Overview of invasive fungal infections and clinical presentation Journal Article

  


Author: Armstrong, D.
Article Title: Overview of invasive fungal infections and clinical presentation
Abstract: The most common opportunistic fungal infections are due to Candida and Aspergillus species, all of which take advantage of neutrophil dysfunction. Candida also invades via infected intravenous catheters, and aspergillus invades the respiratory tracts of patients with mononuclear phagocyte defects. Cryptococcus neoformans, Histoplasma capsulatum and Coccidioides immitis invade and disseminate in people with severe mononuclear phagocyte defects, and the mucorales invade those with neutrophil defects or severe prolonged acidosis secondary to diabetes or infantile diarrhoea. Most of the other opportunistic fungi invade via intravenous catheters or, less often, through the respiratory tract of neutropenic patients. Rhodotorula rubra infections, for instance, are almost always associated with i.v. catheters, as are those of the dematiaceous fungi, such as alternaria. Fusarium species may also be associated with i.v. catheters but can also cause respiratory infections and invade from that site, Trichosporon species may invade from the respiratory or gastrointestinal tract. Penicillium marneffei is now recognized as an opportunistic fungus in HIV-infected individuals, but was well described as infecting patients with mononuclear phagocyte defects before the HIV epidemic. The relevance to the clinician of these varied opportunistic fungal infections resides in the varied susceptibility of the organisms to antifungal agents. Readily available susceptibility studies will be an important factor in managing these regularly lethal infections. 'Emerging fungal pathogens' had already emerged decades ago. What is emerging now is an enormous number of susceptible hosts immunocompromised by cancer chemotherapy, bone marrow and organ transplantation and the HIV epidemic. These numbers will only increase, as will the number of opportunistic fungal infections.
Keywords: review; nonhuman; antifungal agent; immune deficiency; rifampicin; candidiasis; mycosis; aspergillosis; pyrrole derivative; opportunistic infection; flucytosine; coccidioidomycosis; histoplasmosis; central nervous system infection; amphotericin b; cryptococcosis; intracerebroventricular drug administration; human; priority journal; dermatomycosis; mucormycosis
Journal Title: Bailliere's Clinical Infectious Diseases
Volume: 2
Issue: 1
ISSN: 1071-6564
Publisher: Bailliere Tindall  
Date Published: 1995-03-01
Start Page: 17
End Page: 24
Language: English
PROVIDER: scopus
DOI/URL:

https://www.scopus.com/inward/record.uri?eid=2-s2.0-0029064745&partnerID=40&md5=dde2d2ea729db26750e2a35f47775a15
Notes: Review -- Export Date: 28 August 2018 -- Source: Scopus