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

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World Journal of Emergency Medicine 2021年第4期12卷 281-286页

作者： Hong-yan Wei Wen-jie Liang Bin Li Ling-yu Wei An-qi Jiang Wei-dong Chen Peng-hao Guo Jia Xu Department of Emergency Medicine the First Affi liated Hospital of Sun Yat-sen UniversityGuangzhou 510080China Department of Pulmonary and Critical Care Medicine the First Affi liated Hospital of Sun Yat-sen UniversityGuangzhou 510080China Clinical Trial Unit the First Affi liated Hospital of Sun Yat-sen UniversityGuangzhou 510080China Department of Laboratory Medicine the First Affi liated Hospital of Sun Yat-sen UniversityGuangzhou 510080China

BACKGROUND: To investigate the clinical characteristics and risk factors of human immunodeficiency virus(HIV)-negative patients with talaromyces marneffei(T. marneffei) ***: 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 ***: 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 suff ered 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, Pmarneffei infection. Defective cell-mediated immunity, active infection, multiple system, and organ damage can be the risk factors of poor prognosis.

关键词： talaromyces marneffei Human immunodeficiency virus Bone destruction Risk factors

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Comparison of talaromyces marneffei Infection in Human Immunodeficiency Virus-positive and Human Immunodeficiency Virus-negative Patients from Fujian, China

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Chinese Medical Journal 2016年第9期129卷 1059-1065页

作者： Hong-Ru Li Shao-Xi Cai Yu-Sheng Chen Mei-E Yu Neng-Luan Xu Bao-Song Xie Ming Lin Xin-Lan Hu Department of Respiratory and Critical Care Medicine Nanfang Hospital of Southern Medical University Guangzhou Guangdong 510515 China Department of Respiratory and Critical Care Medicine Fujian Provincial Hospital Provincial Clinical MedicalCollege of Fujian M~edical Universi'ty Fuzhou Fujian 350001 China Department of Clinical Laboratory Laboratory of Bacteriology Fujian Provincial Hospital Provincial Clinical Medical College of Fujian Medical University Fuzhou Fujian 350001 China

Background： talaromyces （Penicillium） marneffei （TIM） is an emerging dimorphic human pathogenic fungus that is endemic to Southeast Asia. TM mostly occurs as an opportunistic infection in patients with human immunodeficiency virus （HIV）. The objective of this study was to compare the clinical and laboratory parameters of patients with TM infections who were HIV-positive and HIV-negative and to assess therapies and outcomes. Methods： This was a retrospective analysis of 26 patients diagnosed with disseminated TM infection from September 2005 to April 2014 at Fujian Provincial Hospital, China. Results： Patients with TM infection tend to present with fever, weight loss, and anemia. The time from symptom onset to confirmed diagnosis was greater for HlV-negative patients （n 7; median： 60 days, range： 14-365 days） than for HIV-positive patients （n = 19; median： 30 days, range： 3-90 days, Mann-Whitney U= 31.50, P = 0.041）. HIV-negative patients were more likely to have dyspnea （57.1% vs. 5.3%, Z： = 8.86, P = 0.010）, low neutrophil count （Mann-Whitney U = 27.00, P = 0.029）, high CD4 count （Mann-Whitney U= 0.00, P 0.009）, and high lymphocyte count （Mann-Whitney U = 21.00, P = 0.009）. There were no significant differences in other demographic, clinical, or biochemical characteristics. Among all the patients, 12 HIV-positive patient and 1 HlV-negative patient received amphotericin and fluconazole treatment, 9 of whom improved, l died, 2 had kidney damage, 1 had hypokalemia due to exceeded doses. Conclusions： HIV-negative patients with TM infections tend to have a longer diagnostic interval, a higher percentage of dyspnea, higher levels of CD4 and lymphocytes, and lower neutrophil counts than TM infection in HIV-positive patients. Treatment programs with amphotericin and fluconazole are mostly effective.

关键词： Clinical Characteristics Human lmmunodeficiency Virus talaromyces marneffei

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Dysregulated STAT1 gain-of-function:Pathogen-free autoimmunity and fungal infection

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hLife 2024年第8期2卷 397-418页

作者： Liping Guo Dongli Lian Yuchen Gu Xiaoyu Lu Ying Zhang Xiaohe Li Tatyana Aleksandrovna Khrustaleva Jianfeng Lan Yanhua Liang Vladislav Victorovich Khrustalev Yanyan Mao Yafan Chen Hongzhou Lu Jing Yuan Shenzhen Key Laboratory of Pathogen and Immunity National Clinical Research Center for Infectious DiseaseState Key Discipline of Infectious DiseaseShenzhen Third People’s HospitalSecond Hospital Affiliated to Southern University of Science and TechnologyGuangdongChina Department of Microbiology Basic Medical CollegeGuangxi Medical UniversityGuangxiChina School of Public Health(Shenzhen) Shenzhen Campus of Sun Yat-Sen UniversityGuangdongChina Multidisciplinary Diagnostic Laboratory Institute of Physiology of the National Academy of Sciences of BelarusMinskBelarus Department of General Chemistry Belarusian State Medical UniversityMinskBelarus Health Science Center Shenzhen UniversityGuangdongChina

Inborn errors of the signal transducer and activator of transcription 1(STAT1)result in four types of immunodeficiency disease with varying degrees of impaired STAT1 function:autosomal recessive(AR)complete STAT1 deficiency,AR partial STAT1 deficiency,autosomal dominant(AD)STAT1 deficiency,and AD STAT1 gain-of-function(STAT1-GOF).Of which,the STAT1-GOF mutations promote a clinical syndrome of immune dysregulation characterized by recurrent infections,especially chronic mucocutaneous candidiasis(CMC)and talaromyces marneffei infection and predisposition to humoral ***1-GOF mutations lead to enhanced phosphorylation of STAT1(pSTAT1),delayed dephosphorylation,and impaired nuclear *** a result,the development of T helper(Th)17 cells is impaired,limiting the production of interleukin(IL)-17,which plays an important role in antifungal ***,mutations can also cause a decrease in the proportion of CD4^(+),CD8^(+),and natural killer(NK)*** research demonstrated that in the absence of overt infection,STAT-GOF mice can disrupt naïve CD4^(+)T cell homeostasis and promote expansion and differentiation of abnormal T-follicular helper/T-helper 1-like(Tfh/Th1-like)T cells and germinal center-like(GC-like)B cells,and thus reminds us of the complex molecular mechanism of autoimmune disease with/without fungal infection,which may further involve specific clinical treatment including antifungal and anti-autoimmunity *** addition,sex and location of mutation were also associated with the clinical *** with DNA binding domain(DBD)mutations had a higher prevalence of autoimmunity and aberrant B cell *** CD4^(+)T cell homeostasis occurred sooner and more robustly in females,highlighting the importance of specific treatment to normalize STAT1 expression and restore immune tolerance in patients with STAT1-GOF ***,we provide a comprehensive review of STAT1-GOF aiming to further clar

关键词： signal transducer and activator of transcription 1 gain-of-function(STAT-GOF)mutation fungal infection chronic mucocutaneous candidiasis(CMC) talaromyces marneffei treatment

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