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Fungal pneumonia

Up CAP Fungal pneumonia Guidelines HAP Mycoplasma Pneumocystis jiroveci

  • rare but important causes of pneumonia
  • fungal pneumonia in immunocompetent patients is very rare
  • 2 main groups based on the immune response required to combat infection with these organisms
  • Histoplasma, blastomycosis, coccidioidomycosis, paracoccidioidomycosis and cryptococcus require specific cell-mediated immunity for their control and thus, diseases caused by these organisms can occur in otherwise healthy individuals. Cause much more severe illnesss in patients with impaired cell mediated immunity (eg patients infected with HIV and organ transplant recipients). With the exception of cryptococcus these organisms are rarely seen outside North America.
  • Aspergillus and mucor spores are killed by non-immune. Rarely result in clinical illness in patients with normal neutrophil numbers and function.
  • Candidiasis is effectively a combination of the 2 types of fungal infection in that impaired cell-mediated immunity predisposes to mucosal overgrowth with Candida but impaired phagocytic function or numbers is usually required before deep invasion of tissues occurs.

Further reading

Rex, J. H., Walsh, T. J., Sobel, J. D. et al. (2000). Practice guidelines for the treatment of candidiasis. Infectious Diseases Society of America. Clin. Infect. Dis. 30, 662-678.

Stevens, D. A., Kan, V. L., Judson, M. A. et al. (2000). Practice guidelines for diseases caused by Aspergillus. Clin. Infect. Dis 30, 696-709. 


©Charles Gomersall, April, 2014 unless otherwise stated. The author, editor and The Chinese University of Hong Kong take no responsibility for any adverse event resulting from the use of this webpage.
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