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Talaromyces marneffei endocarditis initially detected by Next Generation Sequencing: A case report
Youqi Ji1, Bingqian Zhuo2, Tao Jiang3
1School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310053, China; Laboratory Medicine Center, Department of Clinical Laboratory, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang 310014, China.
Talaromyces marneffei endocarditis is a rare but serious infection, particularly in elderly patients with cardiac devices. Metagenomic Next-Generation Sequencing (mNGS) aids in early diagnosis, crucial for improving patient outcomes.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Cardiology
Background:
- Talaromyces marneffei (T. marneffei) is a thermally dimorphic fungus causing life-threatening infections like lung and bloodstream infections.
- Endocarditis caused by T. marneffei is exceptionally rare and poses a significant risk to elderly patients with cardiac implants.
- The increasing prevalence of invasive cardiac procedures necessitates attention to infective endocarditis prevention and treatment.
Observation:
- A case study details an 80-year-old female patient diagnosed with Talaromyces marneffei endocarditis.
- The patient received intravenous voriconazole for antifungal treatment without clinical improvement.
- The family opted to forgo further medical intervention.
Findings:
- Metagenomics Next-Generation Sequencing (mNGS) combined with cardiac ultrasound and in vitro culture was employed for diagnosis.
- T. marneffei endocarditis presents diagnostic and therapeutic challenges due to its rarity.
- Early diagnosis through mNGS is critical for effective management.
Implications:
- This case highlights the importance of considering rare fungal pathogens in endocarditis, especially in vulnerable populations.
- Metagenomic Next-Generation Sequencing (mNGS) offers a valuable tool for the early and accurate diagnosis of T. marneffei endocarditis.
- Improved diagnostic strategies can significantly impact treatment decisions and enhance patient survival rates.
