248.3 📌 章末速蚘

  • Paracoccidioidomycosis (P. brasiliensis, Latin America, adult males, mulberry stomatitis + pulmonary): itraconazole or AmB + TMP-SMX
  • Talaromycosis (T. marneffei, SE Asia, HIV CD4 < 100, umbilicated skin papules): liposomal AmB → itraconazole
  • Bamboo rats reservoir for T. marneffei
  • Anti-IFN-γ autoantibodies in adult-onset immunodeficiency
  • Histology: pilot wheel (Paracoccidioides), central septum (Talaromyces)
248.3.0.0.1 盧醫垫 hint
  • Latin American + adult male + chronic oral ulcers + pulmonary disease → paracoccidioidomycosis
  • HIV CD4 < 100 + SE Asia origin + umbilicated skin papules + fever → talaromycosis (AmB + itraconazole)
  • HIV-negative immunocompromise + SE Asian + disseminated fungal → consider anti-IFN-γ autoAb