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Epidemiology and clinical manifestations of Penicillium (Talaromyces) marneffei infection

Authors
Khuanchai Supparatpinyo, MD
Thira Sirisanthana, MD
Section Editor
Carol A Kauffman, MD
Deputy Editor
Jennifer Mitty, MD, MPH

INTRODUCTION

Talaromyces marneffei (formerly Penicillium marneffei) causes a systemic fungal infection referred to as penicilliosis. Penicilliosis was commonly diagnosed in HIV-infected individuals from endemic areas prior to the era of potent antiretroviral therapy (ART), and was an important cause of morbidity and mortality. The widespread use of ART has led to a significant decline in T. marneffei infections among HIV-infected patients in these areas [1]. However, penicilliosis continues to be seen in patients with AIDS (eg, those who are unaware of their HIV infection, who do not have access to ART, or who have suboptimal treatment responses to ART), as well as other immunocompromised individuals.

The mycology, epidemiology, and clinical manifestations of T. marneffei will be reviewed here. The diagnosis and treatment of this infection are discussed elsewhere. (See "Diagnosis and treatment of Penicillium (Talaromyces) marneffei infection".)

HISTORY

T. marneffei (formerly P. marneffei) was first isolated from the bamboo rat (Rhizomys sinensis) in Vietnam in 1956 [2]. The first human case was reported in an American missionary with Hodgkin disease who had been living in Southeast Asia [3]. Thereafter, rare cases of T. marneffei infection were reported, mostly from Southeast Asia and Southern China [4,5]. The first case of penicilliosis in an HIV-infected patient was reported in 1989 from Bangkok, coinciding with the beginning of the AIDS epidemic in the region [6]. P. marneffei was renamed T. marneffei in 2015; however, the disease is still referred to as penicilliosis.

MYCOLOGY

T. marneffei is a dimorphic fungus [7]. The organism typically takes about four to seven days to grow in culture [8]. The growth characteristics include:

T. marneffei grows as a mold at 25ºC on Sabouraud dextrose agar; over time, colonies produce a soluble red pigment that diffuses into the agar [8]. Microscopically, the mycelia show septate hyphae with lateral and terminal conidiophores (picture 1).

           

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Literature review current through: Nov 2016. | This topic last updated: Wed Mar 23 00:00:00 GMT+00:00 2016.
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