Cryosurgery and Next-Generation Sequencing Unravel Talaromycosis Mimicking an Airway Tumor: A Case Report

Qinzhe Zhang,1 Fei Zheng,1 Zongdong Pang,1 Yonghong Xiang,1 Saibin Wang2 1Department of Pulmonary and Critical Care Medicine, Minzu Hospital of Guangxi Zhuang Autonomous Region, NanNing, Guangxi Province, 530000, People’s Republic of China; 2Department of Pulmonary and Critical Care Medicine, Jinhua Municipal Central Hospital, Jinhua, Zhejiang Province, 321000, People’s Republic of ChinaCorrespondence: Yonghong Xiang, Department of Pulmonary and Critical Care Medicine, Minzu Hospital of Guangxi Zhuang Autonomous Region, No. 232, East Mingxiu Road, NanNing, Guangxi Province, 530000, People’s Republic of China, Email [email protected] Saibin Wang, Department of Pulmonary and Critical Care Medicine, Jinhua Municipal Central Hospital, No. 365, East Renmin Road, Jinhua, Zhejiang Province, 321000, People’s Republic of China, Email [email protected]: Tracheobronchial talaromycosis is uncommon in non-HIV infected patients. Reports on tracheobronchial talaromycosis presenting as a tumor-like lesion are also scarce, and the value of bronchoscopic cryosurgery in the treatment of tracheobronchial talaromycosis has not been mentioned. We report a case of tracheobronchial talaromycosis mimicking an airway tumor, which was diagnosed through bronchoscopic cryosurgery, next-generation sequencing(NGS), and tissue culture. The patient presented with neoplastic lesions in the airway and tested positive for anti-interferon-gamma autoantibody(AIGA). Clinical cure was achieved through bronchoscopic cryosurgery followed by a 2-week course of intravenous amphotericin B infusion and atomization induction therapy, along with 3 months of oral voriconazole maintenance therapy. In addition, we collected six reports summarizing the clinical data of tracheobronchial Talaromyces marneffei infection in non-HIV infected patients, including 14 patients with AIGA-positive, and discussed their clinical features. Our research may help increase physicians’ awareness of these types of diseases and provide resources for future diagnosis and treatment.Keywords: talaromycosis, anti-interferon-gamma autoantibody, airway tumor-like lesions, next-generation sequencing, cryosurgery