title: Disseminated Talaromyces marneffei and Mycobacterium intracellulare coinfection in an HIV-infected patient.
abstract: A 25-year-old man with human immunodeficiency virus (HIV) infection presented with fever that had lasted 1 month. The CD4+ T lymphocyte count was 7 cells/μL and computed tomography showed several small lung nodules, splenomegaly, and multiple lymphadenopathy. Talaromyces marneffei was isolated in the initial blood cultures. As the fever persisted despite clearance of fungemia and 10 days of liposomal amphotericin B treatment, cervical lymph node fine-needle aspiration was performed. Mycobacterium intracellulare was isolated from sputum and neck node aspiration cultures. The patient was successfully treated with liposomal amphotericin B, clarithromycin, and ethambutol in addition to antiretroviral therapy. This case suggests that we should consider coinfection of opportunistic pathogens in febrile immunosuppressed patients if the patient does not respond properly to the initial treatment.
authors.affiliation: Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710, Republic of Korea.
authors.forename: Hyeri
authors.initials: H
authors.lastname: Seok
authors.affiliation: Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710, Republic of Korea.
authors.forename: Jae-Hoon
authors.initials: JH
authors.lastname: Ko
authors.affiliation: Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710, Republic of Korea.
authors.forename: Inseub
authors.initials: I
authors.lastname: Shin
authors.affiliation: Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710, Republic of Korea.
authors.forename: Young Hee
authors.initials: YH
authors.lastname: Eun
authors.affiliation: Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710, Republic of Korea.
authors.forename: Seung-Eun
authors.initials: SE
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710, Republic of Korea.
authors.forename: You-Bin
authors.initials: YB
authors.lastname: Lee
authors.affiliation: Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 135-710, Republic of Korea. Electronic address: krpeck@skku.edu.
authors.forename: Kyong Ran
authors.initials: KR
authors.lastname: Peck
mesh_terms: D000328:Adult; D060085:Coinfection / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D016469:Fungemia / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008297:Male; D015269:Mycobacterium avium Complex / Q000302:isolation & purification; D015270:Mycobacterium avium-intracellulare Infection / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D032901:Talaromyces / Q000302:isolation & purification
keywords: Coinfection; HIV; Lymphadenopathy; Mycobacterium intracellulare; Talaromyces marneffei