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(See page 3449 in this issue [doi:10.1128/JCM.01126-11] for photo quiz case presentation) Penicillium marneffei is a highly pathogenic fungus that was first isolated in the 1950s from the bamboo rat in central Vietnam. The primary infection with this organism is typi-cally pulmonary, but disseminated infection, including fun-gemia and dissemination to the liver, spleen, lymphatic sys-tem, bone marrow, and skin, can occur. Systemic disease is often fatal (1, 3). P. marneffei is thermally dimorphic. The “yeast phase, ” elon-gated arthroconidia, is observed at 35 to 37°C. The mold phase of P. marneffei is observed at 25°C and appears as flat colonies that are blue, gray, green, or yellow in the center, with a white periphery. The most distinctive feature of the mycelial form is the presence of a diffusible red pigment, as seen in the photo-graph. Other Penicillium species are not considered to be hu

A 32-Year-Old Male with a 2-Month History of Cough, Fatigue, and Weight Loss