Signs and symptoms
There may be no symptoms, or talaromycosis may present with small painless skin lesions. The head and neck are most often affected. Other features include: fever, general discomfort, weight loss, cough, difficulty breathing, diarrhoea, abdominal pain, swelling of the spleen (splenomegaly), liver swelling (hepatomegaly), swollen lymph nodes (lymphadenopathy), and anemia. There may be no symptoms.In those without HIV infection, the lungs, liver, and mouth are usually affected, with systemic infection rarely occurring. The skin lesions are also often smooth. The disease tends to present differently in those with HIV infection; they are more likely to experience widespread infection. Their skin lesions however, are usually dented in the centre and can appear similar to molluscum contagiosum. Cause
Talaromycosis is usually caused by T. marneffei, however, other species of the Talaromyces genus are also known to cause the disease in rare cases. Risk factors
Talaromycosis rarely affects healthy people and generally occurs in people who are already sick and unable to fight infection such as HIV/AIDS, cancer, organ transplant, long-term steroid use, old age, malnutrition or autoimmune disease. Mechanism
The infection is thought to be acquired through breathing in the organism from the environment. However, the exact source of infection is not known. The infection is not spread person-to-person. In Thailand, talaromycosis is more common during the rainy season; rain may promote the proliferation of the fungus in the environment. Diagnosis
There is no accurate fast serological test.
Talaromycosis is a fungal infection that presents with painless skin lesions of face and neck, fever, anaemia, large lymph glands and liver.It is caused by the fungusTalaromyces marneffei, which is found in soil and decomposing organic matter. The infection is thought to be acquired by breathing in the fungus from the environment, however, the environmental source of the organism is not known. It typically occurs in people who are already sick and unable to fight infection such as HIV/AIDS, cancer, organ transplant, long-term steroid use, old age, malnutrition or autoimmune disease. It generally does not affect healthy people and does not spread from person to person. 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. Medical imaging may reveal shadows in the lungs. The disease can look similar to tuberculosis and histoplasmosis.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. The disease is fatal in 75% of those not given treatment.Talaromycosis is endemic exclusively to southeast Asia (including southern China and eastern India), and particularly in young farmers. The exact number of people in the world affected is not known. Men are affected more than women. The first natural human case of talaromycosis was reported in 1973 in an American minister with Hodgkins disease who lived in Southeast Asia.