The infection sequence associated with Penicillium marneffei is which of the following?

• A. From disseminated infection to mucocutaneous infection
• B. Only mucocutaneous infection occurs
• C. From mucocutaneous infection to disseminated infection
• D. Only disseminated infection occurs

Answer: (C)

Penicillium marneffei infection typically progresses from mucocutaneous involvement to disseminated disease. In many cases, mucocutaneous lesions or mucosal involvement appear early and serve as the initial clinical clue, while the fungus then spreads hematogenously to internal organs such as the liver, spleen, lymph nodes, and bone marrow, leading to a systemic, disseminated illness. This pattern contrasts with a scenario where infection is confined only to mucocutaneous sites or only presents as disseminated disease from the outset without mucocutaneous signs. Therefore, the described sequence is from mucocutaneous infection to disseminated infection.