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Coinfection of disseminated Talaromyces marneffei and Mycobacteria kansasii in a patient with papillary thyroid cancer: A case report.

Abstract Recently, Talaromyces marneffei (T. marneffei) has been reported in human immunodeficiency virus (HIV)-negative patient with underlying diseases, such as oral cancer, colon cancer, haematological malignancies, connective tissue disease, diabetes mellitus, and corticosteroids or immunosuppressive agents. Similar to HIV-positive ones, such patients were observed with CD4 lymphocytopenia.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 29384899
OWN - NLM
STAT- In-Process
LR  - 20180131
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 52
DP  - 2017 Dec
TI  - Coinfection of disseminated Talaromyces marneffei and Mycobacteria kansasii in a 
      patient with papillary thyroid cancer: A case report.
PG  - e9072
LID - 10.1097/MD.0000000000009072 [doi]
AB  - RATIONALE: Recently, Talaromyces marneffei (T. marneffei) has been reported in
      human immunodeficiency virus (HIV)-negative patient with underlying diseases,
      such as oral cancer, colon cancer, haematological malignancies, connective tissue
      disease, diabetes mellitus, and corticosteroids or immunosuppressive agents.
      Similar to HIV-positive ones, such patients were observed with CD4
      lymphocytopenia. PATIENT CONCERNS: We reported a case of a 45-year-old woman who 
      was diagnosed with disseminated T. marneffei and Mycobacteria kansasii (M.
      kansasii) with papillary thyroid cancer as the underlying disease. T-cell subsets
      counts, CD4 T-cell%, CD8 T-cell%, CD4/CD8 ratio, and NK cell% were all turned out
      to be normal. DIAGNOSES: Based on bronchoalveolar lavage fluid and skin lesions
      secretion cultures, blood culture, the patient was diagnosed with disseminated T.
      marneffei and M. kansasii. Pathological examination reported papillary thyroid
      cancer with cervical lymph node metastasis. INTERVENTIONS: The patient received
      the combined and longer antifungal therapy and drug regimens for M. kansasii. She
      had total thyroidectomy with radical neck dissection to treat the papillary
      thyroid cancer. OUTCOMES: The patient had a favorable outcome for 19 months
      without recurrence. LESSONS: T. marneffei could infect non-HIV individuals with
      underlying disease under the condition of normal T-cell counts. The symptoms were
      lack of specificity and were more likely to be misdiagnosed. Such patients with
      unidentified T-cell dysfunction or other unidentified primary immunodeficiency
      disorders may prone to coinfect with other opportunistic pathogens, such as M.
      kansasii. Compared with HIV-positive ones, they need combined and much longer
      antifungal therapy.
CI  - Copyright (c) 2017 The Authors. Published by Wolters Kluwer Health, Inc. All
      rights reserved.
FAU - Zhang, Jing
AU  - Zhang J
AD  - Department of Respiratory Medicine.
FAU - Huang, Xinyan
AU  - Huang X
AD  - Department of Respiratory Medicine.
FAU - Zhang, Xin
AU  - Zhang X
AD  - Department of Respiratory Medicine.
FAU - Zhu, Ying
AU  - Zhu Y
AD  - Department of Radiology.
FAU - Liao, Kang
AU  - Liao K
AD  - Department of Laboratory Medicine, The First Affiliated Hospital of Sun Yat-sen
      University, Guangzhou.
FAU - Ma, Jing
AU  - Ma J
AD  - Department of Respiratory and Critical Care Medicine, Peking University First
      Hospital, Beijing, China.
FAU - Wang, Guangfa
AU  - Wang G
AD  - Department of Respiratory and Critical Care Medicine, Peking University First
      Hospital, Beijing, China.
FAU - Guo, Yubiao
AU  - Guo Y
AD  - Department of Respiratory Medicine.
FAU - Xie, Canmao
AU  - Xie C
AD  - Department of Respiratory Medicine.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
EDAT- 2018/02/01 06:00
MHDA- 2018/02/01 06:00
CRDT- 2018/02/01 06:00
PHST- 2018/02/01 06:00 [entrez]
PHST- 2018/02/01 06:00 [pubmed]
PHST- 2018/02/01 06:00 [medline]
AID - 10.1097/MD.0000000000009072 [doi]
AID - 00005792-201712290-00007 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Dec;96(52):e9072. doi: 10.1097/MD.0000000000009072.