Abstract
Talaromyces marneffei infection involving the trachea presents as diffuse irregular nodules that grow on the tracheal lumen and/or rarely present as concurrent severe eosinophilia. Herein, we report two patients without HIV infection whose main tracheal and/or principal bronchi were involved by T. marneffei infection, which manifested as diffuse proliferative nodules. In case 1, the infection primarily affected the main trachea, resulting in structural cartilage damage, tracheal stenosis, and tracheal absence. In case 2, there were diffuse proliferative nodules in the trachea and bronchi with marked eosinophilia. The final diagnosis was made based on a positive culture from bronchiolar lavage fluid, skin, and tracheal polyps. Case 1 was administered antifungal treatment combined with surgery, but relapse occurred during a 3-month follow-up period. Case 2 was treated by intravenous liposomal amphotericin B combined with atomized inhaled liposomal amphotericin B, and he later showed improvement; there was no relapse during the 12-month period of antifungal treatment. Importantly, atomized inhaled amphotericin B antifungal treatment for T. marneffei infection has never been previously reported.
References
Chitasombat M, Supparatpinyo K. Penicillium marneffei infection in immunocompromised host. Curr Fungal Infect Rep. 2013;7:44–50.
Kawila R, Chaiwarith R, Supparatpinyo K. Clinical and laboratory characteristics of Penicilliosis marneffei among patients with and without HIV infection in Northern Thailand: a retrospective study. BMC Infect Dis. 2013;13:464.
Qiu Y, Zhang J, Liu G, et al. A case of Penicillium marneffei infection involving the main tracheal structure. BMC Infect Dis. 2014;7(14):242.
Cao C, Liang L, Wang W, et al. Common reservoirs for Penicillium marneffei infection in humans and rodents China. Emerg Infect Dis. 2011;17(2):209–14.
Hu Y, Zhang J, Li X, et al. Penicillium marneffei infection: an emerging disease in mainland China. Mycopathologia. 2013;175(1–2):57–67.
Zhang JQ, Yang ML, Zhong XN, et al. A comparative analysis of the clinical and laboratory characteristics in disseminated Penicillium marneffei patients with and without human immunodeficiency virus infection. Chin J Tuberc Respir Dis. 2008;31(10):740–6.
Kummasook A, Cooper CR Jr, Sakamoto A, et al. Spermidine is required for morphogenesis in the human pathogenic fungus Penicillium marneffei. Fungal Genet Biol. 2013;58–59:25–32.
Furuta GT, Atkins FD, Lee NA, et al. Changing roles of eosinophils in health and disease. Ann Allergy Asthma Immunol. 2014;113(1):3–8.
Sirisanthana T, Supparatpinyo K, Perriens J, et al. Amphotericin B and itraconazole for treatment of disseminated Penicillium marneffei infection in human immunodeficiency virus-infected patients. Clin Infect Dis. 1998;26(5):1107–10.
Hoppentocht M, Hagedoorn P, Frijlink HW, et al. Developments and strategies for inhaled antibiotic drugs in tuberculosis therapy: a critical evaluation. Eur J Pharm Biopharm. 2014;86(1):23–30.
Oshima M, Soda H, Oda H, et al. A case of allergic bronchopulmonary aspergillosis caused by Aspergillus terreus. Nihon Kyobu Shikkan Gakkai Zasshi. 1997;35(12):1418–24.
Acknowledgments
The authors thank Zhenbo Feng, Professor of Pathology, Department of Pathology, First Affiliated Hospital of Guangxi Medical University.
Informed Consent
Written informed consent was obtained from each patient for the publication of this case report and any accompanying images. A copy of the written consent form was made available for the Editor of this journal to review.
Conflict of interest
The authors declare that they have no competing interests.
Author information
Authors and Affiliations
Corresponding author
Additional information
Ye Qiu and DeCheng Lu have contributed equally to this project and should be considered co-first authors.
Rights and permissions
About this article
Cite this article
Qiu, Y., Lu, D., Zhang, J. et al. Treatment of Disseminated Talaromyces marneffei with Tracheal Infection: Two Case Reports. Mycopathologia 180, 245–249 (2015). https://doi.org/10.1007/s11046-015-9891-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11046-015-9891-4