Penicillium marneffei; Talaromyces marneffei
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Epidemiology
- endemic in southeast Asia, southern China
- closely associated with distribution of bamboo rat
- associated with AIDS (HIV1 infection)
Pathology
- etiologic agent of penicillosis & talaromycosis
- disseminated infection
Clinical manifestations
- fever
- weight loss
- anorexia
- adenopathy
- hepatosplenomegaly
- papular skin lesions that resemble molluscum contagiosum
- umbilicated papules on face, body, arms, & legs[4]
Laboratory
- HIV1 testing
- complete blood count (CBC)
- peripheral blood smear
- yeastlike organisms 2-4 um in diameter both intracellular & extracellular
- blood cultures: septate hyphae fungus
- dimorphic organism
- skin biopsy:
* images[4]
Management
- amphotericin B
- itraconazole
- resistant to fluconazole
- duration of therapy:
- lifetime therapy may be necessary because of propensity for relapse
- prophylaxis:
- well-fitted dust mask[1]
- prophylactic antifungal agents not recommended
- no vaccine available
Notes
- reclassified as Talaromyces marneffei
More general terms
References
- ↑ Jump up to: 1.0 1.1 Medical Knowledge Self Assessment Program (MKSAP) 11, 15, 16, 17. American College of Physicians, Philadelphia 1998, 2009, 2012, 2015.
- ↑ Cao C, Liang L, Wang W, Luo H et al Common reservoirs for Penicillium marneffei infection in humans and rodents, China. Emerg Infect Dis. 2011 Feb;17(2):209-14 PMID: https://www.ncbi.nlm.nih.gov/pubmed/21291590
- ↑ Jump up to: 3.0 3.1 Si Z, Qiao J Talaromyces marneffei Infection. N Engl J Med 2017; 377:2580. Dec 28, 2017 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29281582 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMicm1704164
- ↑ Jump up to: 4.0 4.1 4.2 4.3 Norasethasopon T, Boonyagars L Images in Clinical Medicine. Talaromycosis. N Engl J Med 2021; 384:1261. April 1 PMID: https://www.ncbi.nlm.nih.gov/pubmed/33789014 https://www.nejm.org/doi/full/10.1056/NEJMicm2032478