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Fungal infections 

Fungal infections
Chapter:
Fungal infections
Author(s):

Philippa C. Matthews

DOI:
10.1093/med/9780198737773.003.0011
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date: 19 July 2018

Cryptococcosis Cryptococcus neoformans

Dimorphic fungi: summary

Organism

Climate and distribution

Clinical syndromes

Treatment

Yeast form (37°C)

Mycelium form

(25–30°C)

Histoplasma capsulatum (see Histoplasmosis: Microbiology, p.[link])

Warm/humid climates;

southern states of USA, West

and Central Africa

  1. (i) Asymptomatic

  2. (ii) Flu-like illness

  3. (iii) Pulmonary infection (± cavitation)

  4. (iv) Dissemination

Amphotericin Itraconazole (Voriconazole/posaconazole are also options)

Small, uniform oval cells

Fungal infections

Large tuberculate macroconidia

Fungal infections

Blastomyces dermatitidis (see Blastomycosis: Microbiology, p.[link])

Warm wet climates; widespread in southern USA, Middle East, Africa, India

  1. (i) Asymptomatic

  2. (ii) Flu-like illness

  3. (iii) Pulmonary infection (± focal consolidation)

  4. (iv) Chronic cutaneous lesions

  5. (v) Dissemination

Amphotericin Itraconazole Fluconazole/voriconazole (Itraconazole also an option)

Round cells with broad-based buds

Fungal infections

Oval conidia; branching hyphae

Fungal infections

Coccidioides immitis (see Coccidiomycosis: Microbiology, p.[link])

Arid/dry regions of North and South America

  1. (i) Asymptomatic

  2. (ii) Flu-like illness

  3. (iii) Acute or chronic pulmonary infection

  4. (iv) Cutaneous lesions

  5. (v) Dissemination

Amphotericin Itraconazole Fluconazole (Itraconazole/voriconazole are also options)

Spherule containing arthrospores

Fungal infections

Thick-walled barrel-shaped arthroconidia

Fungal infections

Paracoccidioides brasiliensis (see Paracoccidiomycosis: Microbiology, p.[link])

Humid parts of Central and South America

  1. (i) Asymptomatic

  2. (ii) Mucosal and cutaneous lesions

  3. (iii) Chronic pulmonary infection

  4. (iv) Dissemination

Amphotericin Itraconazole (Sulpha-drugs and voriconazole are also options)

Large round cells with multiple buds

Fungal infections

Single pyriform conidia

Fungal infections

Sporothrix schenckii

Worldwide

  1. (i) Asymptomatic

  2. (ii) Localized infection of skin/subcutaneous tissue

  3. (iii) Dissemination

Amphotericin

Itraconazole

Cigar-shaped; oval and budding

Fungal infections

Ovoid microconidia in ‘flowerette’ morphology

Fungal infections

Penicillium marneffei (see Pencilliosis: Microbiology, p.[link])

South East Asia, South China

  1. (i) Asymptomatic

  2. (ii) Pulmonary infection

  3. (iii) Mucosal lesions

  4. (iv) Dissemination

Amphotericin Itraconazole (Voriconazole is also an option)

Small oval yeast cells

Fungal infections

Brush-like conidiophores

Fungal infections

Histoplasmosis Histoplasma capsulatum

Blastomycosis blastomyces dermatitidis

Gilchrist’s disease /Chicago disease

Coccidiomycosis Coccidioides immitis

San Joaquin Valley fever

Paracoccidiomycosis Paracoccidioides brasiliensis

Penicilliosis Penicillium marneffei

Madura foot ‘eumycetoma pedis’