Talaromyces marneffei central nervous system infection unveiled by the novel Mp1p antigen detection assay in AIDS patient

Abstract

Background: In acquired immunodeficiency syndrome patients, Talaromyces marneffei infections are mostly disseminated and may involve the skin, mucosa, respiratory system, digestive system, lymphatic system, and as some reports indicate, the nervous system. Mp1p, a cell wall-specific polysaccharide in Talaromyces marneffei, is used for laboratory diagnosis of Talaromyces marneffei in blood and urine samples. However, Cerebrospinal fluid Mp1p diagnosis of Talaromyces marneffei central nervous system infection has not been reported.

Case presentation: We present the case of an acquired immunodeficiency syndrome 35-year-old woman who has had dizziness and headache and was infected with central nervous system Talaromycosis.Magnetic resonance imaging scan which showed intracranial infectious lesions, altered brain atrophic, and periventricular demyelination.The Mp1p antigen was positive by using immunofluorescence in the Cerebrospinal fluid. Talaromyces marneffei was isolated from the Cerebrospinal fluid.After antifungal treatment, her clinical symptoms significantly improved.

Conclusions: Talaromyces marneffei central nervous system infection is rare. If the patient has symptoms of central nervous system, the Cerebrospinal fluid Mp1p antigen and culture should be performed to make a definitive diagnosis.

Keywords: AIDS1,Talaromyces marneffei2,Mp1p3,central nervous system4,talaromycosis5.

Fig. 1

Brain Magnetic resonance imaging. Sulci and fissure widened. Patchy abnormal signals were observed in bilateral frontal lobes, basal ganglia, and anterior and posterior corners of bilateral lateral ventricles which were presented T1 equal or low signal intensity, T2 slightly high signal intensity, T2-Flair low signal intensity in the center of the left basal ganglia lesion (A-C). Patchy enhancement was seen in the right frontal lobe (D).

Fig. 2

Chest CT.The transmittance of both lungs decreased. There were a few fibro stripes under the pleura in the lower lobe of the left lung (A). Enlarged lymph nodes were seen in the mediastinum (B)