AUTHOR=Yang Qin , Yu Chendi , Wu Yue , Cao Ke , Li Xiaonan , Cao Weiguo , Cao Lichao , Zhang Shenrui , Ba Ying , Zheng Yuejie , Zhang Hezi , Wang Wenjian 

TITLE=Unusual Talaromyces marneffei and Pneumocystis jirovecii coinfection in a child with a STAT1 mutation: A case report and literature review

JOURNAL=Frontiers in Immunology

VOLUME=14

YEAR=2023

URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2023.1103184

DOI=10.3389/fimmu.2023.1103184

ISSN=1664-3224

ABSTRACT=<p><italic>Talaromyces marneffei</italic> and <italic>Pneumocystis jirovecii</italic> are the common opportunistic pathogens in immunodeficient patients. There have been no reports of <italic>T. marneffei</italic> and <italic>P. jirovecii</italic> coinfection in immunodeficient children. Signal transducer and activator of transcription 1 (<italic>STAT1</italic>) is a key transcription factor in immune responses. <italic>STAT1</italic> mutations are predominately associated with chronic mucocutaneous candidiasis and invasive mycosis. We report a 1-year-2-month-old boy diagnosed with severe laryngitis and pneumonia caused by <italic>T. marneffei</italic> and <italic>P. jirovecii</italic> coinfection, which was confirmed by smear, culture, polymerase chain reaction and metagenome next-generation sequencing of bronchoalveolar lavage fluid. He has a known <italic>STAT1</italic> mutation at amino acid 274 in the coiled-coil domain of <italic>STAT1</italic> according to whole exome sequencing. Based on the pathogen results, itraconazole and trimethoprim-sulfamethoxazole were administered. This patient’s condition improved, and he was discharged after two weeks of targeted therapy. In the one-year follow-up, the boy remained symptom-free without recurrence.</p>