18F-FDG PET/CT Imaging of Talaromyces marneffei Infection with Bone Destruction in an HIV-Negative Patient: Case Report and Review

Wenting He,1 Senhui Wang,1 Xiaoqi Xiong,2 Wenli Dai1 1Department of Nuclear Medicine, The First College of Clinical Medical Science, China Three Gorges University, Yichang, Hubei, 443003, People’s Republic of China; 2Department of Respiratory and Critical Care Medicine, The First College of Clinical...

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Main Authors: He W, Wang S, Xiong X, Dai W
Format: Article
Language:English
Published: Dove Medical Press 2025-04-01
Series:Infection and Drug Resistance
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Online Access:https://www.dovepress.com/18f-fdg-petct-imaging-of-talaromyces-marneffei-infection-with-bone-des-peer-reviewed-fulltext-article-IDR
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author He W
Wang S
Xiong X
Dai W
author_facet He W
Wang S
Xiong X
Dai W
author_sort He W
collection DOAJ
description Wenting He,1 Senhui Wang,1 Xiaoqi Xiong,2 Wenli Dai1 1Department of Nuclear Medicine, The First College of Clinical Medical Science, China Three Gorges University, Yichang, Hubei, 443003, People’s Republic of China; 2Department of Respiratory and Critical Care Medicine, The First College of Clinical Medical Science, China Three Gorges University, Yichang, Hubei, 443003, People’s Republic of ChinaCorrespondence: Wenli Dai, Department of Nuclear Medicine, The First College of Clinical Medical Science, China Three Gorges University, Yichang, Hubei, 443003, People’s Republic of China, Email daiwenli@ctgu.edu.cnBackground: Talaromycosis is an opportunistic fungal infection caused by Talaromyces marneffei (T. marneffei), commonly occurs in HIV-positive individuals. While less common, it can also affect HIV-negative individuals. We reported a T. marneffei infection in an HIV-negative patient, whose imaging findings and diagnostic process offer valuable clinical insights.Case Presentation: An HIV-negative male adult patient with an intermittent cough for more than two years and worsened for more than one month. Enhanced CT scan indicated lung cancer with rib and lymph nodes metastasis. The lower respiratory tract and bronchial lavage fluid culture of the patient were negative. He received two bronchoscopies, two biopsies and two metagenomic next-generation sequencing (mNGS) tests, which failed to find the malignant cell but sequentially identified the presence of Pasteurella multocida and the Epstein-Barr virus. His condition did not improve after anti-infective treatment for 2weeks. An 18-fluorodeoxy glucose (18F-FDG) PET/CT scan revealed increased radioactivity in right supraclavicular lymph node, left lung and the right tenth rib. Ultimately, a biopsy at the hypermetabolic lesion of left lung, and a third mNGS test confirmed the presence of Talaromyces marneffei. Subsequently, the patient started antifungal therapy with amphotericin B and itraconazole and showed a favorable response.Conclusion: We reviewed all reported PET/CT findings of T. marneffei infection patients, suggesting that fungus T. marneffei should be considered in patients identified as infection and exhibited bone destruction and also highlight the role of PET/CT in guiding the biopsy site.Keywords: Talaromyces marneffei, PET/CT, HIV-negative, bone destruction, metagenomic next-generation sequencing (mNGS)
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spelling doaj-art-5f599a3f2d0c409a8f944abe17ca92062025-08-20T02:26:08ZengDove Medical PressInfection and Drug Resistance1178-69732025-04-01Volume 181745175210187818F-FDG PET/CT Imaging of Talaromyces marneffei Infection with Bone Destruction in an HIV-Negative Patient: Case Report and ReviewHe WWang SXiong XDai WWenting He,1 Senhui Wang,1 Xiaoqi Xiong,2 Wenli Dai1 1Department of Nuclear Medicine, The First College of Clinical Medical Science, China Three Gorges University, Yichang, Hubei, 443003, People’s Republic of China; 2Department of Respiratory and Critical Care Medicine, The First College of Clinical Medical Science, China Three Gorges University, Yichang, Hubei, 443003, People’s Republic of ChinaCorrespondence: Wenli Dai, Department of Nuclear Medicine, The First College of Clinical Medical Science, China Three Gorges University, Yichang, Hubei, 443003, People’s Republic of China, Email daiwenli@ctgu.edu.cnBackground: Talaromycosis is an opportunistic fungal infection caused by Talaromyces marneffei (T. marneffei), commonly occurs in HIV-positive individuals. While less common, it can also affect HIV-negative individuals. We reported a T. marneffei infection in an HIV-negative patient, whose imaging findings and diagnostic process offer valuable clinical insights.Case Presentation: An HIV-negative male adult patient with an intermittent cough for more than two years and worsened for more than one month. Enhanced CT scan indicated lung cancer with rib and lymph nodes metastasis. The lower respiratory tract and bronchial lavage fluid culture of the patient were negative. He received two bronchoscopies, two biopsies and two metagenomic next-generation sequencing (mNGS) tests, which failed to find the malignant cell but sequentially identified the presence of Pasteurella multocida and the Epstein-Barr virus. His condition did not improve after anti-infective treatment for 2weeks. An 18-fluorodeoxy glucose (18F-FDG) PET/CT scan revealed increased radioactivity in right supraclavicular lymph node, left lung and the right tenth rib. Ultimately, a biopsy at the hypermetabolic lesion of left lung, and a third mNGS test confirmed the presence of Talaromyces marneffei. Subsequently, the patient started antifungal therapy with amphotericin B and itraconazole and showed a favorable response.Conclusion: We reviewed all reported PET/CT findings of T. marneffei infection patients, suggesting that fungus T. marneffei should be considered in patients identified as infection and exhibited bone destruction and also highlight the role of PET/CT in guiding the biopsy site.Keywords: Talaromyces marneffei, PET/CT, HIV-negative, bone destruction, metagenomic next-generation sequencing (mNGS)https://www.dovepress.com/18f-fdg-petct-imaging-of-talaromyces-marneffei-infection-with-bone-des-peer-reviewed-fulltext-article-IDRtalaromyces marneffeipet/cthiv-negativebone destructionmetagenomic next-generation sequencing (mngs)
spellingShingle He W
Wang S
Xiong X
Dai W
18F-FDG PET/CT Imaging of Talaromyces marneffei Infection with Bone Destruction in an HIV-Negative Patient: Case Report and Review
Infection and Drug Resistance
talaromyces marneffei
pet/ct
hiv-negative
bone destruction
metagenomic next-generation sequencing (mngs)
title 18F-FDG PET/CT Imaging of Talaromyces marneffei Infection with Bone Destruction in an HIV-Negative Patient: Case Report and Review
title_full 18F-FDG PET/CT Imaging of Talaromyces marneffei Infection with Bone Destruction in an HIV-Negative Patient: Case Report and Review
title_fullStr 18F-FDG PET/CT Imaging of Talaromyces marneffei Infection with Bone Destruction in an HIV-Negative Patient: Case Report and Review
title_full_unstemmed 18F-FDG PET/CT Imaging of Talaromyces marneffei Infection with Bone Destruction in an HIV-Negative Patient: Case Report and Review
title_short 18F-FDG PET/CT Imaging of Talaromyces marneffei Infection with Bone Destruction in an HIV-Negative Patient: Case Report and Review
title_sort 18f fdg pet ct imaging of talaromyces marneffei infection with bone destruction in an hiv negative patient case report and review
topic talaromyces marneffei
pet/ct
hiv-negative
bone destruction
metagenomic next-generation sequencing (mngs)
url https://www.dovepress.com/18f-fdg-petct-imaging-of-talaromyces-marneffei-infection-with-bone-des-peer-reviewed-fulltext-article-IDR
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