Chest CT imaging findings in patients with Talaromyces marneffei infection and thoracic involvement: a systematic review and meta-analysis

To explore the characteristics of chest CT imaging of Talaromyces marneffei pneumonia by meta-analysis, so as to provide reference for clinical diagnosis. A systematic search was conducted in databases including PubMed, Web of Science, Embase, The Cochrane Library, Scopus, CNKI, Wanfang, and VIP from inception to October 2025. Literature was screened according to pre-defined criteria and assessed for quality using the Newcastle–Ottawa Scale. Meta-analysis was performed using R software (version 4.3.x) with the meta package to calculate the pooled prevalence and 95% confidence intervals for each CT feature. The Freeman–Tukey double arcsine transformation was applied to stabilize variance. The meta-analysis quantified the prevalence of chest CT imaging features in Talaromyces marneffei pneumonia. The most frequently reported features were lymphadenopathy (89.2%), patchy consolidation (79.8%), and pleural thickening (66.5%). Other common findings included nodules (62.7%), pleural effusion (58.6%), and dense consolidation (47.3%). Ground-glass opacity (33.6%), pericardial effusion (26.5%), cavities (19.8%), and masses (13.8%) were less frequently reported. Lymphadenopathy, patchy consolidation, and pleural thickening are among the most frequently reported chest CT findings in patients with Talaromyces marneffei infection and thoracic involvement. Recognition of these common findings could raise clinical awareness and contribute to the differential diagnosis, especially in endemic areas or immunocompromised hosts. However, given the heterogeneity of the underlying studies and the non-specific nature of these findings, they should be interpreted with caution and cannot substitute for definitive microbiological or histopathological diagnosis.