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Talaromycosis — SCE Infectious Diseases MCQ

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HardFungal InfectionsTalaromycosisSCE Infectious Diseases

A 40-year-old man with Talaromyces (Penicillium) marneffei infection presents with fever, papulonodular skin lesions with central umbilication, and pancytopenia. He has recently arrived from northern Thailand. HIV test is positive with CD4 15 cells/µL. What is the first-line treatment?

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Correct answer: B — Liposomal Amphotericin B 3–5 mg/kg daily for 2 weeks induction, then Itraconazole 200 mg BD for 10 weeks maintenance

Talaromycosis (formerly penicilliosis) is a systemic mycosis caused by Talaromyces marneffei, endemic to South-East Asia (Thailand, Vietnam, southern China). It occurs almost exclusively in advanced HIV (CD4 <100). Umbilicated papulonodular skin lesions (resembling molluscum) are characteristic. Treatment follows a two-phase approach: induction with Liposomal Amphotericin B (or IV Amphotericin B deoxycholate) for 2 weeks, then consolidation with Itraconazole 200 mg BD for 10 weeks. Secondary prophylaxis with Itraconazole 200 mg daily continues until immune reconstitution.

Reference: BHIVA 2022 – OI guidelines; WHO 2021 – Talaromycosis