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Chapter 28


Introduction to Mycology


Morphologic forms

Asexual reproduction

Conditions conducive to fungal infections

Types of fungal infections (mycoses)

Diagnosis of fungal infections

• Fungal infections mimic other diseases and therefore must be distinguished through careful differential diagnosis (Table 28-1).

TABLE 28-1

Differential Diagnosis of Fungal Infections

Infection Etiologic agent Other conditions to exclude
Aspergillosis Aspergillus species Zygomycoses and other mold infections
Blastomycosis Blastomyces dermatitidis Bacterial and viral pneumonia, atypical mycobacterial infection, other systemic mycoses, bacterial or mycobacterial skin infections
Candidiasis Candida albicans Bacterial and other fungal infections
Chromoblastomycosis Dematiaceous soil fungi Sporotrichosis, tularemia, plague, gangrene, actinomycosis, atypical mycobacterial infection
Coccidioidomycosis Coccidioides immitis Bacterial and viral pneumonia; skin infections caused by bacteria, viruses, or other fungi
Cryptococcosis Cryptococcus neoformans Meningitis caused by bacteria (e.g., Mycobacterium tuberculosis) and viruses, lung cancer, other systemic mycoses (especially histoplasmosis)
Histoplasmosis Histoplasma capsulatum Other systemic mycoses, bacterial and viral pneumonia, tuberculosis
Mycetoma, eumycotic Dematiaceous soil Mycetoma caused by soil bacteria fungi
Paracoccidioidomycosis Paracoccidioides brasiliensis Bacterial and viral pneumonia; skin infections caused by bacteria, viruses, or other fungi
Ringworm (tinea) Trichophyton, Microsporum, and Epidermophyton species Candidal infections; bacterial and viral skin infections
Sporotrichosis Sporothrix schenckii Tularemia, plague, gangrene, nocardiosis, chronic staphylococcal skin infections, atypical mycobacterial infection, other mycoses
Zygomycosis Rhizopus and Mucor species Aspergillosis and other mold infections

1. Culture and microscopic examination

2. Detection of fungal antigens in blood or cerebrospinal fluid (CSF) by Ouchterlony (double-immunodiffusion) test or enzyme-linked immunosorbent assay

Antifungal agents

• Table 28-2 lists common drugs used in treating mycoses and their mode of action.

TABLE 28-2

Antifungal Drugs


II Superficial and Cutaneous Mycoses