马尔尼菲踝节菌 (T. marneffi) 是包括子囊菌门、散囊菌门、散囊菌目、真菌科和蓝细菌在内的真菌群落中唯一对哺乳动物（包括人类）致病的热双相真菌。它作为腐生真菌在其自然栖息地中繁衍生息，在哺乳动物生理温度 37°C 下转变为致病酵母阶段。从历史上看，踝部真菌病主要与人类免疫缺陷病毒（HIV）/获得性免疫缺陷综合征（AIDS）有关，与结核病和隐球菌病一起被列为与艾滋病相关的三种主要机会性感染。随着艾滋病治疗和控制措施的进步，踝部真菌病与HIV合并感染的发病率逐年下降，而未感染HIV的肩部真菌病患者人数却在稳步增加。这些患者表现出多种危险因素，如各种类型的免疫缺陷、恶性肿瘤、自身免疫性疾病、器官移植等。然而，有限的回顾性研究集中于HIV阴性踝部真菌病患者的临床特征和危险因素，特别是儿童和血液恶性肿瘤患者，导致对该患者群体的了解不足。为此，我们对HIV阴性踝关节菌病的流行病学、发病机制、危险因素、临床表现、诊断、治疗和预后等进行了全面综述，并对该疾病的前沿研究方向进行了展望。目的是增强理解力，提高这些患者的诊断和治疗率，最终改善他们的预后。© 作者 2024。由牛津大学出版社代表国际人类和动物真菌学学会出版。

Talaromyces marneffei (T. marneffei) stands out as the sole thermobiphasic fungus pathogenic to mammals, including humans, within the fungal community encompassing Ascomycota, Eurotium, Eurotiumles, Fungiaceae, and Cyanobacteria. Thriving as a saprophytic fungus in its natural habitat, it transitions into a pathogenic yeast phase at the mammalian physiological temperature of 37°C. Historically, talaromycosis has been predominantly associated with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), classified among the three primary opportunistic infections linked with AIDS, alongside tuberculosis and cryptococcosis. As advancements are made in HIV/AIDS treatment and control measures, the incidence of talaromycosis co-infection with HIV is declining annually, whereas the population of non-HIV-infected talaromycosis patients is steadily increasing. These patients exhibit diverse risk factors such as various types of immunodeficiency, malignant tumors, autoimmune diseases, and organ transplantation, among others. Yet, a limited number of retrospective studies have centered on the clinical characteristics and risk factors of HIV-negative talaromycosis patients, especially in children and patients with hematological malignancies, resulting in an inadequate understanding of this patient cohort. Consequently, we conducted a comprehensive review encompassing the epidemiology, pathogenesis, risk factors, clinical manifestations, diagnosis, treatment, and prognosis of HIV-negative talaromycosis patients, concluding with a prospectus of the disease's frontier research direction. The aim is to enhance comprehension, leading to advancements in the diagnosis and treatment rates for these patients, ultimately improving their prognosis.© The Author(s) 2024. Published by Oxford University Press on behalf of The International Society for Human and Animal Mycology.