[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Microbiology](https://durgical.com/en/microbiology/) › [Other fungi of clinical interest](https://durgical.com/en/microbiology/groups/other-fungi-of-clinical-interest/) › Talaromyces marneffei [Microbiology](https://durgical.com/en/microbiology/) · [Other fungi of clinical interest](https://durgical.com/en/microbiology/groups/other-fungi-of-clinical-interest/) # Talaromyces marneffei - Fungus - For completeness A fungus from Southeast Asia that causes disseminated infection in people with advanced AIDS, with skin bumps dented in the centre. Updated 2026-11-01 Also called: Penicillium marneffei (old name), talaromycosis, penicilliosis ## Key points - Dimorphic fungus of Asia (Southeast Asia, southern China, India) in advanced AIDS. - Umbilicated papules on the face and neck plus fever and hepatosplenomegaly. - In tissue it looks like Histoplasma but divides by a central septum, not by budding. - Culture with a diffusible red pigment at room temperature. ## At a glance **Shape** Mould at 25 °C with a red pigment that diffuses into the agar; at 37 °C, yeast-like cells that divide by fission with a cross wall **Family** Trichocomaceae (order Eurotiales) **Type** Thermally dimorphic fungus: mould in the environment, intracellular yeast in tissue **Stain** Wright, Giemsa, PAS or Grocott: yeasts inside macrophages, with a central septum ## Morphology - In tissue: oval cells inside macrophages, like Histoplasma, but with a central septum instead of budding. - In culture at room temperature: a mould colony with a wine-red pigment that diffuses into the medium. ## Transmission - Probably by inhaling conidia from the environment. - Bamboo rats carry the fungus, but there is no evidence of direct spread from rat to person. - Not spread from person to person. **Reservoir:** Soil of endemic areas; Bamboo rats ### Isolation precautions What the care team adds to standard precautions. - Standard ## Virulence factors - Dimorphism: switching to a yeast at body temperature lets it live inside macrophages. - It spreads through blood and the reticuloendothelial system when cell-mediated immunity is badly depressed. ## Diseases it causes - Disseminated talaromycosis as an opportunistic infection of advanced HIV [HIV infection and AIDS →](https://durgical.com/en/conditions/hiv-infection-and-aids/) ## Clinical picture - Fever, weight loss, cough, lymphadenopathy and hepatosplenomegaly. - Painless skin papules on the face and neck, often with central umbilication (like molluscum contagiosum). - In people without HIV it involves the mouth, throat, lung, liver and bone more often. ## Diagnosis - Culture of blood, bone marrow or skin: a mould with red pigment at room temperature. - Smear or biopsy of skin or marrow: intracellular yeasts with a cross septum. - Antigen tests and PCR in specialised centres. ## Treatment Antifungals: amphotericin B for induction, then itraconazole; voriconazole or posaconazole are alternatives. In people with HIV, antiretroviral therapy is a central part of care. Drug class only; doses and regimens are set by the clinician from the current guideline. In Pharmacology: - [Amphotericin B](https://durgical.com/en/pharmacology/amphotericin-b/) - [Itraconazole](https://durgical.com/en/pharmacology/itraconazole/) - [Voriconazole](https://durgical.com/en/pharmacology/voriconazole/) - [Posaconazole](https://durgical.com/en/pharmacology/posaconazole/) ## Prevention - Azole prophylaxis (mainly itraconazole) for severely immunosuppressed people living in endemic areas. - Early diagnosis and treatment of HIV. ## In Colombia Not endemic in Colombia or the Americas: it is suspected in migrants or travellers who lived in Southeast Asia, southern China or India. ## Memory aid Talaromyces splits down the middle: the yeast divides with a central wall, and the mould paints the agar red. ## Test yourself Think of the answer, then tap the question to see it. ## How is Talaromyces told apart from Histoplasma on a bone-marrow smear? Both are yeasts inside macrophages, but Talaromyces divides by fission with a cross septum and Histoplasma by budding. ## What culture feature is classic for Talaromyces marneffei? At room temperature it grows as a mould that releases a red pigment diffusing into the agar. ## In which patient should talaromycosis be suspected? A person with advanced HIV who lived in or travelled to Southeast Asia, southern China or India and has fever, umbilicated papules and hepatosplenomegaly. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/microbiology/talaromyces-marneffei/) ## Related - [Histoplasma capsulatum](https://durgical.com/en/microbiology/histoplasma-capsulatum/) - [Cryptococcus neoformans](https://durgical.com/en/microbiology/cryptococcus-neoformans/) - [Human immunodeficiency virus](https://durgical.com/en/microbiology/human-immunodeficiency-virus/) ## Related conditions - [HIV infection and AIDS](https://durgical.com/en/conditions/hiv-infection-and-aids/) ## What the colours mean **Gram-positive** Thick peptidoglycan wall: stains purple. **Gram-negative** Thin wall with an outer membrane: stains pink. **Acid-fast** Lipid-rich wall (mycobacteria): Ziehl–Neelsen stain. [← Back to the group: Other fungi of clinical interest](https://durgical.com/en/microbiology/groups/other-fungi-of-clinical-interest/) Educational content on microorganisms; not a treatment guide and no substitute for a health professional's advice. No doses are given. Sources: [Talaromycosis (Penicilliosis) Basics | Talaromycosis | CDC](https://www.cdc.gov/talaromycosis/about/index.html) (CDC, 2024). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/microbiology/talaromyces-marneffei/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/microbiology/talaromyces-marneffei/