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| Clinical Analysis of Three Cases of Pulmonary Disease with Non-tuberculous Mycobacterium Tuberculosis Complicated with Talaromyces Marneffei |
| CHEN Hui-yu, CHEN Pin-ru, HUANG Jin-hui,et al |
| State Key Laboratory of Respiratory Disease, Department of Tuberculosis in Guangzhou chest Hospital, Guangzhou 510095,China |
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Abstract 【Objective】To analyze the clinical features,characteristics of imaging ,pathogenic manifestations and related treatment of the non-tuberculous mycobaeteria(NTM)pulmonary disease with Talaromyces marneffei. 【Methods】The clinical data of 3 patients with NTM with Talaromyces marneffei admitted to Guangzhou Check Hospital from January 2017to June 2018 were retrospectively analyzed. 【Results】Of 3 patients,1 was male and 2 were female. All were 50~60 years old. All 3 patients had cough, sputum, and lymph node enlargement with ulceration. Among 3 patients, 2 had repeated bloody sputum,2 had skin and soft tissue abscess with ulceration,and 2 had severe lung infection and respiratory failure which needed transferred to ICU treatment. Three patients with sputum or bronchial lavage fluid were diagnosed as NTM by mycobacterium culture of sputum(2 cases of Mycobacterium avium,1 case of Mycobaeterium intracelhlare).In addition, 2 cases with skin soft tissue abscess and ulceration had pus culture with Marneffei blue-like bacteria growth, and 1 case had blood culture with Marneffei blue-like bacteria growth. All patients had no AIDS with normal T lymphocytes. All were diagnosed with NTM lung disease at the beginning, however, the symptomatic improvement was not obvious after anti-infection treatment. Finally, the diagnosis as Talaromyces marneffei was confirmed. And symptoms were much improved after anti-fungus infection treatment(1 by voriconazole,2 by amphotericin B). 【Conclusion】NTM lung disease combined with Talaromyces marneffei was rare in clinic practice. For the cases of conventional treatment failure NTM lung disease with recurrent skin abscess ulceration and lymph node enlargement plus ulceration, consideration should be given to the possibility of complicating Talaromyces marneffei.
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Received: 21 February 2019
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2019, Vol. 36 
