Report Of 2 Cases Of Lung Cancer Complicated With Talaromyces Marneffei Infection

Objective: To discuss the diagnosis and treatment of lung cancer complicated with Talaromyces marneffei infection and improve the clinician’s understanding of the disease.Methods: To analyze and summarize the clinical characteristics of the those two combined disease,we retrospectively analyzed the clinical data of 2 adult cases of lung cancer complicated with Talaromyces marneffei infection in the First Affiliated Hospital of Guangxi Medical University from January 22,2018 to January 18,2019.Results: The 2 cases of lung cancer complicated with Talaromyces marneffei infection in this report were middle-aged men with long-term smoking history,without chronic disease history,special family history and life-history.The main symptoms are cough and expectoration,and chest pain occurs in the later stage of the disease.The chest imaging examinations suggest pulmonary shadow,and there are malignant signs such as spicule sign and tabulation sign,and pulmonary mass was strengthened to varying degrees and that the mediastinal lymph nodes were enlarged in the contrast-enhancement CT scan.The rest of the lesions in the lung were diverse and translobar,and the size of the pulmonary shadow decreased with the improvement of the disease during the treatment,and gradually increased in the late stage of disease.The first pathological results suggested that organizing pneumonia and chronic inflammation,therefore,the use of glucocorticoid in the treatment of machine pneumonia,antibiotic anti-infection and other treatment.Talaromyces marneffei were cultured with biopsies and immediately treated with amphotericin B liposome.Renal dysfunction occurred during antifungal therapy,and amphotericin B liposomes were discontinued and voriconazole was used instead.During antifungal treatment,symptoms such as fever,cough and expectoration recur in patients.These symptoms can be alleviated in the short term by using anti-infective and anti-nontuberculous mycobacteria treatments.The lung lesion of the patient increased gradually,and finally the pathology was lung adenocarcinoma.Conclusion: 1.The clinical features and imaging findings of lung cancer and Talaromyces marneffei infection are very similar.When the lung lesions of patients with Talaromyces marneffei have obvious malignant signs,and the effect of antifungal therapy is not satisfactory,it is necessary to consider the possibility of suffering from lung cancer at the same time.2.Patients with HIV-negative Talaromyces marneffei infection should be aware of the presenceof tumors and/or other opportunistic infections when anti-IFN-γ antibodies are positive.