Epidemiological and clinical characteristics of Talaromyces marneffei infection: A case series from a tertiary care hospital in South India.
Abstract
Introduction: Talaromyces marneffei, previously known as Penicillium marneffei is a dimorphic fungi mainly affecting immunocompromised individuals and is endemic in North-Eastern regions of India. It is the third most common infection among individuals infected with acquired immunodeficiency syndrome (AIDS). It is acquired by inhalation of conidia. After an initial respiratory infection, it can disseminate. We are describing here the different spectrum of talaromycosis, as seen in our centre.
Methods: Fourpatients who hadlaboratory confirmed diagnosis of Talaromyces marneffei infection, presenting to Christian Medical College, Vellore over a period of 4 years are included.
Results & Discussion: Threepatients (75%) were from the North-Eastern regions of India, with the remaining one hailing from Bangladesh. All patients were immunosuppressed with AIDS being the predominant underlying cause (in 3 patients). CD4 counts of the patients ranged from 7-50 cells/µl. One patient was co-infected with human immunodeficiency virus (HIV) and hepatitis B virus.The clinical presentations of the patients ranged from generalised weakness, multifocal osteomyelitis, papular skin eruption or fever with necrotic nodules over skin. T. marneffei was isolated from bone marrow of first patient, skin biopsy of second and T10 vertebral tissue of the third patient. The organism was cultured from bothbone marrow and skin biopsy from the fourth patient, suggesting dissemination. Three out of 4 patients (75%) survived aftertreatment with amphotericin B and itraconazole. However, one patient succumbed to the infection.
Conclusion: Talaromycosis is endemic in North-Eastern regions of India but with increased medical tourism, there is need for awareness of varying clinical presentations of thisdisease. This will aid in early diagnosis and appropriate management of these immunocompromised patients.
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