Talaromyces marneffei Outside Endemic Areas in India: an Emerging Infection with Atypical Clinical Presentations and Review of Published Reports from India

Mycopathologia. 2020 Oct;185(5):893-904. doi: 10.1007/s11046-019-00420-0. Epub 2020 Jan 1.

Abstract

Talaromycosis is a disseminated disease caused by Talaromyces (Penicillium) marneffei, mainly seen in acquired immunodeficiency syndrome (AIDS) patients. Its distribution is restricted to southeast Asian countries; a small pocket of endemicity exists in the northeast Indian state of Manipur. Here, we present a series of five cases presenting to our tertiary care hospital, originating from non-endemic states neighboring Manipur. In addition to the geographical distinction, a variety of unique features were noted in our cases, including human immunodeficiency virus (HIV)-negative hosts, the absence of typical skin lesions, presentation as pneumonia and generalized lymphadenopathy. Our series highlights the importance of distinguishing this disease from histoplasmosis and tuberculosis, both endemic in India.

Keywords: Assam; HIV seronegative; Penicillium marneffei; Renal transplant; Sikkim; Talaromyces marneffei.

Publication types

  • Case Reports

MeSH terms

  • AIDS-Related Opportunistic Infections
  • Adult
  • Antifungal Agents / therapeutic use
  • Child, Preschool
  • Communicable Diseases, Emerging
  • Diagnosis, Differential
  • Endemic Diseases
  • Female
  • Histoplasmosis / diagnosis
  • Humans
  • India / epidemiology
  • Male
  • Middle Aged
  • Mycoses* / diagnosis
  • Mycoses* / epidemiology
  • Mycoses* / pathology
  • Neglected Diseases
  • Talaromyces* / isolation & purification
  • Talaromyces* / pathogenicity
  • Tertiary Care Centers
  • Tuberculosis / diagnosis

Substances

  • Antifungal Agents

Supplementary concepts

  • Talaromyces marneffei
  • talaromycosis