Infection and Drug Resistance (Mar 2021)

The Presence of Secondary Evans Syndrome in AIDS Patients with Talaromyces marneffei Infection

  • Wang M,
  • Zhang Z,
  • Yan J,
  • Shi J,
  • Liu S,
  • Wan H

Journal volume & issue
Vol. Volume 14
pp. 1265 – 1271


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Mengyan Wang, Zhongdong Zhang, Jun Yan, Jinchuan Shi, Shourong Liu, Hu Wan Department II of Infectious Diseases, Xixi Hospital of Hangzhou, Hangzhou Sixth People’s Hospital, Hangzhou, 310023, People’s Republic of ChinaCorrespondence: Hu Wan; Shourong LiuXixi Hospital of Hangzhou, Hangzhou Sixth People’s Hospital, Hangzhou, 310023, People’s Republic of ChinaTel +13588710040Email [email protected]; [email protected]: Talaromyces marneffei (T.M) is a common opportunistic fungus in human immunodeficiency virus (HIV) infection individual. Secondary Evans syndrome in AIDS patients with Talaromyces marneffei infection has not been reported before. Here, we described cases related to this comorbidity.Methods: AIDS patients diagnosed with Talaromyces marneffei infection from 2016 to 2020 at Xixi Hospital of Hangzhou were included in this retrospective study.Results: Total 76 AIDS patients with T.M infection were enrolled. The most common symptoms were fever and cough (70/76; 55/76, respectively). 53/76 (69.74%) patients got positive results of direct antiglobulin test. 14/76 AIDS-T.M patients combined with secondary Hemophagocytic lymphohistiocytosis (HLH). Five patients were diagnosed with AIDS-T.M associated Evans syndrome. There were severe inflammatory reaction, liver dysfunction, coagulation dysfunction and immunodeficiency status in AIDS-T.M patients with secondary Evans syndrome. All patients received antifungal therapy and three patients received corticosteroids for Evans syndrome treatment. One patient died due to sepsis.Conclusion: AIDS-T.M patients with secondary Evans syndrome is extremely rare and we need to be alert to the occurrence of secondary Evans syndrome in AIDS-T.M patients. Clinicians should timely start effective antifungal treatments with suspicious T.M infection in AIDS patients.Keywords: Talaromyces marneffei, Evans syndrome, human immunodeficiency virus, clinical characteristics