A Retrospective Analysis of Seven Patients with Acquired Immunodeficiency Syndrome and Pharyngeal and/or Laryngeal Talaromyces marneffei Infection

Abstract

1.Talaromyces marneffei, formerly known as Penicillium marneffei, usually affects the monocyte-macrophage system and can cause fatal systemic mycosis in immunocompromised individuals. This retrospective study is the first to describe the clinical and endoscopic (nasal endoscopy, flexible endoscopy) features of penicilliosis with pharynx and/or larynx infection in patients with acquired immunodeficiency syndrome (AIDS).

2.During the study period, 126 patients were diagnosed with penicilliosis. Among them, only seven who presented with culture and/or histopathological evidence of pharyngeal and/or laryngeal T. marneffei infection were included; notably, all of these patients also had AIDS.

3.The most common specific pharyngeal and laryngeal features were sore throat, hoarseness, dysphagia, a pharyngeal and laryngeal mass and/or mucosal ulcerations, and enlargement of multiple cervical and axillary lymph nodes. Evaluation using nasal endoscopy and flexible endoscopy revealed pharyngeal and laryngeal ulcers and/or a mass.

4.Histopathological analysis of all pharyngeal and/or laryngeal tissue samples in our retrospective study revealed positivity for T. marneffei. The most common pathological type was non-reactive necrosis.

5.Histopathology and fungal culture of pharyngeal and laryngeal secretions and tissues are important and safe methods that allow determination of an accurate etiological basis for penicilliosis with pharyngeal and/or laryngeal infection, as well as differentiation from other diseases such as tuberculosis, lymphoma, pharyngeal cancer, and Kaposi's sarcoma.

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