Diagnosis and Treatment of Fungal Infections [3 ed.] 3031358023, 9783031358029

Table of contents :
Preface
In Memoriam: Michael G. Rinaldi
In Memoriam: Deanna Sutton
In Memoriam: Ángela Restrepo Moreno
Contents
Contributors
Part I: Approach to Patients
1: Approach to Patients with Suspected Fungal Diseases
Introduction
Epidemiology
Suspicion Based on Risk Factors
Immunocompromise
Neutropenia and Altered Phagocytic Function
Immunomodulation with Monoclonal Antibodies and Chimeric Antigen Receptor (CAR) T-Cell Therapies
Impaired Cell-Mediated Immunity
Organ Transplantation
Healthcare Exposure (Nosocomial)
Community Exposure
Other Risks
Suspicion Based on Organs Involved
Summary
References
Further Reading
Other Key Resources
Part II: Laboratory and Radiological Diagnosis
2: Basic Mycology
Introduction
Specimen Collection, Transportation, and Pre-treatment
Processing of Specimens for Mycological Investigations
Examining Cultures
Phenotypic Yeast and Yeast-Like Organism Identification
Phenotypic Identification of Filamentous Fungi
Molecular Fungal Identification
Taxonomy, Classification, and Nomenclature
Ascomycota
Basidiomycota
Mucoromycota and Zoopagomycota
References
Further Reading
3: Molecular Taxonomy
Introduction
Candidiasis
Aspergillosis
Hyalohyphomycosis
Phaeohyphomycosis
Mucormycosis
Mucorales
Conidiobolus (Entomophthoromycotina)
Basidiobolus (Basidiobolales)
Cryptococcosis and Trichosporonosis
Endemics/Dimorphic Fungi
Tinea (Dermatophytes)
Conclusions and Recommendations
References
Further Reading
4: Diagnostic Molecular Mycology
Introduction
Current Challenges to Fungal Diagnostic Assay Development
Frequency of Human Mycoses
Expertise in Medical Mycology
Fungal Nomenclature
Template Preparation
Mass Spectrometry-Based Molecular Diagnostic Assays
Matrix Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry (MALDI-TOF-MS)
Raman Spectroscopy
Fourier Transform Infrared Spectroscopy (FTIR)
PCR/Electrospray Ionization Mass Spectroscopy (PCR/ESI-MS)
Hybridization Probes
Fluorescence In Situ Hybridization (Fish)
Ribosomal RNA Hybridization Probes
PCR
Standard PCR
PCR Sequencing
Real-Time PCR
Loop-Mediated Isothermal Amplification (LAMP)
Rolling Circle Amplification (RCA)
Nucleic Acid Sequence–Based Amplification (NASBA)
Whole-Genome Sequencing
Summary
References
Further Reading
5: Diagnostic Histopathology
Introduction
Specimen Preparation
Wet Mounts and Touch Preparations
Cytopathology
Histopathology
Host Inflammatory Response
Pyogenic
Granulomatous
Hoeppli-Splendore Phenomenon
Grains
Stains
Hematoxylin and Eosin (H&E)
Gomori Methenamine Silver (GMS)
Periodic Acid Schiff (PAS)
Mayer’s Mucicarmine Stain
Masson-Fontana
Brown and Brenn Stain (Brown and Hopps, Tissue Gram Stain)
Histopathological Characteristics of Deep Fungal Pathogens
Yeast-Like Cells in Tissue
Blastomycosis
Candidiasis
Chromoblastomycosis
Coccidioidomycosis
Cryptococcosis
Histoplasmosis
Paracoccidiodomycosis
Sporotrichosis
Hyphae in Tissue
Suggested Readings
6: Diagnostic Immunology
Introduction
Host Antibody Testing
Fungal Antigen Testing
Fungal Metabolite Testing
Fungal Nucleic Acid Testing
Pan-Fungal Testing: 1,3-β-D-glucan
Diagnosis of IFD in High-Risk Hemato-Oncological Patients
Diagnosis of Invasive Candidiasis (IC) in High-Risk Intensive Care Unit (ICU) Patients
Diagnosis of Pneumocystis jirovecii Pneumonia (PJP)
Conclusions and Recommendations
Invasive Candidiasis (IC)
Antibody Detection
Antigen Detection
Detection of Fungal Metabolites
Conclusions and Recommendations
Invasive Aspergillosis (IA)
Antibody Detection
Antigen Detection
Detection of Fungal Metabolites
Conclusions and Recommendations
Cryptococcosis
Antibody Detection
Antigen Detection
Detection of Fungal Metabolites
Conclusions and Recommendations
Histoplasmosis
Antibody Detection
Antigen Detection
Detection of Fungal Metabolites
Skin Testing
Conclusions and Recommendations
Blastomycosis
Antibody Detection
Antigen Detection
Detection of Fungal Metabolites
Conclusions and Recommendations
Coccidioidomycosis
Antibody Detection
Antigen Detection
Detection of Fungal Metabolites
Skin Testing
Conclusions and Recommendations
Paracoccidioidomycosis
Antibody Detection
Antigen Detection
Detection of Fungal Metabolites
Conclusions and Recommendations
Other Mycoses
References
Suggested Reading
7: Diagnostic Radiology
Introduction
Central Nervous System Imaging
CNS Mass Lesions
Meningeal Enhancement
Hydrocephalus
Respiratory Tract Imaging
Sinus Imaging
Noninvasive Fungal Sinusitis
Invasive Fungal Rhinosinusitis (IFR)
Pulmonary Imaging
Airspace Consolidation
Interstitial Pattern
Nodules and Masses
Cavitation
Lymphadenopathy
Pleural Abnormalities
Airway Abnormalities
Miscellaneous
Abdominal Imaging
Target Lesions
Organomegaly
Lymphadenopathy
Miscellaneous
Musculoskeletal Imaging
Osteomyelitis
References
Suggested Reading
Part III: Systemic Antifungal Agents
8: Systemic Antifungal Agents
Introduction
Targets of Antifungal Therapy
Polyenes
Triazoles
Echinocandins
Pyrimidine Antifungals
Triterpenoids
Investigational Antifungals
Antifungal Resistance
Laboratory Detection of Resistance
Mechanisms of Resistance
Amphotericin B
Spectrum and Susceptibility
Pharmacokinetics
Adverse Effects
Azoles
Spectrum and Susceptibility
Fluconazole
Itraconazole
Voriconazole
Posaconazole
Isavuconazole
Azole Drug Interactions
Echinocandins
Spectrum and Susceptibility
Pharmacokinetics
Adverse Effects
Fluoropyrimidines
Spectrum and Susceptibility
Pharmacokinetics
Adverse Effects
Combination Antifungal Therapy
Therapeutic Drug Monitoring
References
Suggested Reading
Part IV: Mycoses
9: Candidiasis
Introduction
Etiologic Agents
Epidemiology
Pathogenesis and Immunology
Clinical Manifestations
Cutaneous Candidiasis Syndromes
Oropharyngeal Candidiasis (OPC)
Esophageal Candidiasis
Respiratory Tract Candidiasis
Vulvovaginal Candidiasis
Urinary Tract Candidiasis
Abdominal Candidiasis, Including Peritonitis
Candida Osteomyelitis and Arthritis
Candidemia and Disseminated Candidiasis
Ocular Candidiasis
Cardiac and Endovascular Candidiasis
Central Nervous Systemic (CNS) Candidiasis
Chronic Disseminated Candidiasis (CDC)
Diagnosis
Management
Cutaneous Candidiasis
Gastrointestinal Candidiasis
Genital Tract Candidiasis
Urinary Tract Candidiasis (Candiduria)
Candidemia and Acute Disseminated Candidiasis
Chronic Disseminated Candidiasis
Prevention
Prophylaxis of Candidiasis in Transplant Patients
Prophylaxis of Superficial Candidiasis in HIV-Positive Patients
Empirical Anticandida Treatment
References
10: Infections Due to Non-Candidal Yeasts
Introduction
Trichosporon
Etiologic Agents
Epidemiology
Clinical Manifestations
Diagnosis
Treatment
Saccharomyces
Etiologic Agents
Epidemiology
Diagnosis
Treatment
Rhodotorula
Etiologic Agents
Epidemiology
Clinical Manifestations
Diagnosis
Treatment
Malassezia
Etiologic Agents
Epidemiology
Clinical Manifestations
Diagnosis
Treatment
Other Emerging Yeasts
Saprochaete
Sporobolomyces
Geotrichum
Kodamaea
Disclaimer
References
Further Reading
11: Aspergillosis
Introduction
Etiologic Agents
Epidemiology
Pathogenesis and Immunity
Clinical Manifestations
Allergic Bronchopulmonary Aspergillosis
Aspergilloma
Other Superficial or Colonizing Syndromes
Chronic Pulmonary Aspergillosis
Invasive Pulmonary Aspergillosis
Disseminated Aspergillosis
Sinusitis
Endocarditis
Diagnosis
Treatment
Azoles
Polyenes
Echinocandins
Combination Therapies and Therapeutic Approaches
Summary
References
Further Reading
12: Hyalohyphomycosis: Infection Due to Hyaline Molds
Introduction
Fusariosis
Etiologic Agents
Epidemiology and Clinical Spectrum of Fusariosis in Non-immunocompromised Patients
Epidemiology and Clinical Spectrum of Fusariosis in Immunocompromised Patients
Clinical Manifestations of Fusariosis in Non-immunocompromised Patients
Clinical Manifestations of Fusariosis in Immunocompromised Patients
Skin Involvement
Pneumonia
Fungemia
Diagnosis
Treatment
Prevention
Scedosporiosis and Lomentosporiasis
Etiologic Agents
Epidemiology and Clinical Manifestations
Diagnosis
Treatment
Paecilomyces and Purpureocillium Species
Etiologic Agents
Epidemiology and Clinical Manifestations
Diagnosis
Treatment
Acremonium and Sarocladium Species
Etiologic Agents
Epidemiology and Clinical Manifestations
Diagnosis and Treatment
Other Agents of Hyalohyphomycosis
References
Further Reading
13: Phaeohyphomycosis: Infection Due to Dark (Dematiaceous) Molds
Introduction
Etiologic Agents
Epidemiology
Pathogenesis and Immunology
Clinical Manifestations
Superficial Infections
Allergic Disease
Pneumonia
Brain Abscess
Disseminated Infection
Diagnosis
Treatment
Superficial Infections
Allergic Disease
Pneumonia
Brain Abscess
Disseminated Infection
References
Further Reading
14: Mucormycosis
Introduction
Etiologic Agents
Epidemiology
Pathogenesis and Immunology
Clinical Manifestations
Paranasal Sinus Infection
Pulmonary Infection
Cutaneous Infection
Gastrointestinal Infection
Disseminated Infection
Other Infection
Diagnosis
Clinical Assessment
Diagnostic Imaging
Culture
Histopathology
Non-culture Diagnostic Methods
Treatment
Amphotericin B
Triazoles
Combination Antifungal Therapy
Surgery
Hyperbaric Oxygen
Prognosis
Prevention
References
Further Reading
15: Pneumocystosis
Introduction
Etiologic Agent
Epidemiology
Pathogenesis and Immunology
Clinical Manifestations
Pneumocystis Pneumonia
Extrapulmonary Infections
Diagnosis
Treatment
Prevention
References
Further Reading
16: Cryptococcosis
Introduction
Etiologic Agents
Epidemiology
Pathogenesis and Immunology
Clinical Manifestations
Pulmonary Infection
Central Nervous System (CNS) Infection
Skin Infection
Prostate Infection
Eye Infection
Infection at Other Body Sites
Diagnosis
Direct Examination
Cytology and Histopathology
Serology
Culture and Identification
Molecular Identification Methods
Treatment
Basic Management Principles/Role of Combination Therapy
Alternative Combination Regimens
Host Considerations
Cryptococcal Meningitis in HIV Patients
Organ Transplant Recipients
Non HIV-Infected, Nontransplant Patients
Nonmeningeal Cryptococcosis
Immune Reconstitution Inflammatory Syndrome (IRIS)
Persistent and Relapsed Infection
Antifungal Susceptibility Testing
Management of Elevated CSF Pressure
Prevention
References
Further Reading
Untitled
17: Blastomycosis
Introduction
Etiologic Agents
Phenotypic Characteristics
Genotypic Characteristics
Epidemiology
Pathogenesis and Immunology
Clinical Manifestations
Pulmonary Blastomycosis
Acute Infection
Chronic Infection
Acute Respiratory Distress Syndrome
Extrapulmonary Blastomycosis
Skin Disease
Osseous
Genitourinary
Central Nervous System
Atypical Blastomycosis
Diagnosis
Treatment
References
Further Reading
18: Coccidioidomycosis
Introduction
Etiologic Agents
Epidemiology
Pathogenesis and Immunology
Clinical Manifestations
Pulmonary Infection (Mild to Moderate)
Pulmonary Infection (Severe and Complicated)
Disseminated Disease
Osteomyelitis
Synovitis
Lymphadenitis
Soft Tissue Infections
Cutaneous Disease
Peritonitis
Meningitis
Diagnosis
Culture
Histopathology
Serologic Testing
Skin Testing
Other Laboratory Findings
Radiologic Imaging
Treatment
General Approach
Primary Coccidioidomycosis
Pulmonary Nodule
Pulmonary Cavity
Chronic Progressive Fibrocavitary Pneumonia
Coccidioidomycosis in Pregnancy
Disseminated Disease (Extrapulmonary, Nonmeningeal)
Disseminated Disease (Central Nervous System)
Monitoring Therapy
Prevention
References
Further Reading
19: Emergomycosis
Introduction
Etiological Agent
Epidemiology
Pathogenesis and Immunology
Clinical Manifestations
Diagnosis
Treatment
References
Further Reading
20: Histoplasmosis
Introduction
Etiologic Agent
Epidemiology
Pathogenesis, Virulence, and Immunology
Clinical Manifestations
Asymptomatic Infection
Acute Pulmonary Histoplasmosis
Subacute Pulmonary Histoplasmosis
Chronic Pulmonary Histoplasmosis
Progressive Disseminated Histoplasmosis (PDH)
Fibrosing Mediastinitis and Mediastinal Granuloma
Uncommon Presentations of Disseminated Disease
African Histoplasmosis
Diagnosis
Culture
Antigen Detection
Histopathology
Serologic Tests
Molecular Testing
Cell-Mediated Immunity Testing
Conclusions
Treatment
References
Further Reading
21: Paracoccidioidomycosis
Introduction
The Etiologic Agent
Ecological Aspects
Epidemiological Aspects
Pathogenesis and Immune Response
Clinical Manifestations
Subclinical Infection
Symptomatic Infection
Acute or Subacute Disease (Juvenile Type)
Chronic Disease, Adult Type
Disease in Immunocompromised Patients
PCM and Tuberculosis (TB)
Diagnosis
Direct Examination and Histopathology
Culture
Immunodiagnostic Tests
Nucleic Acid Detection
Treatment
Prevention
References
Further Reading
22: Sporotrichosis
Introduction
Etiologic Agent
Epidemiology
Pathogenesis and Immunology
Clinical Manifestations
Lymphocutaneous Sporotrichosis
Pulmonary Sporotrichosis
Osteoarticular Sporotrichosis
Central Nervous System Sporotrichosis
Disseminated Sporotrichosis
Diagnosis
Treatment
Lymphocutaneous Sporotrichosis
Pulmonary Sporotrichosis
Osteoarticular Sporotrichosis
Central Nervous System Sporotrichosis
Disseminated Sporotrichosis
References
Further Reading
23: Talaromycosis
Introduction
Etiologic Agent
Epidemiology
Pathogenesis and Immunology
Clinical Manifestations
Upper Respiratory Tract Infections
Lower Respiratory Tract Infections
Localized Infections Outside of the Lungs
Disseminated Infection
Talaromycosis Immune Reconstitution Inflammatory Syndrome (IRIS)
Diagnosis
Microscopy and Culture
Molecular Diagnosis
Immunodiagnostics
Matrix-Assisted Laser Desorption/Ionization-Time of Flight (MALDI-TOF)
Treatment
Treating Acute Disease
Emerging Treatment Strategies
Preventing Recurrence
Preventing Disease
References
Further Reading
24: Dermatophytosis (Tinea) and Other Superficial Fungal Infections
Introduction
Etiologic Agents
Epidemiology
Tinea Pedis/Manuum
Tinea Corporis/Cruris
Tinea Capitis
Onychomycosis
Pityriasis Versicolor
Seborrheic Dermatitis and Folliculitis
Pathogenesis
Clinical Manifestations
Tinea Pedis/Manuum
Tinea Corporis/Cruris
Tinea Capitis
Onychomycosis
Pityriasis Versicolor
Seborrheic Dermatitis and Folliculitis
Diagnosis
Treatment
Tinea Pedis/Manuum
Tinea Corporis/Cruris
Tinea Capitis
Onychomycosis
Pityriasis Versicolor
Seborrheic Dermatitis
References
Further Reading
25: Fungal Infections of Implantation (Chromoblastomycosis, Mycetoma, Lobomycosis, and Entomophthoromycosis)
Introduction
Chromoblastomycosis
Etiology
Ecology and Epidemiology
Immunopathogenesis
Clinical Manifestations
Diagnosis
Therapy
Mycetoma
Ecology and Epidemiology
Etiology
Pathogenesis
Clinical Manifestations
Diagnosis
Treatment
Lobomycosis
Etiology and Epidemiology
Clinical Manifestations
Diagnosis
Treatment
Entomophthoromycosis
Epidemiology
Clinical Manifestations
Diagnosis
Treatment
References
Further Reading
Chromoblastomycosis
Instructive Cases
Instructive Case 1
Instructive Case 2
Instructive Case 3
Instructive Case 4
Instructive Case 5
Instructive Case 6
Instructive Case 7
Instructive Case 8
Instructive Case 9
Instructive Case 10
Instructive Case 11
Instructive Case 12
Instructive Case 13
Instructive Case 14
Instructive Case 15
Instructive Case 16
Instructive Case 17
Instructive Case 18
Instructive Case 19
Instructive Case 20
Instructive Case 21
Instructive Cases Discussion
Instructive Case 1
Instructive Case 2
Instructive Case 3
Instructive Case 4
Instructive Case 5
Instructive Case 6
Instructive Case 7
Instructive Case 8
Instructive Case 9
Instructive Case 10
Instructive Case 11
Instructive Case 12
Instructive Case 13
Instructive Case 14
Instructive Case 15
Instructive Case 16
Instructive Case 17
Instructive Case 18
Instructive Case 19
Instructive Case 20
Instructive Case 21
Index

Polecaj historie

Candida Albicans: Overcoming Yeast and Fungal Infections

Yeast and fungal infections are becoming increasingly common, driven by our modern stressful lifestyles, high-sugar diet

196 36 968KB Read more

Diagnosis of Viral and Rickettsial Infections 9780231880770

A collection of discussions on the diagnosis of viral and rickettsial infections with critical evaluation and limitation

162 93 11MB Read more

Diagnosis of Viral and Rickettsial Infections 9780231880770

A collection of discussions on the diagnosis of viral and rickettsial infections with critical evaluation and limitation

188 52 12MB Read more

HPV Infections: Diagnosis, Prevention, and Treatment [1 ed.] 9781681086170, 9781681086187

Human papillomavirus (HPV) infection is one of the most frequently sexually transmitted diseases in the world. HPV infec

153 82 7MB Read more

Screening, Diagnosis and Treatment 9789811505911

672 53 3MB Read more

Pathogenesis, Diagnosis and Treatment 9783030352769

717 130 32MB Read more

Multiple Myeloma: Symptoms, Diagnosis and Treatment : Symptoms, Diagnosis and Treatment [1 ed.] 9781617285424, 9781608761081

Multiple myeloma (also known as myeloma or plasma cell myeloma) is a progressive hematologic disease. It is a cancer of

211 61 6MB Read more

Dysphagia: Risk Factors, Diagnosis and Treatment : Risk Factors, Diagnosis and Treatment [1 ed.] 9781619421073, 9781619421042

Swallowing difficulties or dysphagia, can occur with numerous conditions, some of which are permanent, some reversible,

255 36 3MB Read more

Anal Fissure: Symptoms, Diagnosis and Treatment : Symptoms, Diagnosis and Treatment [1 ed.] 9781620817117, 9781612097169

The presence of an anal fissure is reliably associated with an elevated intra-anal pressure and decreased blood flow to

216 117 2MB Read more

Liver Cancer: Causes, Diagnosis and Treatment : Causes, Diagnosis and Treatment [1 ed.] 9781620810613, 9781612091150

Primary liver cancer, mainly hepatocellular carcinoma (HCC), is the third leading cause of cancer-related deaths worldwi

231 17 7MB Read more