Gastrointestinal Talaromyces marneffei infection in a patient with AIDS: A case report and systematic review.
Gastrointestinal Talaromyces marneffei infection in a patient with AIDS: A case report and systematic review.
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DOI：
10.3389/fimmu.2022.980242
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发表时间：
2022
影响因子：
7.3
通讯作者：
中科院分区：
文献类型：
--
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马尔尼菲篮状菌是一种热二型真菌，影响多个器官，并经常侵入免疫功能低下的个体。然而，只有少数研究报道了与T。马尔尼菲酒。本文报告1例肠T细胞癌。马尔尼菲感染的一名男子谁抱怨了1个月的历史间歇性发热，腹痛，腹泻。人类免疫缺陷病毒抗体检测结果为阳性。小肠活检组织的过碘酸-希夫和Gomorrah's甲胺银染色显示T。马尔尼菲感染。幸运的是，病人的症状迅速解决及时抗真菌治疗。此外，我们总结并描述了肠T细胞瘤患者的临床特征、治疗和结局。马尔尼菲感染。共确定29例患者，其中大多数（65.52%）与获得性免疫缺陷综合征共病。主要临床表现为贫血、发热、腹痛、腹泻、体重减轻和淋巴结肿大。病变部位以横结肠、降结肠、回盲部和升结肠最常见。相当一部分患者（31.03%）出现肠梗阻、肠穿孔和消化道出血。29例患者中，6例行手术治疗，23例经抗真菌治疗后存活，5例死于T。马尔尼菲感染，一人死因不明。T.当流行地区的免疫缺陷患者出现非特异性症状，如发热、腹痛和腹泻时，应考虑马尔尼菲肠道感染。适当和及时的内镜检查可避免延误诊断。早期积极的抗真菌治疗可改善患者的临床结局。
Talaromyces marneffei is a thermally dimorphic fungus that affects multiple organs and frequently invades immunocompromised individuals. However, only a few studies have reported the presence of intestinal infection associated with T. marneffei. Herein, we reported a case of intestinal T. marneffei infection in a man who complained of a 1-month history of intermittent fever, abdominal pain, and diarrhea. The result of the human immunodeficiency virus antibody test was positive. Periodic acid-Schiff and Gomorrah’s methylamine silver staining of the intestinal biopsy tissue revealed T. marneffei infection. Fortunately, the patient’s symptoms rapidly resolved with prompt antifungal treatment. In addition, we summarized and described the clinical characteristics, management, and outcomes of patients with intestinal T. marneffei infection. A total of 29 patients were identified, the majority of whom (65.52%) were comorbid with acquired immunodeficiency syndrome. The main clinical features included anemia, fever, abdominal pain, diarrhea, weight loss, and lymphadenopathy. The transverse and descending colon, ileocecum, and ascending colon were the most common sites of lesions. A considerable number of patients (31.03%) developed intestinal obstruction, intestinal perforation, and gastrointestinal bleeding. Of the 29 patients, six underwent surgery, 23 survived successfully with antifungal treatment, five died of T. marneffei infection, and one died of unknown causes. T. marneffei intestinal infection should be considered when immunodeficient patients in endemic areas present with non-specific symptoms, such as fever, abdominal pain, and diarrhea. Appropriate and timely endoscopy avoids delays in diagnosis. Early aggressive antifungal therapy improves the clinical outcomes of patients.
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