{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T17:50:18Z","timestamp":1790704218605,"version":"4.1.0"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,7,4]],"date-time":"2023-07-04T00:00:00Z","timestamp":1688428800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100012542","name":"Sichuan Province Science and Technology Support Program","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012542","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Sepsis is a life-threatening condition caused by a dysfunctional response to infection from the host. Septic shock, a subset of sepsis, caused by <jats:italic>Talaromyces marneffei<\/jats:italic> infection (talaromycosis) has rarely been reported. Owing to its slow culture and low yield, talaromycosis is typically misdiagnosed in HIV-negative patients as other infections, such as tuberculosis, bacterial pneumonia, and lung cancer, especially in non-endemic regions. Early and accurate diagnosis as well as efficient treatment options are required to improve prognosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A 30-year-old HIV-negative Chinese woman from a non-endemic area of <jats:italic>T. marneffei<\/jats:italic> was initially misdiagnosed with tuberculosis. She had a poor response to anti-tuberculosis treatment. On July 16, 2022, she was admitted to our hospital; the patient developed septic shock on the third day after hospitalization and was ultimately diagnosed with talaromycosis <jats:italic>via<\/jats:italic> metagenomic next-generation sequencing (mNGS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Result<\/jats:title><jats:p>The condition of the patient improved after appropriate treatment with amphotericin B. Furthermore, enzyme-linked immunosorbent assay results confirmed that the patient had a high-titer of anti-interferon gamma (IFN-\u03b3) autoantibodies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>HIV-negative individuals with anti-IFN-\u03b3 autoantibodies typically have relapsing, refractory, and fatal infections, such as talaromycosis, which is typically misdiagnosed in the initial course of the disease. This can lead to septic shock. Clinicians should be aware that they may encounter HIV-negative patients with <jats:italic>T. marneffei<\/jats:italic> infection in non-endemic areas. Thus, mNGS is an effective technology for detecting <jats:italic>T. marneffei<\/jats:italic> infection. Additionally, the detection of anti-IFN-\u03b3 autoantibodies in these patients would aid in knowing their susceptibility to fatal infections.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcimb.2023.1163846","type":"journal-article","created":{"date-parts":[[2023,7,4]],"date-time":"2023-07-04T12:26:25Z","timestamp":1688473585000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":14,"title":["Case report: Diagnosis of Talaromyces marneffei infection in an HIV-negative patient with septic shock and high-titer anti-interferon gamma autoantibodies by metagenomic next-generation sequencing"],"prefix":"10.3389","volume":"13","author":[{"given":"Rao","family":"Du","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yinhe","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Mao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,7,4]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1002\/cpmc.97","article-title":"Laboratory maintenance and growth of Talaromyces marneffei","volume":"56","author":"Andrianopoulos","year":"2020","journal-title":"Curr. Protoc. Microbiol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1016\/S0140-6736(18)30696-2","article-title":"Sepsis and septic shock","volume":"392","author":"Cecconi","year":"2018","journal-title":"Lancet"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1038\/emi.2016.18","article-title":"Talaromyces (Penicillium) marneffei infection in non-HIV-infected patients","volume":"5","author":"Chan","year":"2016","journal-title":"Emerg Microbes Infections"},{"key":"B4","doi-asserted-by":"publisher","first-page":"587","DOI":"10.1186\/s12879-021-06255-9","article-title":"Clinical findings of Talaromyces marneffei infection among patients with anti-interferon-\u03b3 immunodeficiency: a prospective cohort study","volume":"21","author":"Chen","year":"2021","journal-title":"BMC Infect. Dis."},{"key":"B5","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1007\/s10875-019-00688-3","article-title":"Molecular and phenotypic characterization of nine patients with STAT1 GOF mutations in China","volume":"40","author":"Chen","year":"2020","journal-title":"J. Clin. Immunol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"3381","DOI":"10.2147\/IDR.S364388","article-title":"Anti-interferon-\u03b3 autoantibodies impair T-lymphocyte responses in patients with infections","volume":"15","author":"Chen","year":"2022","journal-title":"Infection Drug Resistance"},{"key":"B7","doi-asserted-by":"publisher","first-page":"640","DOI":"10.1093\/clinids\/10.3.640","article-title":"Infections caused by Penicillium marneffei in China and southeast Asia: review of eighteen published cases and report of four more Chinese cases","volume":"10","author":"Deng","year":"1988","journal-title":"Rev. Infect. Dis."},{"key":"B8","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1378\/chest.11-3157","article-title":"Predictive value of interferon-\u03b3 release assays and tuberculin skin testing for progression from latent TB infection to disease state: a meta-analysis","volume":"142","author":"Diel","year":"2012","journal-title":"Chest"},{"key":"B9","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1093\/ajcp\/60.2.259","article-title":"Infection caused by Penicillium marneffei: description of first natural infection in man","volume":"60","author":"DiSalvo","year":"1973","journal-title":"Am. J. Clin. Pathol."},{"key":"B10","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1146\/annurev-pathmechdis-012418-012751","article-title":"Clinical metagenomic next-generation sequencing for pathogen detection","volume":"14","author":"Gu","year":"2019","journal-title":"Annu. Rev. Pathol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"e20190502","DOI":"10.1084\/jem.20190502","article-title":"Anti-IFN-\u03b3 autoantibodies underlie disseminated Talaromyces marneffei infections","volume":"217","author":"Guo","year":"2020","journal-title":"J. Exp. Med."},{"key":"B12","doi-asserted-by":"publisher","first-page":"1170","DOI":"10.1111\/myc.13295","article-title":"Talaromyces marneffei infection in non-HIV-infected patients in mainland China","volume":"64","author":"He","year":"2021","journal-title":"Mycoses"},{"key":"B13","doi-asserted-by":"publisher","first-page":"673","DOI":"10.1182\/blood-2003-04-1065","article-title":"Naturally occurring anti-IFN-gamma autoantibody and severe infections with Mycobacterium cheloneae and Burkholderia cocovenenans","volume":"103","author":"H\u00f6flich","year":"2004","journal-title":"Blood"},{"key":"B14","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1016\/j.jmii.2020.02.007","article-title":"The decreased number and function of lymphocytes is associated with Penicillium marneffei infection in HIV-negative patients","volume":"54","author":"Hu","year":"2021","journal-title":"J. MicrobioL Immunol Infection = Wei Mian Yu Gan Ran Za Zhi"},{"key":"B15","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1007\/s11046-012-9577-0","article-title":"Penicillium marneffei infection: an emerging disease in mainland China","volume":"175","author":"Hu","year":"2013","journal-title":"Mycopathologia"},{"key":"B16","doi-asserted-by":"publisher","first-page":"5376","DOI":"10.3390\/ijms20215376","article-title":"The pathogenesis of sepsis and potential therapeutic targets","volume":"20","author":"Huang","year":"2019","journal-title":"Int. J. Mol. Sci."},{"key":"B17","doi-asserted-by":"publisher","first-page":"617","DOI":"10.2106\/JBJS.19.00001","article-title":"Tuberculosis of the spine","volume":"102","author":"Jain","year":"2020","journal-title":"J. Bone Joint Surgery. Am. Volume"},{"key":"B18","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1186\/s12879-020-04984-x","article-title":"Disseminated Mycobacterium simiae infection in a patient with adult-onset immunodeficiency due to anti-interferon-gamma antibodies - a case report","volume":"20","author":"Keragala","year":"2020","journal-title":"BMC Infect. Dis."},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofac614","article-title":"Disseminated Talaromyces marneffei infection with STAT3-Hyper-IgE syndrome: a case series and literature review","volume":"10","author":"Li","year":"2023","journal-title":"Open Forum Infect. Dis."},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2022.987692","article-title":"Rapid diagnosis of Talaromyces marneffei infection by metagenomic next-generation sequencing technology in a Chinese cohort of inborn errors of immunity","volume":"12","author":"Liu","year":"2022","journal-title":"Front. Cell Infect. Microbiol."},{"key":"B21","doi-asserted-by":"publisher","first-page":"701","DOI":"10.1586\/eri.12.50","article-title":"Sepsis, severe sepsis and septic shock: changes in incidence, pathogens and outcomes","volume":"10","author":"Martin","year":"2012","journal-title":"Expert Rev. Anti-Infective Ther."},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0195569","article-title":"Accuracy of rapid diagnosis of Talaromyces marneffei: a systematic review and meta-analysis","volume":"13","author":"Ning","year":"2018","journal-title":"PloS One"},{"key":"B23","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1007\/s10875-020-00869-5","article-title":"Immunodeficiency disease spectrum in HIV-negative individuals with talaromycosis","volume":"41","author":"Qiu","year":"2021","journal-title":"J. Clin. Immunol."},{"key":"B24","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1186\/s12879-021-07015-5","article-title":"Talaromyces marneffei and mycobacterium tuberculosis co-infection in a patient with high titer anti-interferon-\u03b3 autoantibodies: a case report","volume":"22","author":"Qiu","year":"2022","journal-title":"BMC Infect. Dis."},{"key":"B25","doi-asserted-by":"publisher","first-page":"206","DOI":"10.1016\/j.coi.2021.05.007","article-title":"Anti-interferon-\u03b3 autoantibody-associated immunodeficiency","volume":"72","author":"Shih","year":"2021","journal-title":"Curr. Opin. Immunol."},{"key":"B26","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1128\/CMR.19.1.95-110.2006","article-title":"Penicillium marneffei infection and recent advances in the epidemiology and molecular biology aspects","volume":"19","author":"Vanittanakom","year":"2006","journal-title":"Clin. Microbiol. Rev."},{"key":"B27","doi-asserted-by":"publisher","first-page":"2323","DOI":"10.1001\/jama.2009.1754","article-title":"International study of the prevalence and outcomes of infection in intensive care units","volume":"302","author":"Vincent","year":"2009","journal-title":"JAMA"},{"key":"B28","doi-asserted-by":"publisher","first-page":"455","DOI":"10.1007\/s11046-022-00659-0","article-title":"Talaromyces marneffei infections in 8 Chinese children with inborn errors of immunity","volume":"187","author":"Wang","year":"2022","journal-title":"Mycopathologia"},{"key":"B29","doi-asserted-by":"publisher","first-page":"621","DOI":"10.1177\/1535370218764086","article-title":"Characterization of anti-interferon-\u03b3 antibodies in HIV-negative immunodeficient patients infected with unusual intracellular microorganisms","volume":"243","author":"Wipasa","year":"2018","journal-title":"Exp. Biol. Med."},{"key":"B30","doi-asserted-by":"publisher","first-page":"4535","DOI":"10.1128\/JCM.39.12.4535-4540.2001","article-title":"Differences in clinical and laboratory diagnostic characteristics of penicilliosis marneffei in human immunodeficiency virus (HIV)- and non-HIV-infected patients","volume":"39","author":"Wong","year":"2001","journal-title":"J. Clin. Microbiol."},{"key":"B31","doi-asserted-by":"publisher","first-page":"553","DOI":"10.1007\/s11046-021-00576-8","article-title":"Talaromyces marneffei infection in an HIV-negative child with a CARD9 mutation in China: a case report and review of the literature","volume":"186","author":"You","year":"2021","journal-title":"Mycopathologia"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000001439","article-title":"A retrospective analysis of 7 human immunodeficiency virus-negative infants infected by Penicillium marneffei","volume":"94","author":"Zeng","year":"2015","journal-title":"Medicine"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0130376","article-title":"A clinical study of acquired immunodeficiency syndrome associated Penicillium marneffei infection from a non-endemic area in China","volume":"10","author":"Zheng","year":"2015","journal-title":"PloS One"},{"key":"B34","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1007\/s11046-014-9737-5","article-title":"Retrospective analysis of 15 cases of Penicilliosis marneffei in a southern China hospital","volume":"177","author":"Zhou","year":"2014","journal-title":"Mycopathologia"},{"key":"B35","doi-asserted-by":"publisher","first-page":"323","DOI":"10.3390\/diagnostics13020323","article-title":"The clinical impact of metagenomic next-generation sequencing (mNGS) test in hospitalized patients with suspected sepsis: a multicenter prospective study","volume":"13","author":"Zuo","year":"2023","journal-title":"Diagnostics"}],"container-title":["Frontiers in Cellular and Infection Microbiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2023.1163846\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,7,4]],"date-time":"2023-07-04T12:26:30Z","timestamp":1688473590000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcimb.2023.1163846\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,4]]},"references-count":35,"alternative-id":["10.3389\/fcimb.2023.1163846"],"URL":"https:\/\/doi.org\/10.3389\/fcimb.2023.1163846","relation":{},"ISSN":["2235-2988"],"issn-type":[{"value":"2235-2988","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,4]]},"article-number":"1163846"}}