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Talaromyces (Penicillium) species infection in the central nervous system

Chuan Huan Chuah1, Yu Chen Ong2, Boon Huei Kong2

  • 1Department of Internal Medicine, Hospital Pulau Pinang, Jalan Residensi,Georgetown, Penang, Malaysia,

The Journal of the Royal College of Physicians of Edinburgh
|June 23, 2020
PubMed

Insights

This study reports an extremely rare case of fungal meningitis caused by Talaromyces species in an immunocompromised patient. Despite treatment, the patient did not survive, highlighting the severity of central nervous system fungal infections.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Neurology

Background:

  • Talaromycosis is an opportunistic infection primarily affecting immunocompromised individuals.
  • Infections caused by Talaromyces species other than T. marneffei are rare.
  • Central nervous system (CNS) involvement in Talaromycosis is exceptionally uncommon.

Observation:

  • A 61-year-old patient with end-stage renal disease presented with fever and confusion.
  • Lumbar puncture indicated meningitis, with cerebrospinal fluid (CSF) culture identifying Penicillium chrysogenum.
  • The patient had a concurrent Group B Streptococcus sepsis.

Findings:

  • This case represents an extremely rare instance of intracranial Talaromyces species infection presenting as fungal meningitis.
  • The patient received treatment with amphotericin B, ceftriaxone, and oral itraconazole.
  • Despite initial improvement, the patient unfortunately died two weeks after discharge.

Implications:

  • This case underscores the potential for rare fungal species to cause severe CNS infections.
  • Talaromyces species meningitis, though rare, is a life-threatening condition with a high mortality rate.
  • Globally, all reported cases of CNS Talaromyces infection have been fatal, emphasizing the need for heightened awareness and research.
Keywords:
Talaromyces speciescentral nervous system infectionnon-HIV

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