Table 1.
Summary of the Clinical Characteristics Concerning 19 Patients With Gastrointestinal Talaromycosis: Systematic Literature and Present Report Review
| Year of Publication | Area of Report | Age (Year)/Sex | Occupation | Medical History | Clinical Manifestations | CD4+ (cells/ mm3) | Endoscopic Findings /Abdomen CT | Site(s) of Positive Culture/Histology | Antifungal Treatment | Outcome |
|---|---|---|---|---|---|---|---|---|---|---|
| 1988 [13] | Hong Kong, China | 58/M | NM | Hemolytic anemia | Fever, abdominal pain, anemia, hepatosplenomegaly | ND | Upper descending, colon constrictiona | Liver, colon, lung (a + h) | AMB for 5 days | Died |
| 1988 [14] | China | 0.33/M | None | None | Fever, diarrhea, anemia, hepatosplenomegaly | ND | ND | Liver, spleen, bowel, kidney, lung, adrenal, mesenteric lymph nodes (a + h) | None | Died |
| 1992 [15] | Hong Kong, China | 72/M | NM | AIDS | Dysphagia, anorexia, weight loss, GI bleeding | ND | ND | Small intestine, mesenteric lymph node, liver (a + h) | None | Died |
| 1996 [5] | Hong Kong, China | 32/M | NM | AIDS, TB | Fever, night sweats, dry cough, diarrhea hepatomegaly | 60 | Multiple ulcersa | Colon ulcer (b + c) | AMB for 2 weeks, oral ICZ | Cured |
| 1999 [6] | Taiwan, China | 33/M | NM | Renal transplant | Cough and sputum production, bloody stool, tongue ulcer | NM | Erosion at the antrum, ampulla Vater tumor with bleedinga | Duodenum (b), blood (c) | None | Died |
| 1999 [6] | Taiwan, China | 52/M | NM | AIDS | Fever, abdominal pain, diarrhea, hepatomegaly | 20 | Shallow ulcersa | Colon ulcers (b), blood, bone marrow, skin lesion (c) | AMB for 2 weeks, oral ICZ | Cured |
| 1999 [6] | Taiwan, China | 30/M | NM | AIDS | Fever, dyspepsia, abdominal pain, diarrhea, bloody stool, weight loss | ND | Shallow ulcersa; mesenteric lymphadenopathy and edematous intestineb | Colon ulcer (b), blood (c) | AMB for 2 weeks, oral ICZ | Cured |
| 2004 [7] | China | 21/M | Farmer | Tuberculosis of lymph nodes | Abdominal pain, skin lesion, bloody stools | ND | Erosion at the colona | Skin lesions (b + c), colon (b + h) | Oral ICZ for 10 days | Died |
| 2006 [16] | China | 51/M | NM | AIDS | Fever, diarrhea, weight loss, skin lesions | 20 | Multiple ulcersa; abdominal lymphadenopathyb | Blood, skin lesion (c) | Oral FLZ for 12 weeks, oral ICZ 10 weeks | Cured |
| 2008 [17] | India | 33/M | NM | None | Fever, abdominal pain, vomiting, weight loss hematemesis, anorexia, lymphadenopathy | 7 | Mesenteric lymphadenopathy and intestinal obstructionb | Colon (b), duodenal tissue, bone marrow (c) | AMB for 2 weeks, oral ICZ for 10 weeks | Cured |
| 2010 [8] | Hong Kong, China | 39/M | NM | AIDS | Fever, diarrhea, sore throat, weight loss | 11 | Multiple ulcersa | Colon ulcers, stomach and duodenal (b + c) | AMB for 2 weeks, then oral ICZ for 10 weeks | Cured |
| 2015 [9] | Hong Kong, China | 56/M | NM | Waldenström macroglobulinemia, ITP, PBC | Fever, night sweating, cough, bloody diarrhea | 315 | Multiple shallow ulcersa | Terminal ileal ulcers, stool (c), nasopharyngeal (b + c) | AMB for 2 weeks, oral VCZ | Cured |
| 2016 [10] | China | 41/M | NM | AIDS | Fever, abdominal pain, cough, weight loss | 18 | Multiple ulcers with polypoid lesionsa | Colon (b) | AMB for 2 weeks, oral ICZ for 9 months | Cured |
| 2017 [11] | China | 32/F | NM | AIDS, HBV carriers | Fever, abdominal pain, diarrhea, lymphadenopathy, weight loss | 4 | Multiple ulcersa abdominal lymphadenopathyb | Colon (b), blood (c) | AMB for 2 weeks, oral ICZ for 3 months | Cured |
| 2017 [12] | China | 52/M | NM | AIDS | Abdominal pain, weight loss, anemia, diarrhea | 28 | Multiple ulcersa; mesenteric lymphadenopathy, edem-atous expansion of the colonb | transverse colon (b + h) | iv ICZ for 1 week, oral ICZ | Cured |
| 2020 [13] | India | 38/F | Teacher | AIDS | Abdominal pain, skin lesions, anorexia, weight loss | 69 | Deep ulceration, luminal narrowinga, intestinal obstructionb | Skin lesions, jejunal ulcers (b) | AMB for 2 weeks, oral ICZ for 6 months | Cured |
| PR | China | 37/M | Farmer | AIDS | Abdominal pain | 77 | Multiple ulcersa | Colon (b), blood (c) | AMB for 2 weeks, then oral ICZ for 8 months | Cured |
| PR | China | 50/M | Farmer | AIDS | Abdominal pain, weight loss | 110 | Multiple ulcersa | Colon (b) | FLZ + AMB for 2 weeks, oral ICZ for 12 months | Cured |
| PR | China | 3/M | None | None | Abdominal pain, fever, hepatomegaly | 1078 | Multiple ulcersa | Colon, liver tissue (b), bone marrow (c) | iv VCZ for 4 weeks, oral VCZ for 16 months | Cured |
Abbreviations: AIDS, acquired immunodeficiency syndrome; AMB, amphotericin B; CT, computed tomography; FLZ, fluconazole; GI, gastrointestinal; HBV, hepatitis B virus; ICZ, itraconazole; ITP, idiopathic thrombocytopenic purpura; NM, not mentioned; ND, not done; iv, intravenous; PBC, primary biliary cirrhosis; PR, present report; TB, tuberculosis; VCZ, voriconazole.
NOTE: Diagnostic methods to demonstrate Talaromyces marneffei involved: (a) autopsy, (b) biopsy, (c) culture, and (h) histopathology.
aEndoscopic findings.
bCT findings of the abdomen.