Epidemiology of Talaromycosis (Penicilliosis) Marneffei in India: An Update

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.