Таларомикоз: причины, симптомы и лечение

It is caused by the fungus Talaromyces marneffei, which is found in soil and decomposing organic matter.

There may be no symptoms, Fungi in blood are found in half of case. Biopsies of skin lesions, lymph nodes, and bone marrow demonstrate the presence of organisms on histopathology. Intracellular and extracellular forms are oval and have a characteristic transverse septum. In culture, colonies are powdery green and produce red pigment; however, cultures are negative in a significant number of cases. Medical imaging may reveal shadows in the lungs.

Talaromycosis may be prevented in people at high risk, using the antifungal medication itraconazole, and is treatable with amphotericin B followed by itraconazole or voriconazole.

With treatment, less than 25% of those affected die. Without treatment, more than 75% will die.

The exact number of people in the world affected is not known. Once considered rare, its occurrence increased due to HIV/AIDS to become the third most common opportunistic infection (after extrapulmonary tuberculosis and cryptococcosis) in HIV positive individuals within the endemic area of Southeast Asia. While incidence in those with HIV began to decrease due to antiretroviral treatment, the number of cases in those without HIV began to rise in some endemic areas since the mid 1990s, likely due to improved diagnosis and an increase in other conditions that reduce immunity. The disease has been found to be more common in young farmers. Men are affected more than women.

T. marneffei was first isolated from a bamboo rat in Vietnam in 1956. Three years later, it was described by Gabriel Segretain as a new species with disease potential. The first natural human case of talaromycosis was reported in 1973 in an American minister with Hodgkin's disease who lived in Southeast Asia.

An antigen assay has been developed to detect a key virulence factor Mp1p that has been shown to have a high specificity for Talaromyces marneffei.