• a life-threatening mycosis caused by the dimorphic fungus Talaromyces marneffei. It is a major cause of death in patients with advanced HIV infection in Southeast Asia, China, and India.

• Skin umbilicated papule in HIV

From Lancet: A global call for talaromycosis to be recognised as a neglected tropical disease

Talaromycosis is an invasive fungal infection with a high case­fatality rate, killing up to a third of diagnosed individuals

Talaromycosis (formerly penicilliosis) is caused by the thermally dimorphic fungus Talaromyces marneffei that is endemic in the tropical and subtropical regions of Asia (appendix p 2). T marneffei has a reservoir in wild bamboo rats living in the highlands of endemic regions and in the soil associated with the bamboo rats. Human infection is presumed to occur via inhalation of T marneffei spores from the environment.6 The HIV pandemic has led to a rapid rise in global incidence, particularly in the hyperendemic areas of southeast Asia (Thailand, Vietnam, and Myanmar), east Asia (southern China, Hong Kong, Taiwan), and northeastern India