Clinical characteristics and risk factors of Talaromyces marneffei infection in human immunodeficiency virus-negative patients: A retrospective observational study.

Autor:	Wei HY; Department of Emergency Medicine, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China., Liang WJ; Department of Pulmonary and Critical Care Medicine, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China., Li B; Clinical Trial Unit, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China., Wei LY; Department of Emergency Medicine, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China., Jiang AQ; Department of Emergency Medicine, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China., Chen WD; Department of Emergency Medicine, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China., Guo PH; Department of Laboratory Medicine, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China., Xu J; Department of Emergency Medicine, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China.
Jazyk:	angličtina
Zdroj:	World journal of emergency medicine [World J Emerg Med] 2021; Vol. 12 (4), pp. 281-286.
DOI:	10.5847/wjem.j.1920-8642.2021.04.005
Abstrakt:	Background: To investigate the clinical characteristics and risk factors of human immunodeficiency virus (HIV)-negative patients with Talaromyces marneffei ( T. marneffei ) infection. Methods: We retrospectively collected the clinical information of HIV-negative patients with T. marneffei infection from January 1, 2010 to June 30, 2019, and analyzed the related risk factors of poor prognosis. Results: Twenty-five cases aging 22 to 79 years were included. Manifestations of T. marneffei infection included fever, cough, dyspnea, chest pain or distress, lymphadenopathy, ear, nose, and throat (ENT) and/or skin lesions, bone or joint pain, edema and pain in the lower extremities, digestive symptoms, icterus, malaise, and hoarseness. Two cases had no comorbidity, while 23 cases suffered from autoimmune disease, pulmonary disease, cancer, and other chronic diseases. Sixteen cases had a medication history of glucocorticoids, chemotherapy or immunosuppressors. Pulmonary lesions included interstitial infiltration, nodules, atelectasis, cavitary lesions, pleural effusion or hydropneumothorax, bronchiectasis, pulmonary fibrosis, pulmonary edema, and consolidation. The incidence of osteolytic lesions was 20%. Eight patients received antifungal monotherapy, and 11 patients received combined antifungal agents. Fifteen patients survived and ten patients were dead. The Cox regression analysis showed that reduced eosinophil counts, higher levels of blood urea nitrogen (BUN), alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactic dehydrogenase (LDH), myoglobin (Mb), procalcitonin (PCT), and galactomannan were related to poor prognosis (hazard ratio [ HR ]>1, P <0.05). Conclusions: Bone destruction is common in HIV-negative patients with T. marneffei infection. Defective cell-mediated immunity, active infection, multiple system, and organ damage can be the risk factors of poor prognosis. Competing Interests: Conflicts of interests: All authors declared no conflicts of interest. (Copyright: © World Journal of Emergency Medicine.)
Databáze:	MEDLINE
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