Characteristics of Talaromyces marneffei with bone destruction in Guangxi Province, China: a retrospective study

Background and objective: This study retrospectively analyzed the clinical and imaging features of TM mycosis complicated with bone destruction with the aim to improve understanding, diagnosis, and treatment. Methods: Data of hospitalized TM-infected patients with bone destruction from October 2012 to May 2019 were collected. The clinical and imaging features of the disease were comprehensively analyzed. Results: All 35 patients were non-HIV infected, but some had underlying co-morbid illnesses. The duration of the disease was 1-36 months (median: 5 months). Fever, anemia, weight loss, and respiratory symptoms were the main clinical manifestations of the patients. There were 18 patients (51.4%) who had bone pain. Peripheral blood leukocyte count increased significantly in 27 patients (77.1%). The neutrophil count increased in 28 patients (80%). C-reactive protein (CRP) and immunoglobulin G levels increased in 93.3% (14/15) and 82.1% (23/28) patients, respectively. The imaging examination showed osteolytic lesions, which were multiple in several bony areas. Conclusion: Young and middle-aged patients with non-AIDS TM complicated with underlying diseases should be especially cautious in case of occurrence of bone destruction. The main clinical manifestations of patients with TM complicated with bone destruction were pulmonary symptoms and bone and joint pain, which could be accompanied by progressive consumptive diseases.