Keywords
HIV-negative
Misdiagnosis
Anti-gamma interferon
MALDI-TOF
Submitted : 2023-11-26
Accepted : 2023-12-11
Published : 2023-12-26
Abstract
Talaromycosis is the most common opportunistic fungal infection in AIDS (acquired immunodeficiency syndrome) patients and its causative agent, Talaromyces marneffei, is endemic in Southeast Asia and southern China. However, in recent years, there has been an increasing number of reports of Talaromyces marneffei infection in nonendemic areas around the world, and incidences of infection in HIV (human immunodeficiency virus)-negative patients have also seen an upward trend. Mycobacterium tuberculosis, which causes human tuberculosis, not only invades the lungs but can travel with cells and lymph, and subsequently invade the whole body. Tuberculosis and Talaromyces marneffei share similar clinical manifestations, making them prone to being overlooked or misdiagnosed. This article reports a case of an HIV-negative patient who was repeatedly misdiagnosed with cervical lymph node tuberculosis and pulmonary tuberculosis. The symptoms did not improve after several months of treatment. After a series of diagnostic methods such as matrix-assisted laser desorption ionization time-of-flight (MALDI-TOF) mass spectrometry, galactomannan (GM) test, fungal microscopy, and fungal culture, the patient was finally diagnosed with Talaromyces marneffei infection. This case report is intended to serve as a reference for clinicians to reduce missed diagnoses and misdiagnoses.
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