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Background Talaromyces marneffei <p>(<i>T. marneffei</i>, formerly <i>Penicillium marneffei</i>) is a rare fatal fungus endemic in Southeast Asia and southern China. <i>T. marneffei</i> infections mainly occur in HIV-infected adults, and commonly involves the skin, lung, and reticuloendothelial system. <i>T. marneffei</i> infections of isolated central nervous system (CNS) in immunocompetent pediatric patients in nonendemic areas have rarely been reported.</p> Case presentation <p>We report a rare case of <i>T. marneffei</i>-induced disseminated encephalomyelitis in an immunocompetent girl from a nonendemic area of Eastern China. The main clinical manifestations were abdominal pain with distension and abnormal gait. Contrast-enhanced magnetic resonance imaging (MRI) revealed both brain and spinal cord lesions. The infection status of <i>T. marneffei</i> was quickly determined via the metagenomic next-generation sequencing (mNGS) of spinal cord biopsy tissue. <i>T. marneffei</i> induced disseminated encephalomyelitis was diagnosed. Following successful antifungal treatment with amphotericin B liposomes and voriconazole, the child recovered gradually. To date, only 3 cases of <i>T. marneffei</i> infection of the central nervous system in non-HIV-infected pediatric patients have been reported in the literature. Among them, one child had inborn errors of immunity, and the other two children were from endemic areas. Moreover, the clinical manifestations of those 3 reported cases were disseminated with common infection sites in the lungs. our patient represents a unique case of an immunocompetent child from a nonendemic area with isolated CNS infection.</p> Conclusions <p>We report this rare case and aim to promote pediatric clinicians’ recognition of <i>T. marneffei</i> isolated CNS infection in immunocompetent pediatric patients from nonendemic regions. Furthermore, the early use of mNGS is recommended when non-HIV-infected pediatric patients present with unexplained clinical manifestations and poor response to conventional treatments. Timely diagnosis and appropriate antifungal therapy can improve patient prognosis.</p>

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Talaromyces marneffei infection of central nervous system in an immunocompetent child in a nonendemic area: a case report and literature review

  • 期刊论文

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  • 发表日期：

    2026年5月19日

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  • Guoxia Sheng,
  • Congying Zhao,
  • Lihua Jiang,
  • Xin Zhang,
  • Feng Gao

摘要

Background Talaromyces marneffei

(T. marneffei, formerly Penicillium marneffei) is a rare fatal fungus endemic in Southeast Asia and southern China. T. marneffei infections mainly occur in HIV-infected adults, and commonly involves the skin, lung, and reticuloendothelial system. T. marneffei infections of isolated central nervous system (CNS) in immunocompetent pediatric patients in nonendemic areas have rarely been reported.

Case presentation

We report a rare case of T. marneffei-induced disseminated encephalomyelitis in an immunocompetent girl from a nonendemic area of Eastern China. The main clinical manifestations were abdominal pain with distension and abnormal gait. Contrast-enhanced magnetic resonance imaging (MRI) revealed both brain and spinal cord lesions. The infection status of T. marneffei was quickly determined via the metagenomic next-generation sequencing (mNGS) of spinal cord biopsy tissue. T. marneffei induced disseminated encephalomyelitis was diagnosed. Following successful antifungal treatment with amphotericin B liposomes and voriconazole, the child recovered gradually. To date, only 3 cases of T. marneffei infection of the central nervous system in non-HIV-infected pediatric patients have been reported in the literature. Among them, one child had inborn errors of immunity, and the other two children were from endemic areas. Moreover, the clinical manifestations of those 3 reported cases were disseminated with common infection sites in the lungs. our patient represents a unique case of an immunocompetent child from a nonendemic area with isolated CNS infection.

Conclusions

We report this rare case and aim to promote pediatric clinicians’ recognition of T. marneffei isolated CNS infection in immunocompetent pediatric patients from nonendemic regions. Furthermore, the early use of mNGS is recommended when non-HIV-infected pediatric patients present with unexplained clinical manifestations and poor response to conventional treatments. Timely diagnosis and appropriate antifungal therapy can improve patient prognosis.