• 1. Department of Hematology, The First Affiliated Hospital of the Naval Medical University, Changhai Hospital, Shanghai 200433, P. R. China;
  • 2. Department of Physical Emergency, The First Affiliated Hospital of the Naval Medical University, Changhai Hospital, Shanghai 200433, P. R. China;
  • 3. Department of Pathogenic Microorganism, The First Affiliated Hospital of the Naval Medical University, Changhai Hospital, Shanghai 200433, P. R. China;
  • 4. Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of the Naval Medical University, Changhai Hospital, Shanghai 200433, P. R. China;
QIN Qin, Email: qinq78@163.com; ZHANG Wei, Email: zhangweismmu@126.com
Export PDF Favorites Scan Get Citation

Objective To explore the clinical diagnosis and treatment of Talaromyces marneffei (TM) infection by bone marrow examination, and to clarify the important role and significance of bone marrow smear and pathogenic examination.Methods Retrospective analysis was conducted on a case of disseminated TM infection that was clearly diagnosed through bone marrow related examination. Literature review of TM infection was conducted by retrieving relevant case reports at home and abroad from 1990 to 2018.Results The patient was a 23-year-old man with recurrent cough and onset of fever, superficial lymph node enlargement in multiple parts of the body, no abnormal chest CT sign, and poor efficacy in anti-infection treatment. The patient developed progressive abdominal pain, accompanied by systemic papulosis, decreased consciousness, and progressive decline of blood cells. The patient underwent bone marrow puncture surgery in our hospital, and developed circulatory and respiratory failure half an hour after surgery. TM was confirmed bybone marrow smear and pathogenic culture. In the literature review, 2 855 cases of TM infection were retrieved, among which the majority of cases were confirmed through blood and bone marrow related examination. The positive rate of bone marrow culture was significantly higher than that of blood culture (72.4% and 66.8%, respectively, P=0.007). Compared with bone marrow culture, the misdiagnosis and missed diagnosis rate of bone marrow smear microscopy was 27.6%. Patients diagnosed with TM infection by bone marrow examination had the highest HIV positive rate (95.7%).Conclusions The examination of bone marrow cells and the culture are of great clinical significance for the diagnosis of TM infection. TM infection should be identified in patients suspected of HIV positive with fever, lymph node enlargement and abnormal blood routine.

Citation: YANG Dan, SUN Xingcheng, HUANG Zhengxia, ZHANG Yan, QIN Qin, ZHANG Wei. A case report of bone marrow smear and culture for the diagnosis of Talaromyces marneffei infection and literature review. Chinese Journal of Respiratory and Critical Care Medicine, 2019, 18(3): 236-240. doi: 10.7507/1671-6205.201808055 Copy

Copyright © the editorial department of Chinese Journal of Respiratory and Critical Care Medicine of West China Medical Publisher. All rights reserved

  • Previous Article

    A clinical analysis of 26 cases of allergic bronchopulmonary aspergillosis
  • Next Article

    Clinical analysis of obliterative bronchiolitis