The role of mNGS in the diagnosis of talaromycosis and case series

作者：Jing Zhao, Huiting Su, Dong Zhang, X R Li, Minya Lu, Juan Du, Jia-Yu Guo, Yi Gao, Xin-Fei Chen, Dong-Hua Wen, Shi-Yu Jia, Yao Wang, Qiwen Yang · 发表于：BMC Infectious Diseases · 年份：2025 · DOI：10.1186/s12879-025-10529-x · 被引用次数：10 · 研究领域：Fungal Infections and Studies、Antifungal resistance and susceptibility、Actinomycetales infections and treatment

BACKGROUND: Talaromycosis is a rare fungal infection characterized by non-specific clinical features, often resulting in misdiagnosis. This study aimed to analyze four classic cases of Talaromyces marneffei infection diagnosed using metagenomic next-generation sequencing (mNGS) to improve understanding of its diagnosis and treatment. METHODS: This study retrospectively analyzed cases of T. marneffei identified through mNGS at Peking Union Medical College Hospital. Four confirmed cases of talaromycosis were selected based on clinical diagnoses, supplemented by a review of relevant literature. We reviewed and compared the clinical features, laboratory indicators, treatment regimens, and outcomes of these cases, which exhibited varied characteristics. RESULTS: Among the four patients, two were human immunodeficiency virus (HIV)-positive, and two were HIV-negative. All the participants presented with fever and varying respiratory symptoms, with distinct clinical characteristics aiding diagnosis. Three cases exhibited significant pulmonary infection lesions. Both HIV-positive patients showed T. marneffei bloodstream dissemination and suffered mixed infection with virus. Within them, one case was positive in blood culture, blood mNGS and sputum culture. Another case was positive in blood and bone marrow cultures, brain tissue culture and mNGS. They were both treated with voriconazole and improved. Both HIV-negative patients were T. marneffei positive for BALF mNGS, and only one of ...