Objective: Talaromycosis marneffei (Penicilliosis marneffei) caused by a thermally dimorphic fungus, Talaromyces (Penicillium) marneffeiis emerging as an important systemic opportunistic mycosis in HIV infected patients in several countries in Southeast Asia and in northeast India. This study presents an update on epidemiological and clinical aspects of talaromycosis marneffiei in India.
Methods: A thorough search of literature was done in Medline, PubMed, Biomed lib, Cochrane library and Google Scholar using different sets of keywords, viz. for accessing relevant data on talaromycosis marneffei in different states of India.
Results: Fifty-three cases of this disease have originated from the Manipur State. Twelve autochthonous cases have been reported from Assam, a few cases are also known from northeastern States, viz Meghalaya, Mizoram, Nagaland, Sikkim, and also from Delhi. Maharashtra and Kerala. Clinical manifestations of disseminated infection in AIDS patients are fever, anemia, weight loss, weakness, lymphadenopathy, hepatosplenomegaly, respiratory signs, and characteristic umblicated skin lesions. There were no respiratory symptoms in these cases. There are only four cases in non-HIV/patients from India. The lesser bamboo rat (Cannomys badius) has been found to be a natural host of Talaromyces (Penicillium) marneffei in Manipur. It is noteworthy that one of the tenT. marneffei isolates from bamboo rats shared the genotype with a human isolate from that area providing evidence for common source of infection for the rats and humans and host to host transmission. Natural reservoir of T.marneffei has not been established, though it has been demonstrated that the fungus can survive in sterile soil for several weeks, but only for a few days in unsterile soil. A comprehensive investigation of T. marneffei infection in humans, and of occurrence of the fungus in bamboo rats and in soils of the rat burrows in different geographic locales of India is required.
Conclusion: There is an urgent need for rapid an affordable diagnostic test employing conventional and molecular techniques. This would facilitate in detecting new endemic foci of T. marneffei in India.