Fungal and Parasitic Respiratory Diseases

Study Notes

Fungal pneumonia can affect healthy individuals but is more prevalent in immunocompromised patients.
Exposure to fungi in endemic areas increases risk.
Disseminated fungal disease can cause multi-organ failure.
Main dimorphic fungi causing pneumonia include Blastomyces dermatitidis, Coccidioides immitis and posadasii, and Histoplasma capsulatum. These are typically inhaled from infected soil.
Monomorphic fungi associated with pneumonia include Aspergillus and Mucor.
Aspergillosis can cause chronic lung disease, including aspergillomas (fungus balls) and hypersensitivity pneumonitis.
Mucor infections are commonly linked to diabetes.
Cryptococcus neoformans can lead to severe pneumonia and central nervous system (CNS) disease, particularly in immunocompromised patients.
Pneumocystis jiroveci pneumonia (PCP) causes interstitial pneumonia and is more frequent in HIV-positive patients with low CD4+ T-cell counts.
Diagnosing the specific type of fungal pneumonia often involves examining sputum or bronchial washings for fungal morphology.
Serological blood tests are also sometimes used when culture results are not available.
Physical exams and radiology may suggest pneumonia but aren't specific enough for diagnosis.
Most fungal pneumonias respond to treatments such as fluconazole or itraconazole.
Disseminated infections necessitate treatments like voriconazole or amphotericin B.
Pneumocystis pneumonia is preventable and treatable with trimethoprim-sulfamethoxazole.