ObjectiveTo explore the clinical diagnosis and treatment of Talaromyces marneffei (TM) infection by bone marrow examination, and to clarify the important role and significance of bone marrow smear and pathogenic examination.MethodsRetrospective analysis was conducted on a case of disseminated TM infection that was clearly diagnosed through bone marrow related examination. Literature review of TM infection was conducted by retrieving relevant case reports at home and abroad from 1990 to 2018.ResultsThe patient was a 23-year-old man with recurrent cough and onset of fever, superficial lymph node enlargement in multiple parts of the body, no abnormal chest CT sign, and poor efficacy in anti-infection treatment. The patient developed progressive abdominal pain, accompanied by systemic papulosis, decreased consciousness, and progressive decline of blood cells. The patient underwent bone marrow puncture surgery in our hospital, and developed circulatory and respiratory failure half an hour after surgery. TM was confirmed bybone marrow smear and pathogenic culture. In the literature review, 2 855 cases of TM infection were retrieved, among which the majority of cases were confirmed through blood and bone marrow related examination. The positive rate of bone marrow culture was significantly higher than that of blood culture (72.4% and 66.8%, respectively, P=0.007). Compared with bone marrow culture, the misdiagnosis and missed diagnosis rate of bone marrow smear microscopy was 27.6%. Patients diagnosed with TM infection by bone marrow examination had the highest HIV positive rate (95.7%).ConclusionsThe examination of bone marrow cells and the culture are of great clinical significance for the diagnosis of TM infection. TM infection should be identified in patients suspected of HIV positive with fever, lymph node enlargement and abnormal blood routine.