Talaromycosis | |
---|---|
Other names | Penicillium marneffei,[1] penicilliosis[2] or penicillosis[3] |
Specialty | Infectious diseases |
Symptoms | skin lesions, fever, anaemia, large lymph glands, large liver.[2] Sometimes none.[4] |
Causes | Talaromyces marneffei[1] |
Risk factors | HIV/AIDS, long-term steroids, organ transplant, old age, malnutrition[4] |
Diagnostic method | Microscopy, culture, biopsy,[2] medical imaging[4] |
Differential diagnosis | Tuberculosis, histoplasmosis[4] |
Prevention | Itraconazole[1] |
Treatment | Antifungals[1] |
Medication | Amphotericin B followed by itraconazole or voriconazole[1] |
Prognosis | Often fatal if untreated[1] |
Frequency | unknown[1] M>F[4] |
Talaromycosis is a fungal infection that presents with painless skin lesions of the face and neck, as well as an associated fever, anaemia, and enlargement of the lymph glands and liver.[1][5]
It is caused by the fungus Talaromyces marneffei, which is found in soil and decomposing organic matter.[1] The infection is thought to be contracted by inhaling the fungus from the environment, though the environmental source of the organism is not known.[2] People already suffering from a weakened immune system due to conditions such as HIV/AIDS, cancer, organ transplant, long-term steroid use, old age, malnutrition or autoimmune disease are typically the ones to contract this infection.[2][4] It generally does not affect healthy people and does not spread from person to person.[2] Diagnosis is usually made by identification of the fungus from clinical specimens, either by microscopy or culture. Biopsies of skin lesions, lymph nodes, and bone marrow demonstrate the presence of organisms on histopathology.[2] Medical imaging may reveal shadows in the lungs.[4] The disease can look similar to tuberculosis and histoplasmosis.[4]
Talaromycosis may be prevented in people at high risk, using the antifungal medication itraconazole, and is treatable with amphotericin B followed by itraconazole or voriconazole.[2] The disease is fatal in 75% of those not given treatment.[2]
Talaromycosis is endemic exclusively to southeast Asia (including southern China and eastern India), and particularly in young farmers.[2] The exact number of people in the world affected is not known.[2] Men are affected more than women.[4] The first natural human case of talaromycosis was reported in 1973 in an American minister with Hodgkin's disease who lived in Southeast Asia.[6]