Bone marrow aspirate showing Penicillium marneffei.

A 27-year-old HIV-infected male presented with a 1-month history of poor appetite, cough, low-grade fever, and diffuse rash involving the face and trunk. He lived in the city of Shenzhen in southern China near Hong Kong. He had not previously received antiretroviral therapy. He had pancytopenia with hemoglobin of 78.7 g/L, a total leukocyte count of 3.58 3 10/L, and a platelet count of 96 3 10/L. The alanine transaminase was elevated at 52.5 U/L. Abdomen ultrasonography showed ascites and lymphadenopathy in the hepatic hilar region without hepatosplenomegaly. The clinical suspicion was disseminated penicilliosis. Bone marrow aspiration and culture were performed.