Next-generation sequencing (NGS)-based metagenomic sequencing (mNGS) of CSF is performed in a patient with encephalitis of unknown aetiology. The test returns with detection of Talaromyces (Penicillium) marneffei sequences. The patient is from Northeast India. Which clinical sign would strongly support this diagnosis?
- A Central umbilicated skin papules resembling molluscum contagiosum ✓
- B Eschar at bite site
- C Bull's eye rash (erythema migrans)
- D Strawberry tongue
Explanation
Talaromycosis (previously Penicilliosis marneffei) caused by Talaromyces marneffei is an AIDS-defining disseminated fungal infection endemic to Southeast Asia and Northeast India. A pathognomonic clinical feature is umbilicated papules on the face, trunk, and extremities that closely resemble molluscum contagiosum, representing fungal invasion of the skin. Biopsy of these lesions and staining shows intracellular yeast with a characteristic central septum (dividing by binary fission, not budding). The eschar is seen in scrub typhus; erythema migrans in Lyme disease; strawberry tongue in scarlet fever or Kawasaki disease.
Reference: Ananthanarayan & Paniker's Textbook of Microbiology, 11th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.