Talaromycosis is a rare deep fungal infection caused by Talaromyces marneffei. Currently, methamphetamine has become the second-largest drug abuse category in the world after cannabis and has become a serious public health problem. Methamphetamine can inhibit human immune system and increase the probability of pathogenic microorganism infection. On 8 October 2016, a 20-year-old man with a fever history of 2 months was admitted to our hospital. He had bloody stools and abdominal pain during hospitalization. There was no significant abnormality in physical examination. Because of the misdiagnosis, he underwent improper treatment. Periodic acid-Schiff stain (PAS) staining showed that the mucosa of distal ileum, ascending colon, transverse colon, and sigmoid colon were infiltrated by a large number of tissue cells, which contained a large number of blue purple particles. In addition, a large number of histiocytes and multinucleated giant cells can be seen in the lamina propria of ileum mucosa, and fungal spores can be seen in histiocytes. Finally, he was diagnosed as talaromycosis and took itraconazole 0.2 g twice a day. After 5 days, the temperature dropped to normal and the inflammation disappeared, and he continued to take itraconazole for 6 months. Due to the neglect of the history of drug abuse and the concealment, drug-related talaromycosis is often misdiagnosed. Pathological examination is warranted for diagnosis talaromycosis. This condition requires a long-term anti-fungal therapy.

踝节菌病是一种罕见的深部真菌感染，由马尔尼菲踝节菌引起。目前，甲基苯丙胺已成为仅次于大麻的全球第二大毒品滥用类别，已成为严重的公共卫生问题。冰毒会抑制人体免疫系统，增加病原微生物感染的概率。 2016年10月8日，我院收治一名20岁男性，有2个月发热史。住院期间，他出现便血和腹痛。体格检查未见明显异常。由于误诊，他接受了不当的治疗。过碘酸希夫染色（PAS）染色显示远端回肠、升结肠、横结肠、乙状结肠粘膜有大量组织细胞浸润，其中含有大量蓝紫色颗粒。此外，回肠粘膜固有层可见大量组织细胞和多核巨细胞，组织细胞内可见真菌孢子。最后诊断为踝部真菌病，服用伊曲康唑0.2克，每日两次。 5天后体温降至正常，炎症消失，继续服用伊曲康唑6个月。由于忽视吸毒史和隐瞒，药物相关踝关节菌病常被误诊。诊断踝部真菌病需要病理检查。这种情况需要长期抗真菌治疗。