Fungal Infections in the Compromised Host — An Overview

Abstract

For those interested in medical mycology, the 1960s and 70s represented a period dedicated to raising the awareness of others to the clinical importance of opportunistic mycoses. The medical literature of that period is replete with examples dedicated to this goal, as clinicians who dealt regularly with immunocompromised patients became increasingly aware of the scope of the problem. For example, Hart et al emphasized that most mycoses observed in normal hosts were caused by a characteristic group of fungi, including coccidioidomycosis, histoplasmosis, cryptococcosis, mycetoma, blastomycosis and sporotrichosis; in contrast, compromised patients tended to develop candidiasis, aspergillosis and mucormycosis, as well as disseminated forms of cryptococcosis, histoplasmosis, and coccidioidomycosis¹. Thus, it became clear that as prolonging the survival of immuno- compromised patients became more feasible, increasing numbers of these patients were developing infections, such as disseminated candidiasis, aspergillosis and mucormycosis, rarely seen in normal hosts. Moreover, when infected with fungi which usually cause self-limited disease in normal hosts, those with abnormal host defenses more often developed progressive, disseminated mycoses.