Coexisting of Primary Central Nervous System Lymphoma and Talaromyces marneffei Brain Abscess in an AIDS Patient, A Case Report and Review of the Literature

Abstract

Background

Talaromyces marneffei is prevalent in South Asia. Latent Talaromyces marneffei infection of travellers make the diagnosis difficult. There are similarities in clinical manifestations between Talaromyces marneffei infection and lymphoma. Brain abscess is a rare form of Talaromyces marneffei infection.

Case Presentation

We reported a very rare case of a 19-year-old man with HIV infection who suffered from a brain mass and lymphadenopathy. His blood culture, bone marrow culture and sputum culture all grew Talaromyces marneffei. One month after treatment with voriconazole, the symptoms improved except brain mass. Surgical incision of the brain mass showed a compact mass, and pathological analysis showed the coexisting Talaromyces marneffei abscess and lymphoma. The patient is currently in a stable condition after receiving antifungal therapy and chemotherapy.

Conclusion

Based on a case report of a traveller who suffered from a brain mass of Talaromyces marneffei abscess and lymphoma after a visit to an endemic area, this review summarized the cases where there was confusion between lymphoma and the brain abscess of Talaromyces marneffei. Talaromyces marneffei infection can be found globally due to the increasing number of international travels. Talaromyces marneffei infection and lymphoma had similar characteristics which is easy to misdiagnose in clinic. Infection may also be accompanied by tumors, especially in patients infected with HIV. The manifestations and imaging of brain abscess of Talaromyces marneffei were not characteristic in different patients.

Keywords:

• Talaromyces marneffei
• lymphoma
• misdiagnose
• HIV
• travel

Ethics Approval and Consent to Participate

We obtained the patient’s written informed consent to publish this case report. This study was approved by Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College (Protocol No. JS-3029B)

Data Sharing Statement

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

Author Contributions

Xinchao Liu: Conceptualization, Methodology, Visualization, Investigation, Writing – original draft, Resources. Hao Xin: Writing – original draft. Jing Lin: Writing – review & editing, Supervision. Jian Sun: Supervision. Yu Wang: Supervision. Wei Cao: Supervision. Zhengyin Liu: Supervision. Taisheng Li: Writing – review & editing, Validation, Supervision.

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

This research was supported by grants from National High Level Hospital Clinical Research Funding (grant number: 2022-PUMCH-A-044).