{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T11:04:37Z","timestamp":1785323077465,"version":"3.55.0"},"reference-count":12,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"vor","delay-in-days":209,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Infectious Diseases"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>\n                    Haemophagocytic lymphohistiocytosis (HLH) is a life\u2010threatening hyperinflammatory syndrome that may complicate advanced HIV infection, most commonly triggered by opportunistic infections. We report a man with advanced HIV who presented with prolonged fever and pancytopenia without an identifiable source despite extensive investigation. Bone marrow examination demonstrated haemophagocytosis, while blood mycobacterial culture yielded\n                    <jats:italic>Penicillium marneffei<\/jats:italic>\n                    , now classified as\n                    <jats:italic>Talaromyces marneffei<\/jats:italic>\n                    . Together with prolonged fever, pancytopenia, marked hyperferritinaemia and a retrospective HScore of 189, these findings supported disseminated talaromycosis with an HLH\u2010like hyperinflammatory syndrome; complete HLH\u20102004 testing was not available. The patient demonstrated rapid clinical and haematological recovery following antifungal therapy with amphotericin B, without the need for HLH\u2010directed immunosuppressive treatment. Antiretroviral therapy was subsequently initiated, followed by successful treatment of chronic hepatitis C infection. This case highlights the importance of early consideration of fungal infections and HLH\u2010like syndromes in advanced HIV, as well as the diagnostic value of bone marrow examination in identifying treatable causes of prolonged febrile illness.\n                  <\/jats:p>","DOI":"10.1155\/crdi\/9257582","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T10:37:20Z","timestamp":1785321440000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Advanced HIV Presenting With Pancytopenia and HLH\u2010Like Hyperinflammation Secondary to Disseminated Talaromycosis: A Case Report"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-2584-011X","authenticated-orcid":false,"given":"Zhong Xhen","family":"Khor","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,29]]},"reference":[{"key":"e_1_2_13_1_2","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.21039"},{"key":"e_1_2_13_2_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2018894618"},{"key":"e_1_2_13_3_2","doi-asserted-by":"crossref","first-page":"e00051","DOI":"10.1128\/cmr.00051-22","article-title":"An Overlooked and Underrated Endemic Mycosis\u2014Talaromycosis Due to Talaromyces marneffei","volume":"36","author":"Wang F.","year":"2023","journal-title":"Clinical Microbiology Reviews"},{"key":"e_1_2_13_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0002-9343(97)00253-2"},{"key":"e_1_2_13_5_2","doi-asserted-by":"crossref","first-page":"11","DOI":"10.4269\/ajtmh.2008.78.11","article-title":"Haemophagocytic Syndrome in a Patient With AIDS and Disseminated Penicillium Marneffei Infection","volume":"78","author":"Pei S. N.","year":"2008","journal-title":"American Journal of Tropical Medicine and Hygiene"},{"key":"e_1_2_13_6_2","first-page":"3807","article-title":"Clinical Features and Outcomes of Talaromyces Marneffei\u2013Associated Haemophagocytic Lymphohistiocytosis","volume":"12","author":"Pan M.","year":"2019","journal-title":"Infection and Drug Resistance"},{"key":"e_1_2_13_7_2","first-page":"260","article-title":"Disseminated Talaromyces Marneffei Infection Presenting as Secondary Haemophagocytic Lymphohistiocytosis in an HIV-Infected Patient","volume":"95","author":"Cheok Y. Y.","year":"2020","journal-title":"International Journal of Infectious Diseases"},{"key":"e_1_2_13_8_2","article-title":"Secondary Haemophagocytic Lymphohistiocytosis in an AIDS Patient Infected With Talaromyces Marneffei and Alpha-Thalassaemia: A Case Report and Literature Review","volume":"36","author":"Wu Q.","year":"2024","journal-title":"ID Cases"},{"key":"e_1_2_13_9_2","article-title":"Talaromyces Marneffei Infection Complicated by Secondary Haemophagocytic Lymphohistiocytosis in an Immunocompetent Adult: A Case Report","volume":"24","author":"Hu X.","year":"2024","journal-title":"BioMed Central Infectious Diseases"},{"key":"e_1_2_13_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-023-08953-y"},{"key":"e_1_2_13_11_2","volume-title":"National Antimicrobial Guideline (NAG)","author":"Ministry of Health Malaysia","year":"2024"},{"key":"e_1_2_13_12_2","volume-title":"Clinical Practice Guidelines: Management of Hepatitis C","author":"Ministry of Health Malaysia","year":"2019"}],"container-title":["Case Reports in Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/crdi\/9257582","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/crdi\/9257582","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/crdi\/9257582","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T10:37:24Z","timestamp":1785321444000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/crdi\/9257582"}},"subtitle":[],"editor":[{"given":"Priya","family":"Gusain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":12,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/crdi\/9257582"],"URL":"https:\/\/doi.org\/10.1155\/crdi\/9257582","archive":["Portico"],"relation":{},"ISSN":["2090-6625","2090-6633"],"issn-type":[{"value":"2090-6625","type":"print"},{"value":"2090-6633","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2026-05-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"9257582"}}