Talaromyces Marneffei Infection Presenting with Cervical Lymphadenopathy as the Initial Manifestation

Talaromyces marneffei (TM) is an opportunistic pathogenic fungus primarily prevalent in Southeast Asia. It mainly infects immunocompromised individuals and is rarely observed in those with normal immune function. Additionally, patients infected with TM exhibit non-specific clinical manifestations, which significantly increase the difficulty of diagnosis. In this case, the final diagnosis of TM infection was confirmed through pathological examination following a cervical lymph node puncture and biopsy.

Lymph node biopsy.

Pathological findings following cervical lymph node puncture and biopsy revealed hyperplastic lymphoid follicles of varying sizes, with some follicles exhibiting coagulative necrosis. Surrounding these areas were proliferative granulomas. The histological changes were consistent with granulomatous lymphadenitis, indicative of TM infection. Consequently, antifungal therapy with voriconazole was administered.

For patients with cervical lymphadenopathy, it is crucial to stabilize the condition while simultaneously identifying the underlying cause. Timely performance of relevant diagnostic procedures, such as cervical lymph node puncture and biopsy, is essential to establish a definitive diagnosis.