Objective To evaluate the diagnostic value of reverse transcription-quantitative polymerase chain reaction (RT-qPCR) detection of skin pus specimens in HIV-negative patients with talaromycosis marneffei (TSM).

Methods Twenty-seven patients who had suspected TSM (22 confirmed TSM and 5 non-TSM, all HIV-negative) with skin pus were selected from the First Affiliated Hospital of Guangxi Medical University from January 2020 to December 2024. Meanwhile, skin pus and serum specimens of these 27 patients were collected for RT-qPCR, fungal culture, fungal microscopy, and serological tests, respectively.

Results In the specimens of 22 TSMdiagnosed patients, the positive rate of serum detected by RT-qPCR was 9.09% (2/22), while the positive rate of skin pus specimens detected by RT-qPCR reached 68.18% (15/22). There was a statistically significant difference in the positive rates between the two (P < 0.001). In addition, 5 skin pus specimens from patients with confirmed TSM showed negative fungal culture results, but the same skin pus specimens were tested positive by RT-qPCR. The RT-qPCR results of serum and skin pus specimens from 5 non-TSM patients were negative. The results of this study suggested that the diagnostic efficacy of RT-qPCR detection using skin pus was higher than that of se‐ rum RT-qPCR, pus culture, pus microscopy, and serum galactomannan detection.

Conclusion RT-qPCR detection using skin pus as a specimen can rapidly diagnose TSM infection and has a high application value in the early diagnosis of HIV-negative TSM patients.