Coinfection By Talaromyces Marneffei And Mycobacterium Abscessus In A Human Immunodeficiency Virus-Negative Patient With Anti-Interferon-Gamma Autoantibody: A Case Report

Patients with anti-interferon (IFN)-gamma autoantibodies have weakened immune defenses against intracellular pathogens. Because of its low incidence and non-specific symptoms, diagnosis of anti-IFN-gamma autoantibody syndrome is difficult to establish during the early stages of infection. Here, we report a patient with high titers of serum anti-IFN-gamma autoantibodies suffering from opportunistic infections. The patient presented with intermittent fever for 2 weeks. During his first hospitalization, he was diagnosed with Talaromyces marneffei pulmonary infection and successfully treated with antifungal therapy. However, multiple cervical lymph nodes subsequently became progressively enlarged. Mycobacterium abscessus infection was confirmed by positive cervical lymph node tissue cultures. High-titer serum anti-IFN-gamma antibodies were also detected. Following anti-M. abscessus therapy, both his symptoms and lymph node lymphadenitis gradually improved. Anti-IFN-gamma autoantibody syndrome should be considered in adult patients with severe opportunistic coinfections in the absence of other known risk factors.