An Infectious Disease Specialist’s Viewpoint
Systemic mycoses, once thought to be rare, exotic diseases, are more frequently being recognized as agents of serious infections in a diverse and emergent group of patients. Opportunistic fungal infections represent a significant cause of morbidity and mortality in the immunocompromised patient (MeunierCCarpentier et al. 1981; Gold 1984; Meunier 1987; Cairns 1988). The more common fungi, Candida, Aspergillus, and Cryptococcus, are not, however, the only agents responsible for this surge in the prevalence of mycotic disease. The organisms responsible for the ‘endemic mycoses’, Blastomyces dermatitidis, Coccidioides immitis, Histoplasma capsulatum, and Paracoccidioides brasiliensis, are infecting large numbers of immunologically normal individuals who live in, or who have visited, the endemic areas. H. capsulatum and Co. immitis also are being increasingly recognized as causing refractory and usually fatal disease in immunosuppressed patients, especially those with the acquired immunodeficiency syndrome (AIDS) (Deresinski and Stevens 1975; Bronnimann et al. 1987; Salzman et al. 1988; Johnson et al. 1986). In addition, other fungi (e.g., Fusarium, Penicillium, Trichosporon, see Table 1) once thought to be relatively avirulent have been shown to produce systemic invasive disease (Anaissie et al. 1988; Walling et al. 1987; Deng et al. 1988). Sporotrichosis, chromoblastomycosis, and eumycetoma represent invasive mycotic infections occurring in different parts of the world and with varying frequencies.
KeywordsCandida Species Invasive Aspergillosis Antimicrob Agent Acquire Immunodeficiency Syndrome Invasive Candidiasis
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