Infection and Drug Resistance (Sep 2021)
Disseminated Coinfection by Mycobacterium fortuitum and Talaromyces marneffei in a Non-HIV Case
Abstract
Hongchun Huang,1,* Jingmin Deng,2,* Caixia Qin,1 Jianpeng Zhou,3 Minchao Duan4 1Department of Respiratory and Critical Care Medicine, Guangxi Autonomous Regional Jiangbin Hospital, Nanning, Guangxi, 530021, People’s Republic of China; 2Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530021, People’s Republic of China; 3Department of Respiratory and Critical Care Medicine, The First People’s Hospital of Nanning, Nanning, Guangxi, 530022, People’s Republic of China; 4Department of Respiratory and Critical Care Medicine, Guangxi Medical University Wuming Affiliated Hospital, Nanning, Guangxi, 530199, People’s Republic of China*These authors contributed equally to this workCorrespondence: Minchao DuanDepartment of Respiratory and Critical Care Medicine, Guangxi Medical University Wuming Affiliated Hospital, 26 Yongning Road, Wuming District, Nanning, Guangxi, 530199, People’s Republic of ChinaTel/Fax +86 15507711966Email [email protected]: Mycobacterium fortuitum is a rapidly growing non-tuberculous mycobacterium (NTM) with weak pathogenicity. Here, we present a rare case of disseminated M. fortuitum and Talaromyces marneffei coinfection in a human immunodeficiency virus (HIV) negative patient.Case Presentation: A 28-year-old female was admitted to our hospital due to 2 months of swelling of lymph nodes on the right side of her cervix, accompanied by repeated low fever for more than 1 month. Biopsy of the right cervical lymph node and endobronchial ultrasound-guided transbronchial fine needle aspiration (EBUS-TBNA) both suggested granulomatous inflammation. The bacterial culture and mycobacteria examination of the lesion as well as HIV antibody test were all negative. Disseminated T. marneffei infection was diagnosed by the quantitative polymerase chain reaction (qPCR) results from the blood showing 1798 copies/ul. In the meantime, treatment with amphotericin B combined with cefoxitin was administered for suspected NTM infection. However, the once-dropped fever recurred and the lymph nodes continued to swell. Metagenomics next-generation sequencing (mNGS) detection of the lymph nodes indicated M. fortuitum. After combination treatment with amphotericin B, voriconazole, linazolamide, and imipenem, the patient’s body temperature returned to normal, the lymph node swelling was gradually reduced, and the lung lesion was absorbed.Conclusion: We report the first case of an HIV-negative patient diagnosed with disseminated M. fortuitum and T. marneffei coinfection with nonspecific clinical manifestation, in order to heighten awareness of these infections.Keywords: Mycobacterium fortuitum, Talaromyces marneffei, coinfection, non-HIV
