Mycology Practice Exam

The concept being tested is how certain fungal pathogens initiate disease on mucosal or skin surfaces and have the potential to spread throughout the body in people with weakened immunity. Penicillium marneffei is a classic example: it causes Penicillium marneffei infection (penicilliosis) with mucocutaneous lesions and has a real tendency to disseminate to internal organs such as the liver, spleen, and bone marrow in affected individuals, especially those with advanced HIV/AIDS. This combination of mucocutaneous involvement plus possible systemic spread in an immunocompromised host is the hallmark that makes it the best choice for this question. Candida albicans can cause mucocutaneous infections and, in severely immunocompromised patients, can disseminate as candidemia, but the scenario described in the question is most characteristic of the disseminating mucocutaneous pattern seen with Penicillium marneffei. Histoplasma capsulatum and Aspergillus fumigatus are more commonly associated with pulmonary or systemic infections without the same emphasis on mucocutaneous lesions that readily disseminate.