Disseminated talaromycosis: Truly uncommon or uncommonly recognized?

34 years old male from north-east India, a known case of retroviral disease, presented with shortness of breath and significant weight loss and was found to have pancytopenia, skin lesions, organomegaly, generalized lymphadenopathy, cavitary lung disease with very low CD4 counts. He failed to improve on empirical antitubercular therapy and further evaluation revealed features of disseminated talaromycosis on bone marrow studies. We hereby present an interesting case of a systemic fungal disease in the setting of advanced HIV infection.