Recurrent Talaromyces marneffei Infection Presenting with Intestinal Obstruction in a Patient with Systemic Lupus...

Area of Science:

• Mycology
• Infectious Diseases
• Gastroenterology

Background:

• Talaromyces marneffei is an opportunistic fungal pathogen primarily affecting individuals with HIV/AIDS.
• While rare, Talaromyces marneffei can cause infections in immunocompetent individuals.
• Systemic lupus erythematosus (SLE) is an autoimmune disease that can increase susceptibility to infections.

Observation:

• A 51-year-old woman with a 14-year history of SLE and disseminated talaromycosis experienced partial intestinal obstruction.
• Talaromyces marneffei infection was confirmed as the cause of the obstruction.
• Genetic analysis suggested the current infection was a recurrence of a previous Talaromyces marneffei episode.

Findings:

• Surgical excision of the affected intestine followed by oral itraconazole (400 mg daily for 3 months) resulted in an excellent clinical response.
• Despite initial treatment success, the patient died from an unknown cause over a year later.
• Literature review on Talaromyces marneffei infections associated with SLE and isolated intestinal talaromycosis was conducted.

Implications:

• This case highlights the potential for Talaromyces marneffei to cause severe gastrointestinal complications, including intestinal obstruction, in patients with SLE.
• Recurrent Talaromyces marneffei infections can occur even after successful treatment.
• Further research is needed to understand the long-term outcomes and management strategies for talaromycosis in non-HIV-infected individuals, particularly those with autoimmune diseases.