Opportunistic Mold Infections
This chapter provides an overview of opportunistic mold infections, including aspergillosis, mucormycosis, infections caused by Fusarium spp. and Pseudallescheria boydii, and infections caused by the dematiaceous molds (Table 2.1). Although each of these
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CONTENTS I. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . II. Aspergillosis . . . . . . . . . . . . . . . . . . . . . . . . . . A. Mycology . . . . . . . . . . . . . . . . . . . . . . . . . . B. Epidemiology . . . . . . . . . . . . . . . . . . . . . . C. Clinical Manifestations . . . . . . . . . . . . . . 1. Invasive Pulmonary Aspergillosis and Disseminated Infection . . . . . . . . 2. Invasive Aspergillus Sinusitis . . . . . . . 3. Noninvasive Mycelial Mass of the Lung . . . . . . . . . . . . . . . . . . . . . . 4. Noninvasive Mycelial Mass of the Paranasal Sinuses . . . . . . . . . . . 5. Bronchopulmonary Aspergillosis . . . 6. Allergic Aspergillus Sinusitis . . . . . . . D. Diagnosis . . . . . . . . . . . . . . . . . . . . . . . . . . E. Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . III. Mucormycosis . . . . . . . . . . . . . . . . . . . . . . . . . A. Mycology . . . . . . . . . . . . . . . . . . . . . . . . . . B. Epidemiology . . . . . . . . . . . . . . . . . . . . . . C. Clinical Manifestations . . . . . . . . . . . . . . 1. Rhinocerebral Mucormycosis . . . . . . 2. Invasive Pulmonary Mucormycosis and Disseminated Infection . . . . . . . . 3. Gastrointestinal Mucormycosis . . . . . 4. Skin and Wound Mucormycosis . . . . D. Diagnosis . . . . . . . . . . . . . . . . . . . . . . . . . . E. Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . IV. Infections Caused by Fusarium spp. . . . . . . V. Infections Caused by Pseudallescheria boydii .............................. VI. Dematiaceous Molds . . . . . . . . . . . . . . . . . . . VII. Rare Agents . . . . . . . . . . . . . . . . . . . . . . . . . . . VIII. Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . References . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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II. Aspergillosis
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Species of Aspergillus are responsible for a wide variety of different clinical syndromes, including saprophytic colonization of the pulmonary airspaces in patients with chronic lung disease, chronic noninvasive mycelial masses of the lungs or paranasal sinuses, and rapidly-progressive life-threatening invasive infections of the lungs or paranasal sinuses in neutropenic hosts. In addition, Aspergillus spp. produce a number of different allergic syndromes, including extrinsic allergic alveolitis, bronchopulmonary aspergillosis, and allergic Aspergillus sinusitis.
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I. Introduction This chapter provides an overview of opportunistic mold infections, including aspergillosis, mucormycosis, infections caused by Fusarium spp. and Pseudallescheria boydii, and infections caused by the 1
dematiaceous molds (Table 2.1). Although each of these agents is also capable of causing disease in normal individuals, special emphasis has been placed on infections in compromised hosts.
Overton Brooks Veterans Administration Medical Center and Louisiana State University Health Sciences Center, 510 East Stoner Avenue, Shreveport, LA 71101, USA; e-mail: r
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