Indigenous Disseminated Penicillium marneffei Infection in the State of Manipur, India: Report of Four Autochthonous Cases

Abstract

We describe four cases of disseminated infection caused by endemicPenicillium marneffei in human immunodeficiency virus (HIV)-infected patients from the Manipur state of India. The most common clinical features observed were fever, anorexia, weight loss, hepatosplenomegaly, and, more importantly, skin lesions resembling molluscum contagiosum. The diagnosis in each of the four cases was achieved by direct examination of smears, observance of intracellular yeast-like cells multiplying by fission in biopsied tissue from skin lesions, and isolation of the dimorphic P. marneffei in pure culture in each case. In one case, fluorescent antibody studies allowed specific diagnosis. This report documents a new area in whichP. marneffei is endemic, located in eastern India, and describes the first occurrence in India of P. marneffei in HIV-infected patients as well as the extension of the areas of P. marneffei endemicity westward to the northeastern state of Manipur.

Morphology and multigene phylogeny of Talaromyces amyrossmaniae, a new synnematous species belonging to the section Trachyspermi from India

“…Many species of Talaromyces have been recorded as saprophytes, endophytes, and human pathogens from different geoclimatic regions and microhabitats across India. Most importantly, Talaromyces marneffei is a potentially pathogenic thermally dimorphic fungus causing systemic mycosis in HIV-infected patients; its dissemination was thoroughly studied from Manipur state of India (Singh et al 1999;Ranjana et al 2002). Recent studies on endophytic T. pinophilus isolated from the rhizomes of Curcuma amada from Karnataka revealed the production and partial characterization of L-asparaginase (Krishnapura and Belur 2016).…”

Pathobiology of fungal infections of the central nervous system with special reference to the Indian scenario

“…This fungal infection is recognized in HIV infected individuals from the northeastern state of India, Manipur and the majority of the patients were IV drug abusers sharing unsterilized needles but not a single pathologically confirmed brain lesion has been recorded from that state. [176,177] However, in the literature, successful isolation of the fungus from meninges has been reported. [178] In a follow-up study of 36 cases of Penicilliosis marneffei from Jawaharlal Nehru Medical College Hospital, Imphal, Manipur, other coexisting opportunistic infections like pulmonary/extrapulmonary tuberculosis, oral candidiasis, cryptococcal meningitis, mucocutaneous Herpes simplex and multidermatomal Herpes zoster infections have been reported.…”

Facial eruption in a human immunodeficiency virus (HIV)‐seropositive patient

“…Penicillium marneffei is an opportunistic pathogen endemic in Southeast Asia 1 and Indian subcontinent, especially in Northeast India (Manipur, Assam), and is considered as a new acquired immunodeficiency syndrome (AIDS)defining illness. 2 Bamboo rats are known to be asymptomatic carriers of the fungus; it is unclear whether they are an important reservoir for human infection or only a sentinel animal that is susceptible to infection from an environmental source. Human infections have been reported following traumatic implantation, enteric spread following the eating of bamboo rats as ''game cuisine'', and by inhalation of spores from soil.…”