Guomin Zhang, Guangrong Wu, Yuanyuan Xu, Li Yang, Wei Yang

Department of Radiology, The Third Affiliated Hospital of Zunyi Medical University (The First People’s Hospital of Zunyi), Zunyi, People’s Republic of China

Correspondence: Wei Yang, Email coxsackie@163.com

Abstract: HIV-infected individuals typically present with diverse clinical manifestations and heightened susceptibility to various opportunistic infections. We present a case of a hospitalized HIV patient presenting with dizziness, headache, and lip numbness. Neuroimaging revealed disseminated lesions involving bilateral cerebral hemispheres, spinal cord, pulmonary parenchyma, and mesenteric lymph nodes, subsequently confirmed through cerebrospinal fluid analysis and genetic testing as systemic TM infection. Following a 10-day course of intravenous amphotericin B, the patient demonstrated symptomatic improvement and was discharged. Post-discharge management included combination antiretroviral therapy (Bictegravir/Emtricitabine/Tenofovir alafenamide) with oral itraconazole prophylaxis. One-year follow-up imaging demonstrated near-complete resolution of systemic lesions. This report highlights characteristic radiological patterns and emphasizes the importance of considering disseminated TM infection in HIV patients with neurological involvement, particularly in endemic regions.

Keywords: talaromyces marneffei, multisystem infection, HIV, CT, MRI, case report