Indiana University Infectious Diseases Fellowship
25 Jan,
8 tweets, 4 min read
#idboardreview 30 M from Thailand 🇹🇭 new dx HIV CD4 5 presents w/ fever, sore throat, dry cough, generalized umbilicated skin lesions x2wks. Diagnosis? #medEd #idmedEd #IDtwitter 
#Talaromyces marneffei cause of morbidity and mortality in HIV-infected & other immunosuppressed patients who live in or are from endemic areas especially Southeast Asia. Amphotericin B or Itraconazole should be initiated as soon as possible for patients with talaromycosis
Mortality ranges 8-40%. Common clinical manifestations include fever, weight loss, anemia, weakness, skin lesions, lymphadenopathy and hepatosplenomegaly #talaromycosis
Skin lesions generally on face, up trunk & extremities as pustules, papules, nodules, ulcers or abscesses. Ddx molluscum Pharyngeal/palatial lesions may be seen. Lung lesions are nodular, reticulonodular,or diffuse alveolar infiltrates #talaromycosis
Dx smear of skin lesions or lymph node biopsy. Intercellular yeast resembles histo but extracellular yeast is large & septate in 2-3 cells sausage shape. Mold with red pigment that diffuse in agar #talaromycosis
Galactomannan+ in two third of cases. Disseminated cases in hiv treat w/ ampho x2 wks f/b itraconazole x10 wks #talaromycosis
• • •
Missing some Tweet in this thread? You can try to
force a refresh
