The clinical and laboratory characteristics of AIDS-associated Talaromyces marneffei infection, a rare but a fatal mycosis disease of the central nervous system, remain unclear. Herein, we conducted a retrospective study of ten AIDS patients with cerebrospinal fluid culture-confirmed central nervous system infection caused by Talaromyces marneffei. All 10 patients were promptly treated with antifungal treatment for a prolonged duration and early antiviral therapy (ART). Among them, seven patients were farmers. Nine patients were discharged after full recovery, while one patient died during hospitalization, resulting in a mortality rate of 10%. All patients initially presented symptoms and signs of an increase in intracranial pressure, mainly manifesting as headache, dizziness, vomiting, fever, decreased muscle strength, diplopia or even altered consciousness with seizures in severe patients. Nine patients (90%) showed lateral ventricle dilatation or intracranial infectious lesions on brain CT. Cerebrospinal fluid findings included elevated intracranial pressure, increased leukocyte count, low glucose, low chloride and high cerebrospinal fluid protein. The median CD4+ T count of patients was 104 cells/μL (IQR, 36–224 cells/μL) at the onset of the disease. The CD4+ T cell counts of three patients who eventually died were significantly lower (W = 6.00, p = 0.020) than those of the patients who survived. The common clinical symptoms of T. marneffei central nervous system infection are associated with high intracranial pressure and intracranial infectious lesions. Earlier recognition and diagnosis and a prolonged course of amphotericin B treatment followed by itraconazole combined with early ART might reduce the mortality rate.

中文翻译：

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西南地区患者的艾滋病相关性马尔尼菲塔拉霉菌中枢神经系统感染。

尚不清楚与艾滋病相关的马尔尼菲嗜血杆菌（Talaromyces marneffei）感染的临床和实验室特征，这是一种罕见但致命的中枢神经系统真菌病。在这里，我们进行了一项回顾性研究，对十名艾滋病患者进行了脑脊液培养确诊的马尔尼菲塔拉木霉菌引起的中枢神经系统感染。所有10例患者均接受了长期抗真菌治疗和早期抗病毒治疗（ART）。其中，有7名患者是农民。9名患者完全康复后出院，而一名患者在住院期间死亡，死亡率为10％。所有患者最初都表现出颅内压升高的症状和体征，主要表现为头痛，头晕，呕吐，发烧，肌肉力量下降，重症患者的复视或意识改变甚至癫痫发作。九名患者（90％）在脑部CT上显示了侧脑室扩张或颅内感染性病变。脑脊液检查结果包括颅内压升高，白细胞计数增加，低葡萄糖，低氯化物和高脑脊液蛋白。在疾病发作时，患者的CD4 + T中位数为104细胞/μL（IQR，36–224细胞/μL）。三名最终死亡的患者的CD4 + T细胞计数显着低于存活的患者（W = 6.00，p = 0.020）。马尔尼菲螺旋体中枢神经系统感染的常见临床症状与颅内压高和颅内感染性病变有关。