Paper II — 2019 July (Supplementary) (2010 Scheme) — Q13
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Paper II
2019 July (Supplementary) (2010 Scheme) · 40 marks · 120 min
Question
Penicillosis
Q132 marksShort Notes
Answer
Penicilliosis (talaromycosis) is a systemic, opportunistic fungal infection caused by Talaromyces marneffei (formerly Penicillium marneffei) — the only dimorphic member of this genus.
Epidemiology: endemic to Southeast Asia and parts of northeastern India, associated with the local bamboo rat; likely acquired by inhalation of environmental conidia.
Clinical significance: an important AIDS-defining opportunistic infection in endemic regions, presenting with prolonged fever, weight loss, generalized lymphadenopathy, hepatosplenomegaly, and a characteristic umbilicated, molluscum-contagiosum-like papular skin rash.
Laboratory diagnosis: culture from blood/bone marrow/skin lesion showing dimorphic growth (mould at 25°C with a diffusible red pigment; yeast dividing by fission at 37°C — distinguishing from budding seen in other dimorphic fungal yeasts); histopathology of affected tissue.
Treatment: amphotericin B induction followed by itraconazole maintenance; secondary prophylaxis continued until adequate immune reconstitution with antiretroviral therapy.
