Case Report: First natural infection of Talaromyces marneffei in humans (Di Salvo et al., 1973)
In April 1967 a 61 y-old man presented with a mass on the left side of his neck diagnosed as Hodgkin’s lymphoma, and he received radiotherapy. The patient underwent splenectomy and additional biopsies in May 1971. Gross exam of the spleen revealed a tan nodule, 9 cm diam, which, when cultured on Sabouraud dextrose agar, produced a yeast-like growth.
The isolate was transferred the South Carolina State Health Laboratory for identification. The isolate on SDA incubated at 25oC for 10 d grew as a light brown colony with aerial mycelium and secreted a rose color pigment. Microscopic exam revealed conidiophores containing metulae and conidia typical of Penicillium. At 37oC growth was yeast-like consisting of oval or round cells dividing by a crosswall instead of by budding. The isolate when compared with an authentic culture of Penicillium marneffei, corresponded in all respects. Patient’s spleen tissue was sectioned and stained with Gomori methenamine silver revealing small, oval to round yeast cells (avg. diam., 3 µm) with cell division occurring by fission. Similarity to Histoplasma capsulatum was ruled out by failure to stain with H. capsulatum antiserum.

The patient had a history of travel to SE Asia in the summer of 1970. His travel history and immunocompromised state combined to a make him a suitable host for this opportunistic fungal pathogen.
Incidence and Prevalence. Total cases of talaromycosis worldwide are unknown, but they are declining among HIV-positive persons because of effective antiretroviral therapy. Cases in people without HIV/AIDS are rising in parts of Asia because of improved diagnosis and an increased number of people with other immunosuppressive conditions.