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Abstract   Background  Hematogenous dissemination of  Talaromyces marneffei  can result in multiorgan involvement (skin, lung, and reticuloendothelial system involvement); however, few studies have reported intestinal  T marneffei  infections. We investigated clinical features, management, and patient outcomes concerning  Talaromyces -related intestinal infections.    Methods  Patients with  Talaromycosis  between August 2012 and April 2019 at The First Affiliated Hospital of Guangxi Medical University, China, were retrospectively analyzed. Patients presenting with intestinal  Talaromycosis  and endoscopy-confirmed diagnoses were investigated. We also undertook a systematic review of the relevant English and Chinese literature.    Results  Of 175 patients diagnosed with  Talaromycosis , 33 presented with gastrointestinal symptoms, and 31 underwent stool cultures, 1 of which tested positive. Three patients had gastrointestinal symptoms and negative stool cultures, and endoscopic tissue biopsy confirmed a pathological diagnosis. A systematic review of 14 reports on human  Talaromycosis  identified an additional 16 patients. Fever, weight loss, and anemia were the most common symptoms, along with abdominal pain, diarrhea, and bloody stools. Abdominal computed tomography showed intestinal wall edema and thickening and/or abdominal lymphadenopathy. Endoscopy showed erosion, hyperemia, edema, and multiple intestinal mucosal ulcers. Of the 19 patients, 16 received antifungal therapy, 14 of whom recovered and 2 died. Three patients received no therapy and died.    Conclusions  Gastrointestinal disseminated  Talaromycosis  is not rare and can affect the stomach, duodenum, and colon, and may involve the entire digestive tract. Colon is the most common site. Endoscopy is needed for patients presenting with gastrointestinal symptoms in  T marneffei- infected endemic areas. Systemic application of effective antifungal therapy can improve the prognosis.

Assessment of Talaromyces Marneffei Infection of the Intestine in Three Patients and a Systematic Review of Case Reports