Characteristics and Prognosis of Talaromyces marneffei Infection in Non-HIV-Infected Children in Southern China

Mycopathologia. 2019 Dec;184(6):735-745. doi: 10.1007/s11046-019-00373-4. Epub 2019 Aug 31.

Abstract

Knowledge about the clinical and laboratory characteristics and prognosis of Talaromyces marneffei infection in children is limited. A retrospective study was conducted on pediatric patients with disseminated T. marneffei infection in a clinical setting. Extracted data included demographic information (age and sex), clinical features, laboratory findings, treatment, and prognosis. Eleven HIV-negative children were enrolled. The male/female ratio was 8:3. The median age of onset was 17.5 months (3.5-84 months). The mortality rate in these children was 36.36% (4/11). Seven children had underlying diseases. All of the children had multiple immunoglobulin abnormalities and immune cell decline. Ten children received voriconazole treatment, and most of the children (7/10) had a complete response to therapy at primary and long-term follow-up assessment; only three children died of talaromycosis. One patient recovered from talaromycosis but died of leukemia. The child who received itraconazole treatment also showed clinical improvement. No adverse events associated with antifungal therapies were recorded during and after the treatment. Talaromycosis is an indicator disease for undiagnosed severe immunodeficiencies in children. Awareness of mycoses in children by pediatricians may prompt diagnosis and timely treatment. Voriconazole is an effective, well-tolerated therapeutic option for disseminated T. marneffei infection in non-HIV-infected children.

Keywords: Children; Misdiagnosis; Non-HIV-infected; Talaromyces marneffei; Voriconazole.

MeSH terms

  • AIDS-Related Opportunistic Infections* / drug therapy
  • AIDS-Related Opportunistic Infections* / immunology
  • AIDS-Related Opportunistic Infections* / microbiology
  • AIDS-Related Opportunistic Infections* / mortality
  • Antifungal Agents / adverse effects
  • Antifungal Agents / therapeutic use
  • Child
  • Child, Preschool
  • China
  • Female
  • HIV-1
  • Humans
  • Infant
  • Itraconazole / adverse effects
  • Itraconazole / therapeutic use
  • Male
  • Mycoses* / drug therapy
  • Mycoses* / immunology
  • Mycoses* / microbiology
  • Mycoses* / mortality
  • Retrospective Studies
  • Talaromyces* / drug effects
  • Talaromyces* / pathogenicity
  • Voriconazole / adverse effects
  • Voriconazole / therapeutic use*

Substances

  • Antifungal Agents
  • Itraconazole
  • Voriconazole

Supplementary concepts

  • talaromycosis