Chapter 108: Pneumocystis Pneumonia, Candidiasis, and Other Fungal Infections

Chapter 108: Pneumocystis Pneumonia, Candidiasis, and Other Fungal Infections is a topic covered in the Harrison's Manual of Medicine.

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GENERAL CONSIDERATIONS

  • Yeasts (e.g., Candida, Cryptococcus) appear microscopically as round, budding forms; molds (e.g., Aspergillus, Rhizopus) appear as filamentous forms called hyphae; and dimorphic fungi (e.g., Histoplasma) are spherical in tissue but appear as molds in the environment.
    • Endemic fungi (e.g., Coccidioides) are not part of the normal human microbiota and infect hosts preferentially by inhalation.
    • Opportunistic fungi (e.g., Candida and Aspergillus) invade the host from normal sites of colonization (e.g., mucous membranes or the GI tract).
  • Definitive diagnosis of any fungal infection requires histopathologic identification of the fungus invading tissue and accompanying evidence of an inflammatory response.
    • Other tests that detect antigens (e.g., for Histoplasma, Cryptococcus, Aspergillus) or antibody (e.g., for Coccidioides) have different degrees of specificity and sensitivity.

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GENERAL CONSIDERATIONS

  • Yeasts (e.g., Candida, Cryptococcus) appear microscopically as round, budding forms; molds (e.g., Aspergillus, Rhizopus) appear as filamentous forms called hyphae; and dimorphic fungi (e.g., Histoplasma) are spherical in tissue but appear as molds in the environment.
    • Endemic fungi (e.g., Coccidioides) are not part of the normal human microbiota and infect hosts preferentially by inhalation.
    • Opportunistic fungi (e.g., Candida and Aspergillus) invade the host from normal sites of colonization (e.g., mucous membranes or the GI tract).
  • Definitive diagnosis of any fungal infection requires histopathologic identification of the fungus invading tissue and accompanying evidence of an inflammatory response.
    • Other tests that detect antigens (e.g., for Histoplasma, Cryptococcus, Aspergillus) or antibody (e.g., for Coccidioides) have different degrees of specificity and sensitivity.

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