Fungal Infection – Diagnosis and Management

Malcolm D. Richardson - University Hospital of South Manchester and Manchester Academic Health Science Centre, University of Manchester David W. Warnock - National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia

Preface to the fourth edition, xxvi Preface to the first edition, xxviii Acknowledgements, xxix 1 Introduction, 1 1.1 The nature of fungi, 1 1.2 Classification and nomenclature of fungi and fungal diseases, 3 1.3 Fungi as human pathogens, 5 1.4 The changing pattern of fungal infection, 7 1.5 New directions in diagnosis, 9 1.6 New directions in treatment and prevention, 10 2 Laboratory diagnosis of fungal infection, 12 2.1 Introduction, 12 2.2 Collection of specimens, 13 2.3 Specimens for serological tests, 18 2.4 Specimens for antifungal drug level determinations, 18 2.5 Transport of specimens, 18 2.6 Interpretation of laboratory test results, 18 2.7 Molecular diagnosis of fungal infection, 28 3 Antifungal drugs, 32 3.1 Introduction, 32 3.2 Allylamines, 32 3.4 Other allylamine compounds for topical administration, 35 3.5 Azoles, 35 3.6 Fluconazole, 40 3.7 Itraconazole, 44 3.8 Ketoconazole, 48 3.9 Posaconazole, 50 3.10 Voriconazole, 53 3.11 Other imidazole compounds for topical administration, 57 3.12 Echinocandins, 59 3.13 Anidulafungin, 60 3.14 Caspofungin, 61 3.15 Micafungin, 63 3.16 Polyenes, 65 3.17 Amphotericin B, 66 3.18 Other polyene compounds for topical administration, 76 3.19 Flucytosine, 76 3.20 Griseofulvin, 79 3.21 Other miscellaneous compounds for topical administration, 81 3.22 Prophylactic treatment for prevention of fungal infection, 82 3.23 Empirical treatment of suspected fungal infection in the neutropenic patient, 84 3.24 Pre-emptive antifungal treatment, 85 3.25 Combination antifungal treatment of invasive fungal infections, 85 3.26 Laboratory monitoring, 86 4 Dermatophytosis, 91 4.1 Introduction, 91 4.2 The causal organisms and their habitat, 92 4.3 Epidemiology, 93 4.4 Laboratory diagnosis of dermatophytosis, 94 4.5 Tinea capitis, 95 4.6 Tinea corporis, 102 4.7 Tinea cruris, 105 4.8 Tinea pedis, 107 4.9 Tinea manuum, 111 4.10 Tinea unguium, 113 5 Superficial candidosis, 121 5.1 Definition, 121 5.2 Geographical distribution, 121 5.3 The causal organisms and their habitat, 121 5.4 Epidemiology, 122 5.5 Clinical manifestations, 124 5.6 Essential investigations and their interpretation, 130 5.7 Management, 130 5.8 Prevention, 136 6 Other cutaneous fungal infections, 138 6.1 Pityriasis versicolor, 138 6.2 Other Malassezia infections, 142 6.3 Piedra, 143 6.4 White piedra, 144 6.5 Black piedra, 145 6.6 Tinea nigra, 147 6.7 Neoscytalidium infection, 148 6.8 Alternaria infection, 149 7 Mould infections of nails, 151 7.1 Definition, 151 7.2 Geographical distribution, 151 7.3 The causal organisms and their habitat, 151 7.4 Epidemiology, 152 7.5 Clinical manifestations, 152 7.6 Differential diagnosis, 153 7.7 Essential investigations and their interpretation, 153 7.8 Management, 154 7.9 Prevention, 155 8 Keratomycosis, 156 8.1 Definition, 156 8.2 Geographical distribution, 156 8.3 The causal organisms and their habitat, 156 8.4 Epidemiology, 157 8.5 Clinical manifestations, 158 8.6 Essential investigations and their interpretation, 159 8.7 Management, 160 9 Otomycosis, 162 9.1 Definition, 162 9.2 Geographical distribution, 162 9.3 The causal organisms and their habitat, 162 9.4 Epidemiology, 162 9.5 Clinical manifestations, 163 9.6 Differential diagnosis, 164 9.7 Essential investigations and their interpretation, 164 9.8 Management, 164 10 Aspergillosis, 166 10.1 Definition, 166 10.2 Geographical distribution, 166 10.3 The causal organisms and their habitat, 166 10.4 Epidemiology, 167 10.5 Clinical manifestations, 170 10.6 Essential investigations and their interpretation, 182 10.7 Management, 186 10.8 Empirical treatment of suspected invasive aspergillosis, 194 10.9 Prevention, 195 11 Invasive candidosis, 201 11.1 Definition, 201 11.2 Geographical distribution, 201 11.3 The causal organisms and their habitat, 201 11.4 Epidemiology, 202 11.5 Clinical manifestations, 208 11.6 Candidosis in special hosts, 217 11.7 Essential investigations and their interpretation, 217 11.8 Management, 221 11.9 Empirical treatment of suspected invasive candidosis, 232 11.10 Prevention, 232 12 Cryptococcosis, 236 12.1 Definition, 236 12.2 Geographical distribution, 236 12.3 The causal organisms and their habitat, 236 12.4 Epidemiology, 238 12.5 Clinical manifestations, 240 12.6 Essential investigations and their interpretation, 244 12.7 Management, 246 12.8 Prevention, 251 13 Mucormycosis, 253 13.1 Definition, 253 13.2 Geographical distribution, 253 13.3 The causal organisms and their habitat, 253 13.4 Epidemiology, 254 13.5 Clinical manifestations, 256 13.6 Differential diagnosis, 259 13.7 Essential investigations and their interpretation, 259 13.8 Management, 260 13.9 Prevention, 262 14 Pneumocystosis, 264 14.1 Definition, 264 14.2 Geographical distribution, 264 14.3 The causal organisms and their habitat, 264 14.4 Epidemiology, 265 14.5 Clinical manifestations, 268 14.6 Differential diagnosis, 269 14.7 Essential investigations and their interpretation, 270 14.8 Management, 271 14.9 Prevention, 274 15 Blastomycosis, 277 15.1 Definition, 277 15.2 Geographical distribution, 277 15.3 The causal organism and its habitat, 277 15.4 Epidemiology, 278 15.5 Clinical manifestations, 279 15.6 Differential diagnosis, 282 15.7 Essential investigations and their interpretation, 282 15.8 Management, 283 15.9 Prevention, 286 16 Coccidioidomycosis, 288 16.1 Definition, 288 16.2 Geographical distribution, 288 16.3 The causal organisms and their habitat, 288 16.4 Epidemiology, 289 16.5 Clinical manifestations, 291 16.6 Differential diagnosis, 294 16.7 Essential investigations and their interpretation, 294 16.8 Management, 297 16.9 Prevention, 301 17 Histoplasmosis, 304 17.1 Definition, 304 17.2 Geographical distribution, 304 17.3 The causal organism and its habitat, 305 17.4 Epidemiology, 305 17.5 Clinical manifestations, 307 17.6 Differential diagnosis, 312 17.7 Essential investigations and their interpretation, 313 17.8 Management, 316 17.9 Prevention, 320 18 Paracoccidioidomycosis, 322 18.1 Definition, 322 18.2 Geographical distribution, 322 18.3 The causal organism and its habitat, 322 18.4 Epidemiology, 323 18.5 Clinical manifestations, 324 18.6 Differential diagnosis, 327 18.7 Essential investigations and their interpretation, 327 18.8 Management, 329 18.9 Prevention, 331 19 Chromoblastomycosis, 332 19.1 Definition, 332 19.2 Geographical distribution, 332 19.3 The causal organisms and their habitat, 332 19.4 Epidemiology, 333 19.5 Clinical manifestations, 333 19.6 Differential diagnosis, 334 19.7 Essential investigations and their interpretation, 334 19.8 Management, 335 20 Entomophthoromycosis, 338 20.1 Introduction, 338 20.2 Basidiobolomycosis, 338 20.3 Conidiobolomycosis, 341 21 Mycetoma, 344 21.1 Definition, 344 21.2 Geographical distribution, 344 21.3 The causal organisms and their habitat, 344 21.4 Epidemiology, 346 21.5 Clinical manifestations, 346 21.6 Differential diagnosis, 347 21.7 Essential investigations and their interpretation, 348 21.8 Management, 349 22 Sporotrichosis, 352 22.1 Definition, 352 22.2 Geographical distribution, 352 22.3 The causal organism and its habitat, 352 22.4 Epidemiology, 353 22.5 Clinical manifestations, 354 22.6 Differential diagnosis, 356 22.7 Essential investigations and their interpretation, 357 22.8 Management, 358 22.9 Prevention, 360 23 Hyalohyphomycosis, 362 23.1 Introduction, 362 23.2 Fusarium infection, 362 23.3 Scedosporium infection, 369 23.4 Other agents of hyalohyphomycosis, 373 24 Penicillium marneffei infection, 376 24.1 Introduction, 376 24.2 Geographical distribution, 376 24.3 The causal organism and its habitat, 376 24.4 Epidemiology, 377 24.5 Clinical manifestations, 378 24.6 Differential diagnosis, 378 24.7 Essential investigations and their interpretation, 379 24.8 Management, 380 24.9 Prevention, 381 25 Phaeohyphomycosis, 383 25.1 Introduction, 383 25.2 Geographical distribution, 384 25.3 The causal organisms and their habitat, 384 25.4 Epidemiology, 385 25.5 Clinical manifestations, 387 25.6 Differential diagnosis, 390 25.7 Essential investigations and their interpretation, 391 25.8 Management, 392 26 Other invasive yeast infections, 396 26.1 Introduction, 396 26.2 Systemic Malassezia infection, 396 26.3 Trichosporonosis, 399 26.4 Other yeast infections, 402 27 Unusual fungal and pseudofungal infections, 405 27.1 Introduction, 405 27.2 Adiaspiromycosis, 405 27.3 Lacaziosis, 408 27.4 Pythiosis, 410 27.5 Rhinosporidiosis, 414 Further reading, 416 Select bibliography, 419 Index, 421