Pulmonary infection caused by Talaromyces amestolkiae

A 38-year-old woman was admitted for uterine fibroid surgery. A routine preoperative CT chest scan identified bilateral patchy, high-density shadows, with unclear boundaries, more evident in the upper lobes (figure 1A). She had no respiratory symptoms, such as coughing or expectoration, and was an office worker with allergies to seafood and mango. She denied having comorbidities including diabetes, renal disease, liver disease, malignancy or HIV. In March 2023, she received cefuroxime anti-infective treatment during her hospitalisation for gynaecological surgery and did not continue antibiotics after discharge. Six months later, in November 2023, a follow-up CT chest revealed radiographic progression of bilateral upper lobe changes (figure 1B). Despite being asymptomatic, she was prescribed moxifloxacin at the outpatient clinic for presumed bilateral bacterial pneumonia. A subsequent CT chest a week later showed no noticeable improvement in her lung condition. Therefore, she was hospitalised for further examination to determine the cause of the lung infection. During her hospitalisation, the results of her …