Fungal and Parasitic Respiratory Diseases PDF

Fungal and parasitic diseases of the respiratory system Fungal pneumonia can occur in healthy people, but immunosuppressed patients are at higher risk. Patients may be exposed to fungi in areas where they are endemic. Disseminated disease may cause multiorgan failure The main dimorphic fungi to...

Fungal and parasitic diseases of the respiratory system Fungal pneumonia can occur in healthy people, but immunosuppressed patients are at higher risk. Patients may be exposed to fungi in areas where they are endemic. Disseminated disease may cause multiorgan failure The main dimorphic fungi to cause pneumonia are Blastomyces dermatitidis, Coccidioides immitis and posadasii, and Histoplasma capsulatum, usually inhaled from infected soil. Monomorphic fungi causing pneumonia include Aspergillus and Mucor Aspergillosis may cause chronic lung disease with aspergillomas (fungus balls) or hypersensitivity pneumonitis. Mucor infections are most common in patients with diabetes. Cryptococcus neoformans may cause severe pneumonia and CNS disease, especially in immunocompromised patients. Pneumocystis jiroveci pneumonia causes interstitial pneumonia and is more common in patients with HIV and CD4 + T-cell counts Culture and staining of sputum or bronchial washings for specific fungal morphology is the best way to diagnose fungal pneumonia. Serologic tests are available to run on sputum or blood when culture data are unhelpful. Physical exam and radiology findings may suggest pneumonia but do not identify which type. Most fungal pneumonias respond to treatment with fluconazole or itraconazole. Pneumocystis pneumonia is prevented and treated with trimethoprimsulfamethoxazole. Disseminated infections require or voriconazole or amphotericin B.