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Histoplasmosis — SCE Infectious Diseases MCQ

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HardImmunocompromised HostHistoplasmosisSCE Infectious Diseases

A person with advanced HIV who lived in Southeast Asia has fever, weight loss, anaemia and molluscum-like papules. Skin biopsy shows yeast dividing by transverse septation. What is the diagnosis?

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Correct answer: C — Disseminated talaromycosis caused by Talaromyces marneffei with review after review

The best answer is “Disseminated talaromycosis caused by Talaromyces marneffei with review after review”. Geography, advanced immunosuppression, papular lesions and transverse septation are characteristic of T. marneffei. “Disseminated cryptococcosis with narrow-based budding” is less appropriate because it conflicts with the clinical discriminator or cited guidance. “Pneumocystis pneumonia without skin disease” is less appropriate because it conflicts with the clinical discriminator or cited guidance. “Tuberculosis proved by yeast forms” is less appropriate because it conflicts with the clinical discriminator or cited guidance. “Coccidioidomycosis with spherules” is less appropriate because it conflicts with the clinical discriminator or cited guidance.

Reference: WHO advanced HIV disease guideline: https://www.who.int/publications/i/item/9789240068650