Irumagun, Saitama 350-0495, Japan
Kazuo Imai
Department of Infectious Disease and Infection Control, Saitama Medical University, 38 Morohongo, Moroyamamachi, Irumagun, Saitama 350-0495, Japan
Jun Sakai
Department of Infectious Disease and Infection Control, Saitama Medical University, 38 Morohongo, Moroyamamachi, Irumagun, Saitama 350-0495, Japan
Masahiro Kodana
Department of Clinical Laboratory, Saitama Medical University, 38 Morohongo, Moroyamamachi, Irumagun, Saitama 350-0495, Japan
Erika Naito
Department of Respiratory Medicine, Saitama Medical University, 38 Morohongo, Moroyamamachi, Irumagun, Saitama 350-0495, Japan
Yoshitaka Uchida
Department of Respiratory Medicine, Saitama Medical University, 38 Morohongo, Moroyamamachi, Irumagun, Saitama 350-0495, Japan
Makoto Nagata
Department of Respiratory Medicine, Saitama Medical University, 38 Morohongo, Moroyamamachi, Irumagun, Saitama 350-0495, Japan
Shigefumi Maesaki
Department of Infectious Disease and Infection Control, Saitama Medical University, 38 Morohongo, Moroyamamachi, Irumagun, Saitama 350-0495, Japan; Corresponding author.
We report a case of Talaromyces marneffei fungemia in a patient with HIV infection with a history of travelling to southern China. At first, Pneumocystis pneumonia was considered in this case because chest CT images showed typical ground-glass opacity and elevated β-D-glucan levels. However, PCR testing of sputum for Pneumocystis jirovecii was negative and a filamentous fungus was isolated from blood cultures. The cultured fungus was subsequently identified as T. marneffei, and the patient was considered to have pneumonia caused by this organism. However, skin disease and lymphadenopathy, which are common in T. marneffei infections, were not observed during the disease course. This patient was successfully treated with voriconazole and consequently the chest CT shadow disappeared. In the present case, T. marneffei infection required differentiation from pneumonia with Pneumocystis jirovecii infection.
