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Earning CME CreditTo obtain credit, you should first read the journal article. After reading the article, you should be able to answer the following,related, multiple-choice questions. To complete the questions (with a minimum 75% passing score) and earn continuing medicaleducation (CME) credit, please go to http://www.medscape.org/journal/eid. Credit cannot be obtained for tests completedon paper, although you may use the worksheet below to keep a record of your answers. You must be a registered user onMedscape.org. If you are not registered on Medscape.org, please click on the “Register” link on the right hand side of thewebsite to register. Only one answer is correct for each question. Once you successfully answer all post-test questions you willbe able to view and/or print your certificate. For questions regarding the content of this activity, contact the accredited provider,CME@medscape.net. For technical assistance, contact CME@webmd.net. American Medical Association’s Physician’s RecognitionAward (AMA PRA) credits are accepted in the US as evidence of participation in CME activities. For further informationon this award, please refer to http://www.ama-assn.org/ama/pub/about-ama/awards/ama-physicians-recognition-award.page.The AMA has determined that physicians not licensed in the US who participate in this CME activity are eligible for AMA PRACategory 1 Credits. Through agreements that the AMA has made with agencies in some countries, AMA PRA credit maybe acceptable as evidence of participation in CME activities. If you are not licensed in the US, please complete the questionsonline, print the certificate and present it to your national medical association for review.Article TitleDisseminated Infections with Talaromyces marneffei in Non-AIDSPatients Given Monoclonal Antibodies against CD20 and Kinase InhibitorsCME Questions1. According to the case series report by Chan andcolleagues, which of the following statements aboutthe clinical and epidemiologic characteristics ofTalaromyces marneffei infection is correct?A. T. marneffei infection is the most important pathogenicthermal dimorphic fungus causing systemic mycosis inSoutheast AsiaB. T. marneffei infection is typically limited to thegastrointestinal and/or urinary tractC. T. marneffei infection is usually self-limited with a goodprognosis for recoveryD. T. marneffei infection is common among non-AIDShematology patients2. Your patient is a 57-year-old Chinese man withacute myeloid leukemia and fever. According to thecase series report by Chan and colleagues, which ofthe following statements about the recent emergenceof disseminated T. marneffei infection in non-AIDSpatients with hematologic malignant neoplasmstreated with targeted therapies is correct?A. The appearance of 4 cases in the past 2 years is theresult of a change in the methodologies of a laboratorydiagnosis of T. marneffei infectionB. The appearance of 4 cases in the past 2 years isthe result of a dramatic increase in the number ofhematology patients at the investigators' hospital1. The activity supported the learning objectives.Strongly DisagreeActivity EvaluationC. Recent emergence of disseminated T. marneffeiinfection is most likely because of overallimmunosuppressionD. Recent emergence of disseminated T. marneffeiinfection is most likely because of targeted therapies,such as anti-CD20 monoclonal antibodies and kinaseinhibitors3. According to the case series report by Chanand colleagues, which of the following statementsabout possible mechanisms of action underlyingdisseminated T. marneffei infection in non-AIDSpatients with hematologic malignant neoplasmstreated with targeted therapies would most likelybe accurate?A. Rituximab and obinutuzumab used in 2 cases areanti-CD20 monoclonal antibodies that predominantlytarget T cellsB. T. marneffei infection is usually seen at CD4+ countsof more than 300/µLC. Patients with B-cell dysfunction may have impairedproduction of neutralizing antibodies against keyvirulence factors of T. marneffeiD. The investigators do not suggest any role ofcytokine-producing B-cellsStrongly Agree1 2 3 4 52. The material was organized clearly for learning to occur.Strongly DisagreeStrongly Agree1 2 3 4 53. The content learned from this activity will impact my practice.Strongly DisagreeStrongly Agree1 2 3 4 54. The activity was presented objectively and free of commercial bias.Strongly DisagreeStrongly Agree1 2 3 4 5Emerging Infectious Diseases • www.cdc.gov/eid • Vol. 21, No. 7, July 2015 1283