Employees at risk
Perhaps the most important personal factor that predisposes to an increased risk is age. In the United States in 1998 17 million workers were over age 55 and by 2018 this population is expected to more than double. Workers in this age group are more likely to develop lower back pain that may be worsened by work conditions that normally do not affect a younger worker. Older workers are also more likely by be killed in a construction related fall. They are also at higher risk for injury due to age-related hearing loss, visual impairment, and use of multiple prescription medications that has been linked to higher rates of work injuries. In addition to age, other personal risk factors for injury include obesity  particularly its associated risk with back injury, and depression.Lack of proper education or training can also predispose an individual to an occupational injury. For example, there is limited needlestick injury awareness among agriculture workers, and there is a need for comprehensive programs to prevent needlestick injuries on livestock operations. Proper animal handling techniques and training, or stockmanship, can also decrease the risk of livestock injury. A handlers timing, positioning, speed, direction of movement, and sounds made will affect the behavior of an animal and consequently the safety of the handler. The agriculture industry has begun to focus more on proper education and training, and has made a variety of resources available to producers.
Diagnosis relies on identifying Talaromyces marneffei in cultures from clinical specimens such as sputum, blood, skin scrapings, lymph node, and bone marrow, by which time the disease is in the late-stage. Fungi in blood are found in half of case.Non-specific laboratory findings may show evidence of the fungus invading tissue, such as low platelets due to bone marrow infiltration, and elevated transaminases due to liver involvement.Biopsies of skin lesions, lymph nodes, and bone marrow demonstrate the presence of organisms on histopathology. Intracellular and extracellular forms are oval and have a characteristic transverse septum. In culture, colonies are powdery green and produce red pigment; however, cultures are negative in a significant number of cases.Medical imaging may reveal shadows in the lungs. Differential diagnosis
The disease can look similar to tuberculosis and histoplasmosis

Treatment
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. Outcomes
With treatment, less than 25% of those affected die. Without treatment, more than 75% will die. Epidemiology
The exact number of people in the world affected is not known. Once considered rare, its occurrence increased due to HIV/AIDS to become the third most common opportunistic infection (after extrapulmonary tuberculosis and cryptococcosis) in HIV-positive individuals within the endemic area of Southeast Asia.