B48.4

Clinical Causes: Fungal infection by Talaromyces marneffei Inhalation of fungal spores from the environment, especially in soil or decaying vegetation Transmission is not typically person-to-person, but rather environmental exposure Immune suppression due to HIV/AIDS, cancer treatments, organ transplantation, or immunosuppressive therapies Living in or traveling to regions with endemic presence of the fungus, such as Southeast Asia

Key Symptoms: Fever that persists or recurs General malaise and fatigue Weight loss and loss of appetite Skin lesions, which may appear as papules, ulcers, or nodules Cough, which may be associated with difficulty breathing Swollen lymph nodes Signs of organ involvement, such as abdominal pain or diarrhea in some cases Potential involvement of the liver, spleen, or bone marrow, leading to further complications

Diagnosis Path: Microscopic examination of skin lesions, blood, or tissue samples with special stains to identify the fungus Fungal cultures from blood, tissue, or other body fluids Serologic tests and molecular diagnostics, such as PCR, to detect fungal DNA Imaging studies if internal organ involvement is suspected

Treatment Protocols: Induction therapy with amphotericin B or voriconazole to quickly target the infection Follow-up maintenance therapy with itraconazole or fluconazole to prevent relapse Addressing underlying immune suppression, such as optimizing HIV treatment if applicable Supportive care to manage symptoms and complications, including hydration and nutritional support