Early differential diagnosis models of Talaromycosis and Tuberculosis in HIV-negative hosts using clinical data and machine learning

IF 4.7 3区医学 Q1 INFECTIOUS DISEASES

Journal of Infection and Public Health Pub Date : 2025-03-11 DOI:10.1016/j.jiph.2025.102740

Ye Qiu , Zheng-tu Li , Shi-xiong Yang , Wu-shu Chen , Yong Zhang , Qun-yu Kong , Ling-rui Chen , Jie Huang , Lü Lin , Kan Xie , Wen Zeng , Shao-qiang Li , Yang-qing Zhan , Yan Wang , Jian-quan Zhang , Feng Ye

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引用次数: 0

Abstract

Background

Talaromyces marneffei is an emerging pathogen, and the number of infections in HIV-negative individuals is increasing. In HIV-negative individuals, talaromycosis is usually misdiagnosed as another disease, especially tuberculosis (TB).

Methods

We retrospectively extracted the clinical data of HIV-negative patients with Talaromyces marneffei infection from 2018 to 2023, analyzed the differences between TB patients and talaromycosis patients and attempted to establish differential diagnosis models utilizing clinical prediction models for these two diseases.

Results

Overall, 718 patients, including 137 patients with talaromycosis and 581 patients with pulmonary tuberculosis (PTB), were enrolled in this study. According to the multivariate analysis, age > 65 years, expectoration, and PLT count were independent predictors for TB. Fever, chest pain, gasping, rash, lymphadenectasis, osteolysis, Neu count, EOS count, and ALB were independent predictors for talaromycosis. Receiver operating characteristic (ROC) curve analysis of the training set showed that the area under the curve (AUC) (95 % CI) of the clinical differential model based on logistic regression analysis was 0.918 (0.884–0.953). The model was verified in the validation set. ROC curve analysis of the validation set showed that the AUC (95 % CI) was 0.900 (0.841–0.959).

Conclusion

These new differential diagnosis models can calculate the probability of either talaromycosis or tuberculosis.

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来源期刊

Journal of Infection and Public Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -INFECTIOUS DISEASES

CiteScore

13.10

自引率

1.50%

发文量

203

审稿时长

96 days

期刊介绍： The Journal of Infection and Public Health, first official journal of the Saudi Arabian Ministry of National Guard Health Affairs, King Saud Bin Abdulaziz University for Health Sciences and the Saudi Association for Public Health, aims to be the foremost scientific, peer-reviewed journal encompassing infection prevention and control, microbiology, infectious diseases, public health and the application of healthcare epidemiology to the evaluation of health outcomes. The point of view of the journal is that infection and public health are closely intertwined and that advances in one area will have positive consequences on the other. The journal will be useful to all health professionals who are partners in the management of patients with communicable diseases, keeping them up to date. The journal is proud to have an international and diverse editorial board that will assist and facilitate the publication of articles that reflect a global view on infection control and public health, as well as emphasizing our focus on supporting the needs of public health practitioners. It is our aim to improve healthcare by reducing risk of infection and related adverse outcomes by critical review, selection, and dissemination of new and relevant information in the field of infection control, public health and infectious diseases in all healthcare settings and the community.