Chapter 5. Talaromyces Marneffei: Biology, Epidemiology, Diagnosis and Treatment

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Mateusz Benkowski and Kevin Kavanagh
Department of Biology, Maynooth University, Maynooth, Co. Kildare, Ireland

Part of the book: The Book of Fungal Pathogens

Abstract

Talaromyces marneffei, which was known as Penicillium marneffei until 2011, is a thermally dimorphic fungus endemic to large parts of Southeast Asia, which displays distinct morphological and metabolic differences between the yeast, and hyphal growth forms. The yeast phase of growth is the pathogenic form of the fungus, which is capable of infecting humans and displays a variety of virulence factors. While the fungus is responsible for high levels of infection and death in HIV-positive and HIV-negative populations in affected areas neither the source nor the mode of transmission of the fungus has been identified, although evidence points to an environmental reservoir. Clinical manifestations vary greatly which creates a problem for diagnosis and contributes to high mortality rates. The immune response is mediated via macrophages, neutrophils, CD4+ T cells and cytokines. Amphotericin B treatment followed by prophylaxis with itraconazole is used to treat infection but treatment is only effective if infection is diagnosed early where diagnosis relies on the physician suspecting T. marneffei infection. The area of incidence has expanded in recent years leading to the suggestion that climate change may be a contributing factor.

Keywords: bamboo rat, HIV infection, infection, Penicillium, Talaromyces, emerging pathogen


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