This is a case report of disseminated Penicillium marneffei infection in a patient with leprosy, responding to antifungal therapy. Radiologically there were nodules in the left lung, right pleural effusion, lymphadenopathy in neck, mediastinum and upper abdomen and abscesses in the liver and right parietal lobe. This case highlights a rare infection in a non-HIV related immunocompromised patient, and its nonspecific radiologic manifestations.