Non-HIV talaromycosis: Radiological and clinical analysis

Medicine (Baltimore). 2020 Mar;99(10):e19185. doi: 10.1097/MD.0000000000019185.

Abstract

To investigate the characteristics of spiral computed tomography (CT), positron emission tomography-computed tomography (PET/CT) and clinical manifestations of talaromycosis to improve the diagnostic level and deepen its recognition in radiology.Radiological, clinical, and pathological manifestations of 15 patients of non-HIV talaromycosis confirmed by bronchofiberscope lung biopsy and/or abscess puncture fluid culture and/or blood culture and/or sputum culture were analyzed retrospectively. All patients underwent chest CT, among them, six had a brain MRI, and six had a PET/CT scan before treatment.On plain CT scan, there were multiple patches and massive consolidation in 6 patients, multiple patchy consolidations and patchy ground-glass opacities in 3 patients, solitary or multiple nodules and masses in 3 patients, multiple cavities and small nodules in 3 patients. Multiple lymphadenectasis appeared in bilateral hila, mediastinum, and neck in 10 patients. In contrast CT scan, the parenchyma of the lesions had a slight enhancement in 10 patients, moderate enhancement in 3 patients, obvious enhancement in 2 patients. Seven cases had bone destruction and hyperplasia, cranial involvement in 1 patient and liver involvement in 3 patients, respectively. On PET/CT, five patients showed elevated standard uptake value (SUV).The radiological manifestations of non-HIV talaromycosis show multiple consolidations, ground-glass opacities, multiple nodules or masses in bilateral lungs, deep-seated enlarged lymph nodes and bone destruction in multiple systems. The final diagnosis should be based on the culture of talaromycosis.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Biopsy
  • Child
  • Child, Preschool
  • Diagnosis, Differential
  • Early Diagnosis
  • Female
  • Fluorodeoxyglucose F18
  • HIV Infections
  • Humans
  • Infant
  • Lung Diseases, Fungal / diagnostic imaging*
  • Lung Diseases, Fungal / microbiology
  • Lung Diseases, Fungal / pathology
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Mycoses / diagnostic imaging*
  • Mycoses / microbiology
  • Mycoses / pathology
  • Positron Emission Tomography Computed Tomography
  • Radiopharmaceuticals
  • Retrospective Studies
  • Tomography, X-Ray Computed
  • Young Adult

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18

Supplementary concepts

  • talaromycosis