Fungal Group Fungal Disease Source Guidelines

Total Page:16

File Type:pdf, Size:1020Kb

Fungal Group Fungal Disease Source Guidelines Fungal Fungal disease Source Guidelines Relevant articles Group ESCMID guideline for the diagnosis and management of Candida diseases 2012: 1. Developing European guidelines in clinical microbiology and infectious diseases 2. Diagnostic procedures 3. Non-neutropenic adult patients 4. Prevention and management of Candida diseases ESCMID invasive infections in neonates and children caused by Candida spp 5. Adults with haematological malignancies and after haematopoietic stem cell transplantation (HCT) 6. Patients with HIV infection or AIDS Candidaemia and IDSA clinical practice guidelines 2016 IDSA invasive candidiasis ISPD ISPD guidelines/recommendations Candida peritonitis Special article: reducing the risks of peritoneal dialysis-related infections Invasive IDSA IDSA clinical practice guidelines 2010 WHO management guidelines WHO Cryptococcal meningitis Guidelines for the prevention and AIDSinfo treatment of opportunistic infections in HIV-infected Adults and adolescents Southern Guideline for the prevention, African diagnosis and management of HIV cryptococcal meningitis among HIV- clinicians infection persons: 2013 update society IDSA Clinical practice guidelines 2007 IDSA Histoplasmosis disseminated Guidelines for the prevention and treatment of opportunistic infections in AIDSinfo HIV-infected Adults and adolescents IDSA Clinical practice guidelines 2007 Histoplasmosis IDSA acute pulmonary AIDSinfo Guidelines for the prevention and treatment of opportunistic infections in HIV-infected Adults and adolescents Invasive IDSA Clinical practice guidelines 2008 aspergillosis IDSA ERS/EAACI guidelines for acute and Invasive ERS/EA chronic rhinosinusitis with and without rhinosinusitis ACI nasal polyps based on systematic review ESCMID and ECMM joint clinical guidelines for the diagnosis Mucormycosis ESCMID andmanagement of mucormycosis 2013 WHO guidelines for management of opportunistic infections and WHO antiretroviral treatment in adolescents and adults in ethopia Guidelines for the prevention and Pneumocystis treatment of opportunistic infections in AIDSinfo pneumonia HIV-infected Adults and adolescents Article: An official American Thoracic Society statement: Treatment of fungal infections in adult pulmonary and critical care patients. Talaromyces marneffei infection International ERS/ATS guidelines on ERS/ATS definition, evaluation and treatment of severe asthma ABPA Article: Allergic bronchopulmonary aspergillosis: review of literature and proposal of new diagnostic and classification critera Allergic fungal rhinosinusitis Allergic Occupational Lung Disease International ERS/ATS guidelines on SAFS ERS/ATS definition, evaluation and treatment of severe asthma Thunderstorm Asthma Chronic pulmonary ESCMID/ CPA guidelines in European aspergillosis (CPA) ERS Respiratory Journal 2015 Blastomycosis IDSA IDSA clinical practice guidelines 2008 IDSA Coccidioidomycosis guidelines 2005 IDSA Chronic Lung Coccidioidomycosis or Deep tissue Guidelines for the prevention and AIDSinfo treatment of opportunistic infections in HIV-infected Adults and adolescents Managing corneal disease: focus on Fungal keratitis suppurative keratitis Fungus ball of the IDSA Clinical practice guidelines 2008 IDSA sinus Granulomatous invasive fungal rhinosinusitis Histoplasmosis IDSA clinical practice guidelines 2007 chronic cavitary IDSA pulmonary Article: practice guidelines for the treatment of coccidioidomycosis Paracoccidioidomyc osis Article: Treatment options for paracoccididodomycosis and new strategies investigated 2013 European guideline for the Candida balanitis management of balanoposthitis IDSA clinical practice guidelines 2016 IDSA Oesophageal Guidelines for Prevention and candidiasis Treatment of Opportunisitic infections AIDSinfo in HIV-infected Adults and adolescents IDSA clinical practice guidelines 2016 IDSA Oral candidiasis Guidelines on the treatment of skin WHO and oral HIV-associated conditions in Mucosal children and adults infection Guidelines for Prevention and Treatment of Opportunisitic infections AIDSinfo in HIV-infected Adults and adolescents Guideline: vuvovaginal candidosis (AWMF 015/072) (excluding chronic Vaginal thrush mucocutaneous candidosis) Athlete's foot 2013 European guideline for the Candida balanitis management of balanoposthitis Skin, nails and ESCMID and ECMM joint clinical guidelines for the diagnosis and hair Chromoblastomyco ESCMID management of systemic sis phaeohyphomycosis: diseases caused by black fungi Onychomycosis AAO- Clinical Practice Guidelines: Acute Otitis externa HNSF Otitis Externa 2014 Guidelines of care for superficial Pityriasis versicolor AAD mycotic infections of the skin: Pityriasis (tinea) versicolor Ringworm Evidence-based Danish Guidelines Seborrheic for the treatment of Malassezia dermatitis related skin diseases Clinical practice guidelines for the management of sporotrichosis 2007 Sporotrichosis update BAD British Association of Dermatologists' guidelines for the management of tinea capitis 2014 Tinea capitis Guidelines on the treatment of skin WHO and oral HIV-associated conditions in children and adults Guidelines for the management of ESPD tinea capitis in children Guidelines on the treatment of skin Tinea cruris WHO and oral HIV-associated conditions in children and adults Guidelines on the treatment of skin and oral HIV-associated conditions in children and adults Tinea cruris Guidelines of care for superficial mycotic infections of the skin: Tinea WHO corporis, tinea cruris, tinea faciei, tinea manuum and tinea pedis Guidelines on the treatment of skin and oral HIV-associated conditions in children and adults Guidelines of care for superficial Tinea manuum mycotic infections of the skin: Tinea corporis, tinea cruris, tinea faciei, tinea manuum and tinea pedis .
Recommended publications
  • Fungal Infection
    The Pocket Guide to Fungal Infection Second Edition Malcolm D. Richardson PhD, FIBiol, FRCPath Mycology Unit Department of Bacteriology and Immunology University of Helsinki Helsinki, Finland Elizabeth M. Johnson PhD Mycology Reference Laboratory Health Protection Agency Bristol, United Kingdom The Pocket Guide to Fungal Infection Second Edition To families and friends The Pocket Guide to Fungal Infection Second Edition Malcolm D. Richardson PhD, FIBiol, FRCPath Mycology Unit Department of Bacteriology and Immunology University of Helsinki Helsinki, Finland Elizabeth M. Johnson PhD Mycology Reference Laboratory Health Protection Agency Bristol, United Kingdom © 2005 Malcolm D. Richardson, Elizabeth M. Johnson Published by Blackwell Publishing Ltd Blackwell Publishing, Inc., 350 Main Street, Malden, Massachusetts 02148-5020, USA Blackwell Publishing Ltd, 9600 Garsington Road, Oxford OX4 2DQ, UK Blackwell Publishing Asia Pty Ltd, 550 Swanston Street, Carlton, Victoria 3053, Australia The right of the Authors to be identified as the Authors of this Work has been asserted in accordance with the Copyright, Designs and Patents Act 1988. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by the UK Copyright, Designs and Patents Act 1988, without the prior permission of the publisher. First edition published 2000 Reprinted 2000, 2002 Second Edition 2005 Library of Congress Cataloging-in-Publication Data Richardson, M. D. The pocket guide to fungal infection / Malcolm D. Richardson, Elizabeth M. Johnson. — 2nd ed. p. ; cm. Includes bibliographical references and index. ISBN-13: 978-1-4051-2218-4 ISBN-10: 1-4051-2218-8 1.
    [Show full text]
  • Fungal Infections from Human and Animal Contact
    Journal of Patient-Centered Research and Reviews Volume 4 Issue 2 Article 4 4-25-2017 Fungal Infections From Human and Animal Contact Dennis J. Baumgardner Follow this and additional works at: https://aurora.org/jpcrr Part of the Bacterial Infections and Mycoses Commons, Infectious Disease Commons, and the Skin and Connective Tissue Diseases Commons Recommended Citation Baumgardner DJ. Fungal infections from human and animal contact. J Patient Cent Res Rev. 2017;4:78-89. doi: 10.17294/2330-0698.1418 Published quarterly by Midwest-based health system Advocate Aurora Health and indexed in PubMed Central, the Journal of Patient-Centered Research and Reviews (JPCRR) is an open access, peer-reviewed medical journal focused on disseminating scholarly works devoted to improving patient-centered care practices, health outcomes, and the patient experience. REVIEW Fungal Infections From Human and Animal Contact Dennis J. Baumgardner, MD Aurora University of Wisconsin Medical Group, Aurora Health Care, Milwaukee, WI; Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, WI; Center for Urban Population Health, Milwaukee, WI Abstract Fungal infections in humans resulting from human or animal contact are relatively uncommon, but they include a significant proportion of dermatophyte infections. Some of the most commonly encountered diseases of the integument are dermatomycoses. Human or animal contact may be the source of all types of tinea infections, occasional candidal infections, and some other types of superficial or deep fungal infections. This narrative review focuses on the epidemiology, clinical features, diagnosis and treatment of anthropophilic dermatophyte infections primarily found in North America.
    [Show full text]
  • Estimated Burden of Fungal Infections in Oman
    Journal of Fungi Article Estimated Burden of Fungal Infections in Oman Abdullah M. S. Al-Hatmi 1,2,3,* , Mohammed A. Al-Shuhoumi 4 and David W. Denning 5 1 Department of microbiology, Natural & Medical Sciences Research Center, University of Nizwa, Nizwa 616, Oman 2 Department of microbiology, Centre of Expertise in Mycology Radboudumc/CWZ, 6500 Nijmegen, The Netherlands 3 Foundation of Atlas of Clinical Fungi, 1214GP Hilversum, The Netherlands 4 Ibri Hospital, Ministry of Health, Ibri 115, Oman; [email protected] 5 Manchester Fungal Infection Group, Manchester Academic Health Science Centre, The University of Manchester, Manchester M13 9PL, UK; [email protected] * Correspondence: [email protected]; Tel.: +968-25446328; Fax: +968-25446612 Abstract: For many years, fungi have emerged as significant and frequent opportunistic pathogens and nosocomial infections in many different populations at risk. Fungal infections include disease that varies from superficial to disseminated infections which are often fatal. No fungal disease is reportable in Oman. Many cases are admitted with underlying pathology, and fungal infection is often not documented. The burden of fungal infections in Oman is still unknown. Using disease frequencies from heterogeneous and robust data sources, we provide an estimation of the incidence and prevalence of Oman’s fungal diseases. An estimated 79,520 people in Oman are affected by a serious fungal infection each year, 1.7% of the population, not including fungal skin infections, chronic fungal rhinosinusitis or otitis externa. These figures are dominated by vaginal candidiasis, followed by allergic respiratory disease (fungal asthma). An estimated 244 patients develop invasive aspergillosis and at least 230 candidemia annually (5.4 and 5.0 per 100,000).
    [Show full text]
  • Tinea Capitis
    TPGC01.qxd 1/5/06 1:15 PM Page 4 Dermatophytosis Tinea capitis Tinea capitis due to Trichophyton tonsurans. Kerion due to Trichophyton verrucosum. Definition Tinea capitis describes infection of the scalp and hair with a dermatophyte. Geographical distribution World-wide, but more common in Africa, Asia and southern and eastern Europe, occurring mainly in prepubescent children. Increasing incidence. 4 TPGC01.qxd 1/5/06 1:15 PM Page 5 Dermatophytosis Hair infected by Microsporum gyseum showing large-spored ecothrix invasion. Macroconidia of Microsporum canis. Causal organisms and habitat • Several Trichophyton spp. and Microsporum spp. • Zoophilic M. canis (cats and dogs) is common in western Europe. • Anthropophilic T. violaceum is predominant in eastern and southern Europe and north Africa. • Anthropophilic T. tonsurans is increasing in prevalence, especially in North America. 5 TPGC01.qxd 1/5/06 1:15 PM Page 6 Dermatophytosis Microsporum canis in culture. • Anthropophilic species can be contagious and endemic. • T. schoenleinii causes favus. Clinical manifestations • Mild scaling lesions to widespread alopecia. • Kerion: highly inflammatory, suppurating lesion caused by zoophilic dermatophytes. • Black dot appearance seen with ectothrix hair invasion. • Favus is a distinctive infection with grey, crusting lesions. • Asymptomatic carrier state recognized, may promote spread of infection. • T. tonsurans and T. violaceum – most commonly implicated in the carrier state. • Minimal inflammatory response. • Low spore numbers. • Topical treatment
    [Show full text]
  • Mucormycosis of the Central Nervous System
    Journal of Fungi Review Mucormycosis of the Central Nervous System 1 1,2, , 3, , Amanda Chikley , Ronen Ben-Ami * y and Dimitrios P Kontoyiannis * y 1 Infectious Diseases Unit, Tel Aviv Sourasky Medical Center, Tel Aviv 64239, Israel 2 Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 64239, Israel 3 Department of Infectious Diseases, The University of Texas, M.D. Anderson Cancer Center, Houston, TX 77030, USA * Correspondence: [email protected] (R.B.-A.); [email protected] (D.P.K.) These authors contribute equally to this paper. y Received: 6 June 2019; Accepted: 7 July 2019; Published: 8 July 2019 Abstract: Mucormycosis involves the central nervous system by direct extension from infected paranasal sinuses or hematogenous dissemination from the lungs. Incidence rates of this rare disease seem to be rising, with a shift from the rhino-orbital-cerebral syndrome typical of patients with diabetes mellitus and ketoacidosis, to disseminated disease in patients with hematological malignancies. We present our current understanding of the pathobiology, clinical features, and diagnostic and treatment strategies of cerebral mucormycosis. Despite advances in imaging and the availability of novel drugs, cerebral mucormycosis continues to be associated with high rates of death and disability. Emerging molecular diagnostics, advances in experimental systems and the establishment of large patient registries are key components of ongoing efforts to provide a timely diagnosis and effective treatment to patients with cerebral mucormycosis. Keywords: central nervous system; mucormycosis; Mucorales; zygomycosis 1. Introduction Mucormycosis is the second most frequent invasive mold disease after aspergillosis [1–3], with rising incidence reported in some countries [4–7].
    [Show full text]
  • Tinea Faciei Presenting Butterfly Erythema in a Boy
    TINEA FACIEI PRESENTING BUTTERFLY ERYTHEMA IN A BOY Serpil Şener Department of Dermatology, Beydagi State Hospital, Malatya, Turkey Tinea faciei is the most frequently misdiagnosed entity among cutaneous fungal infections. The atypical clinical features support the separation of this disease from tinea corporis. This often lacks a distinct raised scaly border, and may mimic a photodermatosis such as lupus erythematosus or dermatomyositis. Other photodermatoses to consider include polymorphous light eruption, contact dermatitis, and rosacea. In this article, a 9-year-old boy with tinea faciei presenting butterfly rash was reported because of its rarity. Key words: Dermatophytosis, tinea faciei, butterfly rash Eur J Gen Med 2007; 4(3):141-142 INTRODUCTION DISCUSSION Tinea faciei is a superficial dermatophyte Tinea faciei is a relatively uncommon infection limited to the glabrous skin of the superficial dermatophyte infection limited to face. In pediatric and female patients, the the glabrous skin of the face. It can be found infection may appear on any surface of the worldwide, but has a predilection for tropical face. In men, the condition is known as tinea humid climates (4). The causative agent varies barbae when a dermatophyte infection of according to the geographic region. In Asia, bearded areas occurs (1). The clinical features Trychophyton mentagrophytes and T. rubrum vary considerable. Annular or circinate are the most frequent etiologic agents (1,5). lesions, plaques with a raised margin, simple Infection results either from direct contact to papular lesions, and flat patches of erythema, an external source, for example a domestic as well as scaling, itching and exacerbation animal, or there may be secondary spread after sun exposure may occur (1-3).
    [Show full text]
  • HIV Infection and AIDS
    G Maartens 12 HIV infection and AIDS Clinical examination in HIV disease 306 Prevention of opportunistic infections 323 Epidemiology 308 Preventing exposure 323 Global and regional epidemics 308 Chemoprophylaxis 323 Modes of transmission 308 Immunisation 324 Virology and immunology 309 Antiretroviral therapy 324 ART complications 325 Diagnosis and investigations 310 ART in special situations 326 Diagnosing HIV infection 310 Prevention of HIV 327 Viral load and CD4 counts 311 Clinical manifestations of HIV 311 Presenting problems in HIV infection 312 Lymphadenopathy 313 Weight loss 313 Fever 313 Mucocutaneous disease 314 Gastrointestinal disease 316 Hepatobiliary disease 317 Respiratory disease 318 Nervous system and eye disease 319 Rheumatological disease 321 Haematological abnormalities 322 Renal disease 322 Cardiac disease 322 HIV-related cancers 322 306 • HIV INFECTION AND AIDS Clinical examination in HIV disease 2 Oropharynx 34Neck Eyes Mucous membranes Lymph node enlargement Retina Tuberculosis Toxoplasmosis Lymphoma HIV retinopathy Kaposi’s sarcoma Progressive outer retinal Persistent generalised necrosis lymphadenopathy Parotidomegaly Oropharyngeal candidiasis Cytomegalovirus retinitis Cervical lymphadenopathy 3 Oral hairy leucoplakia 5 Central nervous system Herpes simplex Higher mental function Aphthous ulcers 4 HIV dementia Kaposi’s sarcoma Progressive multifocal leucoencephalopathy Teeth Focal signs 5 Toxoplasmosis Primary CNS lymphoma Neck stiffness Cryptococcal meningitis 2 Tuberculous meningitis Pneumococcal meningitis 6
    [Show full text]
  • Epidemiological Alert: COVID-19 Associated Mucormycosis
    Epidemiological Alert: COVID-19 associated Mucormycosis 11 June 2021 Given the potential increase in cases of COVID-19 associated mucormycosis (CAM) in the Region of the Americas, the Pan American Health Organization / World Health Organization (PAHO/WHO) recommends that Member States prepare health services in order to minimize morbidity and mortality due to CAM. Introduction In recent months, an increase in reports of cases of Mucormycosis (previously called zygomycosis) is the term used to name invasive fungal infections (IFI) COVID-19 associated Mucormycosis (CAM) has caused by saprophytic environmental fungi, been observed mainly in people with underlying belonging to the subphylum Mucoromycotina, order diseases, such as diabetes mellitus (DM), diabetic Mucorales. Among the most frequent genera are ketoacidosis, or on steroids. In these patients, the Rhizopus and Mucor; and less frequently Lichtheimia, most frequent clinical manifestation is rhino-orbital Saksenaea, Rhizomucor, Apophysomyces, and Cunninghamela (Nucci M, Engelhardt M, Hamed K. mucormycosis, followed by rhino-orbital-cerebral Mucormycosis in South America: A review of 143 mucormycosis, which present as secondary reported cases. Mycoses. 2019 Sep;62(9):730-738. doi: infections and occur after SARS CoV-2 infection. 1,2 10.1111/myc.12958. Epub 2019 Jul 11. PMID: 31192488; PMCID: PMC6852100). Globally, the highest number of cases has been The infection is acquired by the implantation of the reported in India, where it is estimated that there spores of the fungus in the oral, nasal, and are more than 4,000 people with CAM.3 conjunctival mucosa, by inhalation, or by ingestion of contaminated food, since they quickly colonize foods rich in simple carbohydrates.
    [Show full text]
  • An Aggressive Case of Mucormycosis
    Open Access Case Report DOI: 10.7759/cureus.9610 An Aggressive Case of Mucormycosis Donovan Tran 1 , Berndt Schmit 2 1. Diagnostic Radiology, University of Arizona College of Medicine - Tucson, Tucson, USA 2. Radiology, University of Arizona College of Medicine - Tucson, Tucson, USA Corresponding author: Donovan Tran, [email protected] Abstract Mucormycosis is an aggressive fungal disease that can occur in individuals with certain predisposing factors, such as diabetes mellitus and pharmacologic immunosuppression. An astounding aspect of this disease is the speed at which it can spread to surrounding structures once it begins to germinate inside the human body. This case involves a 24-year-old male patient who presented to the emergency room complaining of a headache after a dental procedure who developed fulminant rhinocerebral mucormycosis within days. The objective of this report is to shed light on how fast this disease spreads, discuss current management of rhinocerebral mucormycosis, and illustrate the subtle, but critical radiographic findings to raise clinical awareness for this life-threatening disease. Categories: Emergency Medicine, Radiology, Infectious Disease Keywords: rhinocerebral mucormycosis, mucormycosis, rhizopus, invasive fungal sinusitis, retroantral fat, isavuconazole Introduction We share our world with fungi. They are ubiquitous in nature; current estimates put the number of fungal species to be as high as 5.1 million [1]. As plentiful as they are, only hundreds of these species are pathogenic to humans, collectively killing more than 1.6 million people annually [2]. Common fungi that cause illness are Aspergillus species, Candida albicans, Cryptococcus neoformans, Blastomyces dermatitidis, and Rhizopus species. The term mucormycosis refers to any fungal infection caused by fungi belonging to the Mucorales order [3].
    [Show full text]
  • Therapies for Common Cutaneous Fungal Infections
    MedicineToday 2014; 15(6): 35-47 PEER REVIEWED FEATURE 2 CPD POINTS Therapies for common cutaneous fungal infections KENG-EE THAI MB BS(Hons), BMedSci(Hons), FACD Key points A practical approach to the diagnosis and treatment of common fungal • Fungal infection should infections of the skin and hair is provided. Topical antifungal therapies always be in the differential are effective and usually used as first-line therapy, with oral antifungals diagnosis of any scaly rash. being saved for recalcitrant infections. Treatment should be for several • Topical antifungal agents are typically adequate treatment weeks at least. for simple tinea. • Oral antifungal therapy may inea and yeast infections are among the dermatophytoses (tinea) and yeast infections be required for extensive most common diagnoses found in general and their differential diagnoses and treatments disease, fungal folliculitis and practice and dermatology. Although are then discussed (Table). tinea involving the face, hair- antifungal therapies are effective in these bearing areas, palms and T infections, an accurate diagnosis is required to ANTIFUNGAL THERAPIES soles. avoid misuse of these or other topical agents. Topical antifungal preparations are the most • Tinea should be suspected if Furthermore, subsequent active prevention is commonly prescribed agents for dermatomy- there is unilateral hand just as important as the initial treatment of the coses, with systemic agents being used for dermatitis and rash on both fungal infection. complex, widespread tinea or when topical agents feet – ‘one hand and two feet’ This article provides a practical approach fail for tinea or yeast infections. The pharmacol- involvement. to antifungal therapy for common fungal infec- ogy of the systemic agents is discussed first here.
    [Show full text]
  • List Item Posaconazole SP-H-C-611-II
    European Medicines Agency London, 4 December 2006 Product Name: POSACONAZOLE SP Procedure number: EMEA/H/C/611/II/01 authorised SCIENTIFIC DISCUSSION longer no product Medicinal 7 Westferry Circus, Canary Wharf, London, E14 4HB, UK Tel. (44-20) 74 18 84 00 Fax (44-20) 74 18 86 68 E-mail: [email protected] http://www.emea.europa.eu 1 Introduction Fungal infections are a major cause of morbidity and mortality in immunocompromised patients. Filamentous mould and yeast-like fungi are ubiquitous organisms found worldwide in many different media. The Candida species are the most common cause of fungal infections. However, epidemiologic shifts have begun to occur, most likely due to the prophylactic and empiric use of antifungal agents. Emerging fungal pathogens, such as Aspergillus, Fusarium, and Zygomycetes, are changing the clinical spectrum of fungal diagnoses. Pathogens General risk factors for invasive fungal infections are exposure to pathogens, an impaired immune system, and fungal spores. The presence of a colonised environment, partnered with a disruption in a physiologic barrier, potentiates the risk of an invasive fungal infection in an immunologically impaired host, such as a patient infected with HIV, someone taking chronic systemic steroids, or a transplant recipient. In addition, contaminated implanted devices (e.g., catheters, prostheses), external devices (e.g., contact lenses), and community reservoirs (e.g., hand lotion, pepper shakers) have all been implicated as sources of fungal outbreaks. Candida albicans continues to be the most frequent cause of invasive fungal infections in most patient populations. However, prophylaxis and the widespread use of antifungal agents as empiric therapy for neutropenic fever have led to a shift in the epidemiology of invasive Candida infections.
    [Show full text]
  • Fungal Diseases
    Abigail Zuger Fungal Diseases For creatures your size I offer a free choice of habitat, so settle yourselves in the zone that suits you best, in the pools of my pores or the tropical forests of arm-pit and crotch, in the deserts of my fore-arms, or the cool woods of my scalp Build colonies: I will supply adequate warmth and moisture, the sebum and lipids you need, on condition you never do me annoy with your presence, but behave as good guests should not rioting into acne or athlete's-foot or a boil. from "A New Year Greeting" by W.H. Auden. Introduction Most of the important contacts between human beings and the fungi occur outside medicine. Fungi give us beer, bread, antibiotics, mushroom omelets, mildew, and some devastating crop diseases; their ability to cause human disease is relatively small. Of approximately 100,000 known species of fungi, only a few hundred are human pathogens. Of these, only a handful are significant enough to be included in medical texts and introductory courses like this one. On the other hand, while fungal virulence for human beings is uncommon, the fungi are not casual pathogens. In the spectrum of infectious diseases, they can cause some of the most devastating and stubborn infections we see. Most human beings have a strong natural immunity to the fungi, but when this immunity is breached the consequences can be dramatic and severe. As modern medicine becomes increasingly adept in prolonging the survival of some patients with naturally-occurring immunocompromise (diabetes, cancer, AIDS), and causing iatrogenic immunocompromise in others (antibiotics, cytotoxic and MID 25 & 26 immunomodulating drugs), fungal infections are becoming increasingly important.
    [Show full text]