The authors reported the first case of Penicillium mameffei in the Nation Lung Hospital, HIV-infected patient who had lived in a P. marneffei endemic area. Penicilliosis in HIV-infected patients may be misdiagnosed as Mycobacterium tuberculosis because multiple nodules and mediastinal lymphadenopathy are radiologic findings of penicilliosis. Fungal cultures or direct staining of infected tissues is equired to differentiate penicilliosis from tuberculosis. Penicilliosis may also be misdiagnosed as Pneumocystis jirovecii pneumonia. PCP rarely reveals pleural effusions, while P. marneffei infection sometimes accompany pleural effusion. Sputum examination may also be helpful to differentiate PCP from a P. Mameffeiinfection. The authors suppose that it is important to consider P. mameffei when immunocompromised patients with histories of visits to areas of endemicity reveal respiratory disease, generalized lymphadenopathy, and central umbilicated vesicular skin lesions.