Encyclopedia of AIDS

Living Edition
| Editors: Thomas J. Hope, Douglas Richman, Mario Stevenson

Talaromyces (Penicillium) marneffei and HIV

Living reference work entry
DOI: https://doi.org/10.1007/978-1-4614-9610-6_419-1


Talaromyces marneffei, formerly Penicillium marneffei, is a dimorphic fungus. (Samson et al. 2011) T. marneffei infection (TMI) is a common opportunistic infection in HIV-infected patients living in the endemic areas, particularly Southeast Asia, Southern China, and India. However, there have been reports in HIV-infected travelers who have traveled to the endemic areas. (Vanittanakom et al. 2006). The clinical manifestations varied widely from asymptomatic to disseminated infection involving several organs including central nervous system. The epidemiology, clinical manifestations, diagnosis, treatment, and prevention will be described here.


T. marneffei was first isolated in 1956 from the internal organs of bamboo rats (Rhizomys sinensis) in Vietnam (Capponi et al. 1956). The first natural human infection was reported in 1973 in an American missionary who had been living in Southeast Asia (DiSalvo et al. 1973). He suffered from non-Hodgkin lymphoma several...


Immune Reconstitution Inflammatory Syndrome Primary Prophylaxis Indirect Fluorescent Antibody Test Oral Itraconazole cART Initiation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
This is a preview of subscription content, log in to check access.


  1. Bulterys PL, Le T, Quang VM, Nelson KE, Lloyd-Smith JO. Environmental predictors and incubation period of AIDS-associated Penicillium marneffei infection in Ho Chi Minh City, Vietnam. Clin Infect Dis. 2013;56(9):1273–9.CrossRefPubMedPubMedCentralGoogle Scholar
  2. Capponi M, Segretain G, Sureau P. Penicillosis from Rhizomys sinensis. Bull Soc Pathol Exot Filiales. 1956;49(3):418–21.PubMedGoogle Scholar
  3. Chaiwarith R, Charoenyos N, Sirisanthana T, Supparatpinyo K. Discontinuation of secondary prophylaxis against penicilliosis marneffei in AIDS patients after HAART. AIDS. 2007;21(3):365–7.CrossRefPubMedGoogle Scholar
  4. Chaiwarith R, Fakthongyoo A, Praparattanapan J, Boonmee D, Sirisanthana T, Supparatpinyo K. Itraconazole vs fluconazole as a primary prophylaxis for fungal infections in HIV-infected patients in Thailand. Curr HIV Res. 2011;9(5):334–8.CrossRefPubMedGoogle Scholar
  5. Chariyalertsak S, Vanittanakom P, Nelson KE, Sirisanthana T, Vanittanakom N. Rhizomys sumatrensis and Cannomys badius, new natural animal hosts of Penicillium marneffei. J Med Vet Mycol. 1996a;34(2):105–10.CrossRefPubMedGoogle Scholar
  6. Chariyalertsak S, Sirisanthana T, Supparatpinyo K, Nelson KE. Seasonal variation of disseminated Penicillium marneffei infections in northern Thailand: a clue to the reservoir? J Infect Dis. 1996b;173(6):1490–3.CrossRefPubMedGoogle Scholar
  7. Chariyalertsak S, Sirisanthana T, Supparatpinyo K, Praparattanapan J, Nelson KE. Case-control study of risk factors for Penicillium marneffei infection in human immunodeficiency virus-infected patients in northern Thailand. Clin Infect Dis. 1997;24(6):1080–6.CrossRefPubMedGoogle Scholar
  8. Chariyalertsak S, Supparatpinyo K, Sirisanthana T, Nelson KE. A controlled trial of itraconazole as primary prophylaxis for systemic fungal infections in patients with advanced human immunodeficiency virus infection in Thailand. Clin Infect Dis. 2002;34(2):277–84.CrossRefPubMedGoogle Scholar
  9. Deng ZL, Yun M, Ajello L. Human penicilliosis marneffei and its relation to the bamboo rat (Rhizomys pruinosus). J Med Vet Mycol. 1986;24(5):383–9.CrossRefPubMedGoogle Scholar
  10. DiSalvo AF, Fickling AM, Ajello L. Infection caused by Penicillium marneffei: description of first natural infection in man. Am J Clin Pathol. 1973;60(2):259–63.CrossRefPubMedGoogle Scholar
  11. Drouhet E. Penicilliosis due to Penicillium marneffei: a new emerging systemic mycosis in AIDS patients traveling or living in Southeast Asia: review of 44 cases of non AIDS patients reported over 20 years. J Mycol Med. 1993;4:195–224.Google Scholar
  12. Hall C, Hajjawi R, Barlow G, Thaker H, Adams K, Moss P. Penicillium marneffei presenting as an immune reconstitution inflammatory syndrome (IRIS) in a patient with advanced HIV. BMJ Case Rep. 2013. doi: 10.1136/bcr-2012-007555
  13. Hilmarsdottir I, Coutellier A, Elbaz J, Klein JM, Datry A, Gueho E, Herson S. A French case of laboratory-acquired disseminated Penicillium marneffei infection in a patient with AIDS. Clin Infect Dis. 1994;19(2):357–8.CrossRefPubMedGoogle Scholar
  14. Ho A, Shankland GS, Seaton RA. Penicillium marneffei infection presenting as an immune reconstitution inflammatory syndrome in an HIV patient. Int J STD AIDS. 2010;21(11):780–2.CrossRefPubMedGoogle Scholar
  15. Jones PD, See J. Penicillium marneffei infection in patients infected with human immunodeficiency virus: late presentation in an area of nonendemicity. Clin Infect Dis. 1992;15(4):744.CrossRefPubMedGoogle Scholar
  16. Kawila R, Chaiwarith R, Supparatpinyo K. Clinical and laboratory characteristics of penicilliosis marneffei among patients with and without HIV infection in Northern Thailand: a retrospective study. BMC Infect Dis. 2013;13:464.CrossRefPubMedPubMedCentralGoogle Scholar
  17. Le T, Wolbers M, Chi NH, Quang VM, Chinh NT, Lan NP, Lam PS, Kozal MJ, Shikuma CM, Day JN, Farrar J. Epidemiology, seasonality, and predictors of outcome of AIDS-associated Penicillium marneffei infection in Ho Chi Minh City, Viet Nam. Clin Infect Dis. 2011;52(7):945–52.CrossRefPubMedPubMedCentralGoogle Scholar
  18. Li JC, Pan LQ, Wu SX. Mycologic investigation on Rhizomys pruinous senex in Guangxi as natural carrier with Penicillium marneffei. Chin Med J (Engl). 1989;102(6):477–85.Google Scholar
  19. Nakai T, Uno J, Ikeda F, Tawara S, Nishimura K, Miyaji M. In vitro antifungal activity of Micafungin (FK463) against dimorphic fungi: comparison of yeast-like and mycelial forms. Antimicrob Agents Chemother. 2003;47(4):1376–81.CrossRefPubMedPubMedCentralGoogle Scholar
  20. Odabasi Z, Paetznick VL, Rodriguez JR, Chen E, Ostrosky-Zeichner L. In vitro activity of anidulafungin against selected clinically important mold isolates. Antimicrob Agents Chemother. 2004;48(5):1912–5.CrossRefPubMedPubMedCentralGoogle Scholar
  21. Panel on Opportunistic Infections in HIV-Infected Adults and Adolescents. Guidelines for the prevention and treatment of opportunistic infections in HIV-infected adults and adolescents: recommendations from the Centers for Disease Control and Prevention, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America. 2013. Available at http://aidsinfo.nih.gov/contentfiles/lvguidelines/adult_oi.pdf. Accessed 31 July 2015.
  22. Radford SA, Johnson EM, Warnock DW. In vitro studies of activity of voriconazole (UK-109,496), a new triazole antifungal agent, against emerging and less-common mold pathogens. Antimicrob Agents Chemother. 1997;41(4):841–3.PubMedPubMedCentralGoogle Scholar
  23. Ranjana KH, Priyokumar K, Singh TJ, Gupta Ch C, Sharmila L, Singh PN, Chakrabarti A. Disseminated Penicillium marneffei infection among HIV-infected patients in Manipur state, India. J Infect. 2002;45(4):268–71.CrossRefPubMedGoogle Scholar
  24. Saikia L, Nath R, Hazarika D, Mahanta J. Atypical cutaneous lesions of Penicillium marneffei infection as a manifestation of the immune reconstitution inflammatory syndrome after highly active antiretroviral therapy. Indian J Dermatol Venereol Leprol. 2010;76(1):45–8.CrossRefPubMedGoogle Scholar
  25. Samson RA, Yilmaz N, Houbraken J, Spierenburg H, Seifert KA, Peterson SW, Varga J, Frisvad JC. Stud Mycol. 2011;70(1):159–183.Google Scholar
  26. Segretain G. Penicillium marneffei n.sp., agent of a mycosis of the reticuloendothelial system. Mycopathologia. 1959;11:327–53.Google Scholar
  27. Sekhon AS, Garg AK, Padhye AA, Hamir Z. In vitro susceptibility of mycelial and yeast forms of Penicillium marneffei to amphotericin B, fluconazole, 5-fluorocytosine and itraconazole. Eur J Epidemiol. 1993;9(5):553–8.CrossRefPubMedGoogle Scholar
  28. Sirisanthana T, Supparatpinyo K, Perriens J, Nelson KE. Amphotericin B and itraconazole for treatment of disseminated Penicillium marneffei infection in human immunodeficiency virus-infected patients. Clin Infect Dis. 1998;26(5):1107–10.CrossRefPubMedGoogle Scholar
  29. Supparatpinyo K, Schlamm HT. Voriconazole as therapy for systemic Penicillium marneffei infections in AIDS patients. Am J Trop Med Hyg. 2007;77(2):350–3.PubMedGoogle Scholar
  30. Supparatpinyo K, Nelson KE, Merz WG, Breslin BJ, Cooper Jr CR, Kamwan C, et al. Response to antifungal therapy by human immunodeficiency virus-infected patients with disseminated Penicillium marneffei infections and in vitro susceptibilities of isolates from clinical specimens. Antimicrob Agents Chemother. 1993;37(11):2407–11.CrossRefPubMedPubMedCentralGoogle Scholar
  31. Supparatpinyo K, Khamwan C, Baosoung V, Nelson KE, Sirisanthana T. Disseminated Penicillium marneffei infection in southeast Asia. Lancet. 1994;344(8915):110–3.CrossRefPubMedGoogle Scholar
  32. Supparatpinyo K, Perriens J, Nelson KE, Sirisanthana T. A controlled trial of itraconazole to prevent relapse of Penicillium marneffei infection in patients infected with the human immunodeficiency virus. N Engl J Med. 1998;339(24):1739–43.CrossRefPubMedGoogle Scholar
  33. Vanittanakom N, Cooper Jr CR, Fisher MC, Sirisanthana T. Penicillium marneffei infection and recent advances in the epidemiology and molecular biology aspects. Clin Microbiol Rev. 2006;19(1):95–110.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  1. 1.Division of Infectious Diseases, Department of Medicine, Faculty of MedicineChiang Mai UniversityChiang MaiThailand
  2. 2.Research Institute for Health SciencesChiang Mai UniversityChiang MaiThailand