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Case Report: Disseminated Talaromyces (Penicillium) marneffei and Mycobacterium tuberculosis Coinfection in a Japanese Patient with Acquired Immunodeficiency Syndrome

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  • 1 Division of General Internal Medicine, Jichi Medical University Hospital, Tochigi, Japan
  • | 2 Division of Infectious Diseases, Jichi Medical University Hospital, Tochigi, Japan
  • | 3 Division of General Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan
  • | 4 Division of Clinical Laboratory, Saitama Medical Center, Jichi Medical University, Saitama, Japan
  • | 5 Medical Mycology Research Center, Chiba University, Chiba, Japan

Talaromyces marneffei is a dimorphic fungus endemic mainly in southeast and south Asia. It causes severe mycosis, usually in immunocompromised individuals, such as those with human immunodeficiency virus (HIV) infection. Concomitant infection with T. marneffei and other opportunistic pathogens is plausible because the majority of T. marneffei infections occur in patients with advanced HIV infection. Nonetheless, coinfection in the same site has rarely been reported, and poses a considerable diagnostic and therapeutic challenge. We report the case of an HIV-infected Japanese patient who had lived in Thailand for 6 years. The patient developed T. marneffei and Mycobacterium tuberculosis coinfection, and both pathogens were isolated from the same sites: a blood specimen and a lymph node aspirate. Clinicians should be aware of concomitant infection with T. marneffei and other pathogens in patients with advanced HIV disease who are living in or who have visited endemic areas.

Author Notes

 Address correspondence to Shuji Hatakeyama, Division of General Internal Medicine/Division of Infectious Diseases, Jichi Medical University Hospital, 3311-1 Yakushiji, Shimotsuke-shi, Tochigi 329-0498, Japan. E-mail: shatake-tky@umin.ac.jp

Authors’ addresses: Shuji Hatakeyama, Division of General Internal Medicine, Jichi Medical University Hospital, Tochigi, Japan, and Division of Infectious Diseases, Jichi Medical University Hospital, Tochigi, Japan, E-mail: shatake-tky@umin.ac.jp. Takeshi Yamashita, Division of General Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan, E-mail: t.yamashita@jichi.ac.jp. Toshiyasu Sakai, Division of Clinical Laboratory, Saitama Medical Center, Jichi Medical University, Saitama, Japan, E-mail: tsakai@omiya.jichi.ac.jp. Katsuhiko Kamei, Medical Mycology Research Center, Chiba University, Chiba, Japan, E-mail: k.kamei@faculty.chiba-u.jp.

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