Abstract

Talaromycosis marneffei (Penicilliosis marneffei) caused by a thermally dimorphic fungus, Talaromyces (Penicillium) marneffei is emerging as an important systemic opportunistic mycosis in HIV infected patients in several countries in Southeast Asia and in northeast India. This study presents an update on epidemiological and clinical aspects of talaromycosis marneffiei in India. A thorough search of literature was done in Medline, PubMed, and Google Scholar, for accessing relevant data. Fifty-three cases of this disease have originated from the Manipur State. Several cases have been reported from Assam, a few are also known from Meghalaya, Mizoram, Nagaland, Sikkim, Delhi and Maharashtra. Clinical manifestations of disseminated infection in AIDS patients are fever, anemia, weight loss, weakness, lymphadenopathy, hepatosplenomegaly, respiratory signs, and characteristic skin lesions. The bamboo rat (Cannomys badius) has been found to be a natural host of Talaromyces (Penicillium) marneffei in Manipur. It is noteworthy that one of the ten T. marneffei isolates from bamboo rats shared the genotype with a human isolate from that area providing evidence for common source of infection for the rats and humans and host to host transmission. Natural reservoir of T. marneffei has not been established, though it has been demonstrated that the fungus can survive in sterile soil for several weeks, but only for a few days in unsterile soil. There is need for comprehensive investigation of T. marneffei infection in humans, and for occurrence of the fungus in bamboo rats and in soils of the rat burrows in India employing conventional and molecular techniques.

Highlights

  • Talaromycosis marneffei (Penicilliosis marneffei) is caused by a thermally dimorphic fungus, Talaromyces (Penicillium) marneffei, a member of the family Trichocomaceae, order Eurotiales, class Eurotiomycetes of division Ascomycota

  • Infection caused by Talaromycosis marneffei is emerging as an important systemic opportunistic infection, being potentially life-threatening in HIV+ patients with low CD4 counts [32]

  • Talaromycosis marneffei is geographically limited to Southeast Asian countries, viz. Hong Kong, Thailand, Vietnam, Taiwan, China, Laos, Cambodia, Philippines’, Malaysia, Myanmar and northeast India

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Summary

INTRODUCTION

Talaromycosis marneffei (Penicilliosis marneffei) is caused by a thermally dimorphic fungus, Talaromyces (Penicillium) marneffei, a member of the family Trichocomaceae, order Eurotiales, class Eurotiomycetes of division Ascomycota. It is the only dimorphic species in the genus Talaromyces [25]. A large number of cases have occurred in non-HIV-infected patients [6]. This infection is rare in Europe and all the cases described were residents or had stayed in an endemic area. The first four cases in India were of disseminated infection in HIV+ patients from Manipur State in northeast (NE) India [29], the patients had fever, weight loss, anorexia, hepatosplenomegaly, and molluscum contagiosum like lesions on face and upper trunk

MATERIALS AND METHODS
Geographic distribution of cases
Occurrence in soil and environmental reservoir of infection
Clinical spectrum of infections
CONCLUSION

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