Treatment of Disseminated Talaromyces marneffei with Tracheal Infection: Two Case Reports

• Published in: Mycopathologia (1975) Vol. 180; no. 3-4; pp. 245 - 249
• Main Authors: Qiu, Ye, Lu, DeCheng, Zhang, Jianquan, Zhong, Xiaoning, Liu, Guangnan, Li, Bixun
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer Netherlands 01.10.2015; Springer; Springer Nature B.V
• Subjects: Acquired immune deficiency syndrome; Administration, Inhalation; Adult; AIDS; Amphotericin B; Antifungal Agents - therapeutic use; Antiparasitic agents; Biomedical and Life Sciences; Bronchoalveolar Lavage Fluid - microbiology; Bronchoscopy; Case reports; Debridement; Eukaryotic Microbiology; Health aspects; HIV; HIV infections; Human immunodeficiency virus; Humans; Infection; Infections; Life Sciences; Male; Medical Microbiology; Microbial Ecology; Microbiology; Middle Aged; Mycoses - diagnosis; Mycoses - drug therapy; Mycoses - pathology; Mycoses - surgery; Plant Sciences; Skin - microbiology; Stains & staining; Talaromyces; Talaromyces - isolation & purification; Throat; Trachea - microbiology; Tracheitis - diagnosis; Tracheitis - drug therapy; Tracheitis - pathology; Tracheitis - surgery; Tuberculosis; China; Tracheal nodules; Amphotericin B; Eosinophilia; Atomized inhaled
• ISSN: 0301-486X; 1573-0832
• DOI: 10.1007/s11046-015-9891-4

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.