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Disseminated Talaromyces marneffei infection presenting as multiple intestinal perforations and diffuse hepatic granulomatous inflammation in an infant with STAT3 mutation: a case report.
Pan, Mianluan; Qiu, Ye; Zeng, Wen; Tang, Shudan; Wei, Xuan; Zhang, Jianquan.
Afiliação
  • Pan M; Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China.
  • Qiu Y; Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China.
  • Zeng W; Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China.
  • Tang S; Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China.
  • Wei X; Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China.
  • Zhang J; Department of Respiratory Medicine, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, 518033, Guangdong, China. jqzhang2002@sina.com.
BMC Infect Dis ; 20(1): 394, 2020 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-32493232
ABSTRACT

BACKGROUND:

Talaromyces marneffei is a highly pathogenic fungus that can cause life-threatening fatal systemic mycosis. Disseminated Talaromycosis marneffei affects multiple organs, including the lungs, skin, and reticuloendothelial system. However, T. marneffei infection has rarely been reported in human immunodeficiency virus (HIV)-negative infants with multiple intestinal perforations and diffuse hepatic granulomatous inflammation. CASE PRESENTATION We present the case of an HIV-negative 37-month-old boy who has had recurrent pneumonia since infancy and was infected with disseminated Talaromycosis. Contrast-enhanced computed tomography of the whole abdomen showed hepatomegaly and intestinal wall thickening in the ascending colon and cecum with mesenteric lymphadenopathy. Colonoscopy showed a cobblestone pattern with erosion, ulcer, polypoid lesions, and lumen deformation ranging from the colon to the cecum. T. marneffei was isolated from the mucous membrane of the colon, liver, and bone marrow. After antifungal treatment and surgery, his clinical symptoms significantly improved. Whole-exome sequencing using the peripheral blood of the patient and his parents' revealed a heterozygous missense mutation in exon 17 of the STAT3 gene (c.1673G>A, p.G558D).

CONCLUSIONS:

In T. marneffei infection-endemic areas, endoscopic examination, culture, or histopathology from the intestine tissue should be performed in disseminated Talaromycosis patients with gastrointestinal symptoms. Timely and systemic antifungal therapy could improve the prognosis. Immunodeficiency typically should be considered in HIV-negative infants with opportunistic infections.
Assuntos
Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Assunto principal: Talaromyces / Fator de Transcrição STAT3 / Hepatopatias / Micoses Tipo de estudo: Relato de casos / Estudo diagnóstico / Estudo prognóstico Limite: Criança, pré-escolar / Humanos / Masculino Idioma: Inglês Revista: BMC Infect Dis Assunto da revista: Doenças Transmissíveis Ano de publicação: 2020 Tipo de documento: Artigo País de afiliação: China

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Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Assunto principal: Talaromyces / Fator de Transcrição STAT3 / Hepatopatias / Micoses Tipo de estudo: Relato de casos / Estudo diagnóstico / Estudo prognóstico Limite: Criança, pré-escolar / Humanos / Masculino Idioma: Inglês Revista: BMC Infect Dis Assunto da revista: Doenças Transmissíveis Ano de publicação: 2020 Tipo de documento: Artigo País de afiliação: China
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