Characteristics of Endemic Mycoses Talaromyces marneffei Infection Associated with Inborn Errors of Immunity
- 01-12-2025
- Itraconazole
- Research
Published in:
- Authors
- Shubin Xing
- Zhenzhen Zhang
- Cong Liu
- Wenjing Zhang
- Zhiyong Zhang
- Xuemei Tang
- Yongwen Chen
- Wuyang He
- Xiaodong Zhao
- Yunfei An
- Published in
- Journal of Clinical Immunology | Issue 1/2025
Abstract
Background
Talaromyces marneffei (T. marneffei) is an opportunistic pathogen that causes endemic mycoses, which could lead to multiple organ damage. Talaromycosis is frequently disregarded as an early cautionary sign of immune system disorders in non-HIV-infected children.
Objective
We conduct a comprehensive review of the genotypes and clinical features of talaromycosis in patients with IEI to enhance clinical awareness regarding T. marneffei as a potential opportunistic pathogen in individuals with immune deficiencies.
Methods
A systematic literature review was performed by searching PubMed, Cochrane Central Register of Controlled Trials, Web of Science, EMBASE, and Scopus. Data on IEI patients with talaromycosis, including genotypes and their immunological and clinical features, were collected.
Results
Fifty patients with talaromycosis and IEI were included: XHIM (30.0%), STAT3-LOF deficiency (20.0%), STAT1-GOF (20.0%), IL2RG (6.00%), IFNGR1 (6.0%), IL12RB1 (4.0%), CARD9 (4.0%), COPA (4.0%), ADA (2.0%), RELB deficiency (2.0%), and NFKB2 (2.0%). Common symptoms of respiratory (43/50, 86.0%), skin (17/50, 34.0%), lymph node (31/50, 62.0%), digestive (34/50, 68.0%), and hematologic (22/50, 44.0%) systems were involved. The CT findings of the lungs may include lymph node calcification (9/30), interstitial lesions (8/30), pulmonary cavities (8/30), or specific pathogens (4/30), which could be easily misdiagnosed as tuberculosis infection. Amphotericin B (26/43), Voriconazole (24/43) and Itraconazole (22/43) were used for induction therapy. Ten patients were treated with Itraconazole sequentially and prophylaxis. 68.0% (34/50) of patients were still alive, and 4.0% (2/50) of were lost to follow-up. The disseminated T. marneffei infection resulted in the deaths of 14 individuals.
Conclusions
The XHIM, STAT1-GOF, and STAT3-LOF demonstrated the highest susceptibility to talaromycosis, indicating the potential involvement of cellular immunity, IL-17 signaling, and the IL-12/IFN-γ axis in T. marneffei defense. T. marneffei infection may serve as an early warning indicator of IEI. For IEI patients suspected of T. marneffei, metagenomic next-generation sequencing (mNGS) could rapidly and effectively identify the causative pathogen. Prompt initiation of antifungal therapy is crucial for optimizing patient outcomes.
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- Title
- Characteristics of Endemic Mycoses Talaromyces marneffei Infection Associated with Inborn Errors of Immunity
- Authors
-
Shubin Xing
Zhenzhen Zhang
Cong Liu
Wenjing Zhang
Zhiyong Zhang
Xuemei Tang
Yongwen Chen
Wuyang He
Xiaodong Zhao
Yunfei An
- Publication date
- 01-12-2025
- Publisher
- Springer US
- Published in
-
Journal of Clinical Immunology / Issue 1/2025
Print ISSN: 0271-9142
Electronic ISSN: 1573-2592 - DOI
- https://doi.org/10.1007/s10875-024-01798-3
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