Talaromyces marneffei
Species of fungus
Talaromyces marneffei, formerly known as Penicillium marneffei, is a dimorphic fungus endemic to Southeast Asia. It is a significant opportunistic pathogen in immunocompromised individuals, particularly those with HIV/AIDS.
Morphology
Talaromyces marneffei exhibits dimorphism, meaning it can exist in two different forms depending on the temperature. At 25°C, it grows as a mold, producing characteristic greenish colonies with a red pigment that diffuses into the medium. At 37°C, it converts to a yeast-like form, which is the pathogenic form in humans.
Pathogenesis
Talaromyces marneffei infection, known as talaromycosis, occurs primarily in individuals with weakened immune systems. The fungus is inhaled as spores, which then convert to the yeast form in the body, leading to systemic infection. Symptoms include fever, weight loss, and respiratory issues, often resembling tuberculosis or histoplasmosis.
Diagnosis
Diagnosis of Talaromyces marneffei infection is typically made through culture of the organism from clinical specimens such as blood, bone marrow, or skin lesions. Microscopic examination can reveal the characteristic yeast cells with transverse septa.
Treatment
The treatment of choice for talaromycosis is amphotericin B, followed by itraconazole for maintenance therapy. Early diagnosis and treatment are crucial to prevent severe complications and mortality.
Epidemiology
Talaromyces marneffei is endemic to regions of Southeast Asia, including Thailand, Vietnam, and southern China. It is associated with bamboo rat habitats, although the exact ecological niche and mode of transmission to humans remain under investigation.
Prevention
Preventive measures for talaromycosis include avoiding exposure to environments where the fungus is endemic, particularly for individuals with compromised immune systems. Prophylactic antifungal therapy may be considered for high-risk patients.
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Contributors: Prab R. Tumpati, MD