Mould Identification: A Virtual Self Assessment
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Unknown 10 = Talaromyces marnefei
|A 33-year-old HIV + homosexual man presented with a 4 month history of a generalised papular rash, associated with diarrhea and weight loss. A biopsy showed numerous small yeast cells and the culture shown below was isolated.|
"Molluscum contagiosum" like lesions are typical in patients with P. marneffei infection. This patient also had a travel history to Hong Kong and Southern China.
|Direct Microscopy (GMS staining)|
The yeast-cells are spherical to ellipsoidal, 2 to 6 um in diameter, and divide by fission rather than budding, a characteristic visible on stained touch smears that distinguishes P. marneffei from Histoplasma capsulatum.
A Giemsa stained touch smear of a skin biopsy or bone marrow aspirate is a rapid and sensitive diagnostic method that readily demonstrates the presence of typical yeast-like cells with a central septa, either within histiocytes or scattered through the tissue.
On Sabouraud's dextrose agar at 25C, colonies are fast growing, suede-like to downy, white with yellowish-green conidial heads. Colonies become greyish-pink to brown with age and produce a diffusible brownish-red to wine red-pigment.
Conidiophores are hyaline, smooth-walled and bear terminal verticils of 3 to 5 metulae, each bearing 3 to 7 phialides. Conidia are globose to subglobose, 2 to 3 um in diameter, smooth-walled and are produced in basipetal succession from the phialides.
What is your identification?Talaromyces marneffei
Histoplasma capsulatum var. duboisii