Fungal diseases:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia, Pa.
Saunders
2009
|
| Schriftenreihe: | Clinics in chest medicine
30,2 |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XII S., S. 203 - 413 Ill., graph. Darst., Kt. 27 cm |
| ISBN: | 9781437704617 1437704611 |
Internformat
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| 245 | 1 | 0 | |a Fungal diseases |c guest ed. Kenneth S. Knox ; George A. Sarosi |
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Datensatz im Suchindex
| _version_ | 1804139218667044864 |
|---|---|
| adam_text | Titel: Fungal diseases
Autor: Knox, Kenneth S.
Jahr: 2009
Fungal Diseases
Contents
Preface xi
Kenneth S. Knox and GeorgeA. Sarosi
Overview of Antif ungal Agents 203
George R.Thompson III, Jose Cadena, and Thomas F. Patterson
This article is a comprehensive clinically focused review of currently available anti-
fungals administered by way of the intravenous or inhalational route: amphotericin
B and its lipid formulations, fluconazole, itraconazole, posaconazole, voriconazole,
caspofungin, micafungin, anidulafungin, and flucytosine. Emphasis is placed on
pharmacodynamics and kinetics, drug interactions, adverse events, and evidence
for their use. Selected clinical trials demonstrating the efficacy of these agents are
also reviewed.
Histoplasmosis 217
Carol A. Kauffman
Histoplasmosis is the most common endemic mycosis causing human infection.
Large outbreaks have been ascribed to histoplasmosis, but most infections are
sporadic. Similar to the other fungi in this category, initial exposure to Histoplasma
capsulatum is by way of the respiratory tract, but once inhaled into the alveoli, the
organism readily spreads in macrophages throughout the reticuloendothelial sys¬
tem. Compared with a decade ago, improvements in diagnostic tests have made
it feasible to more quickly establish a diagnosis of histoplasmosis, thus allowing ap¬
propriate antifungal therapy to be started promptly. Treatment guidelines have been
updated recently and are reviewed for the various forms of histoplasmosis.
Blastomycosis: New Insights into Diagnosis, Prevention, and Treatment 227
James A. McKinnell and Peter G. Pappas
The basic science and clinical understanding of infection with Blastomyces dermati-
tidis has been a field of constant evolution and continued revision of hypotheses. This
article highlights some areas in which recent progress has the potential for significant
impact on the clinical care of patients. Specifically, this article examines the applica¬
tion of modern technology to epidemiologic studies, the development of novel vac¬
cine candidates, emerging populations at risk for the disease, rapid diagnostic
tools, and the application of novel antifungal agents in the treatment of blastomycosis.
Coccidioidomycosis: A Review of Recent Advances 241
Neil M. Ampel
Coccidioidomycosis is one of three dimorphic endemic mycoses recognized in North
America. Over the past decade, the disease has been resurgent, particularly in the
southwest United States. With this increase in incidence have come new observa¬
tions and insights and re-examination of past issues. This article explores some of
these areas by focusing principally on recent publications that are of importance.
Contents
Cryptococcosis: An Emerging Respiratory Mycosis 253
Shaunna M. Huston and Christopher H. Mody
Cryptococcosis occurs in immunocompromised and, in special cases, immuno-
competent individuals. There have been a number of important advances in the field,
but, despite current treatment, patients continue to die of the infection. This article
reviews cryptococcosis epidemiology, clinical features, and management. Current
knowledge is incomplete, however, so this article also discusses some of the
gaps in the present understanding of cryptococcosis. The hope is that current re¬
search striving to understand the mechanisms of host evasion of Cryptococcus
will result in improved treatment regimens that decrease both the mortality and
morbidity of cryptococcosis.
Pneumocystis Pneumonia: Current Concepts in Pathogenesis, Diagnosis, and Treatment 265
Bryan J. Krajicek, Charles F.Thomas, Jr, and Andrew H. Limper
Pneumocystis pneumonia (PCP) is an infection of the lungs caused by the opportu¬
nistic fungal genus Pneumocystis. In humans, PCP is a serious and potentially life-
threatening infection occurring in immunocompromised individuals, particularly
those who have AIDS, or following immune suppression from malignancy, organ
transplantation, or therapies for inflammatory diseases. Several recent studies
have contributed to understanding of the biology and pathogenesis of the organism
yielding new diagnostic approaches and therapeutic targets. Although trimetho-
prim-sulfamethoxazole remains the mainstay of prophylaxis and treatment, ongoing
concerns for emerging Pneumocystis resistance supports the continuing investiga¬
tion for novel therapeutic agents.
Invasive Fungal Infections in the Era of Biologies 279
Tamra M. Arnold, Catherine R. Sears, and Chadi A. Hage
With the advent and widespread use of immunomodulating biologic agents, emerg¬
ing invasive fungal infections are reported increasingly. To date there is no reliable
method to screen patients before starting anti-tumor necrosis factor (TNF) therapy
to predict their risk for acquiring fungal infections, partly because most of these in¬
fections are de novo infections. Patients should be counseled about avoiding high-
risk activities that are associated with the endemic mycosis in their geographic
areas. Physicians should keep a high level of suspicion for endemic fungal infections
when patients receiving anti-TNF therapy or other biologies present with pulmonary
or systemic infections. Rapid diagnosis and initiation of antifungal therapy are of
utmost importance.
Candida in the ICU 287
Rabih O. Darouiche
Invasive Candida infections are becoming increasingly recognized in critically ill pa¬
tients. These infections result in serious morbidity, can be life threatening, and are
expensive to manage. Early suspicion of Candida infection and the use of timely
and proper antifungal treatment can improve outcome. Although treatment of docu¬
mented, deep-seated Candida infections in nonneutropenic patients has been stud¬
ied extensively, guidelines for the management of suspected but undocumented
cases of invasive Candida infections in critically ill patients have not been clearly
established. Future work should focus on better delineation of the sector of critically
ill patients who have suspected invasive Candida infection and who could benefit
Contents
from the use of empiric antifungal therapy, and on the investigation of novel ap¬
proaches for the potential salvage of devices infected with Candida species.
Fungal Infections in Hematopoietic Stem Cell Transplantation and Solid-Organ
Transplantation—Focus on Aspergillosis 295
Marcio Nucci and Elias Anaissie
Invasive fungal infections (IFIs) represent a major complication in recipients of hema¬
topoietic stem cell transplantation and solid-organ transplantation. The incidence of
IFIs in transplant recipients has increased over the past 20 years, and these
infections continue to be associated with high morbidity and mortality. This article
reviews the important concepts guiding the management of IFIs in transplant recip¬
ients, including epidemiologic trends, new risk factors, and a timetable of infections,
pathogens, therapy, and prevention of these infections. An emphasis is given to
invasive aspergillosis.
Unique Characteristics of Fungal Infections in Lung Transplant Recipients 307
Shahid Husain
This article focuses on the unique clinical features of prevalent fungal infections and
their management implications in lung transplant recipients. Topics include epidemi¬
ology, risk factors, clinical syndromes, non invasive diagnostic methods and antifun¬
gal prophylaxis. The article not only highlights the current state of knowledge in
these areas but also points towards future direction of research to conquer fungal
infections in lung transplants.
Noninvasive Pulmonary Aspergillus Infections 315
Brent P. Riscili and Karen L.Wood
Aspergillus can cause several forms of pulmonary disease ranging from colonization
to invasive aspergillosis and largely depends on the underlying lung and immune
function of the host. This article reviews the clinical presentation, diagnosis, patho-
genesis, and treatment of noninvasive forms of Aspergillus infection, including aller¬
gic bronchopulmonary aspergillosis (ABPA), aspergilloma, and chronic pulmonary
aspergillosis (CPA). ABPA is caused by a hypersensitivity reaction to Aspergillus
species and is most commonly seen in patients who have asthma or cystic fibrosis.
Aspergillomas, or fungus balls, can develop in previous areas of cavitary lung dis¬
ease, most commonly from tuberculosis. CPA has also been termed semi-invasive
aspergillosis and usually occurs in patients who have underlying lung disease or
mild immunosuppression.
Molds: Hyalohyphomycosis, Phaeohyphomycosis, and Zygomycosis 337
Susanna Naggie and John R. Perfect
Emerging fungi previously thought to be nonpathogenic are now recognized as play¬
ing a significant role in the increased incidence of invasive fungal disease. This
change in the epidemiology of invasive fungal infections (IFIs) has occurred in the
era of aggressive new therapies for hematopoietic stem cell and solid organ trans¬
plantation and malignancy, which have lead to profound immunosuppression for
longer durations and has extended the survival of these critically ill patients. The sig¬
nificant morbidity and mortality associated with these infections is not only related to
Contents
the host populations but to delayed recognition and diagnosis and high rates of
resistance in some of these emerging pathogens to standard antifungal therapies.
Role of Bronchoalveolar Lavage Diagnostics in Fungal Infections 355
Kenneth S. Knox and Laura Meinke
Although a biopsy may need to be performed in complicated patients, bronchoal¬
veolar lavage (BAL) is an important adjunct to the diagnosis of pulmonary and dis¬
seminated fungal infections. Culture is the gold standard for diagnosis in many
instances, but cytologic and morphologic analysis is often diagnostic. Although
newer molecular and antigen techniques may be applied to BAL samples, the role
of such tests is yet to be defined for many pathogens.
Approach to the Diagnosis of Invasive Aspergillosis and Candidiasis 367
L. Joseph Wheat
Detection of galactomannan antigen in serum or bronchoalveolar lavage fluid is useful
for diagnosis of invasive aspergillosis, but the current serologic tests are not useful.
(1 - 3)-S-D-glucan can be detected in the serum of patients who have aspergillosis,
candidiasis, and a few other mold infections, but false-positive results limit its reliabil¬
ity for diagnosis. None of these methods is useful for diagnosis of zygomycosis and
certain other less common mold infections. This article focuses on the detection of
antigen and B-D-glucan for diagnosis of invasive aspergillosis and candidiasis.
Approach to the Diagnosis of the Endemic Mycoses 379
L. Joseph Wheat
The endemic mycoses are often overlooked in the evaluation of community-
acquired pneumonia, and appropriate testing is not performed until the patient
has failed to improve on antibacterial therapy. Antigen detection and fungal serology
may be helpful in diagnosis of endemic mycoses as causes for pneumonia. Guide¬
lines for recognition and evaluation of endemic mycoses as causes for community-
acquired pneumonia are proposed. Performance of antigen testing on bronchial
washings or lavage fluid may improve the sensitivity for diagnosis over microscopic
examination and the speed of diagnosis over culture. This article focuses on antigen
detection and serology for diagnosis of endemic mycoses. Of note is that isolation of
the fungus by culture remains the only method for definitive diagnosis, and the only
method for diagnosis in some patients.
Fungal Molecular Diagnostics 391
Nancy L. Wengenack and Matthew J. Binnicker
This article summarizes the current state of the art in molecular diagnostic methods
for the detection and identification of fungi as performed in the mycology laboratory.
The advantages and limitations of current molecular testing methods are evaluated,
with examples provided from the recent literature. Finally, commentary is provided
on the future of molecular fungal diagnostics, including the potential role of multiplex
detection assays, microarrays, and the molecular determination of antifungal resis¬
tance directly from clinical specimens.
Index 409
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| spelling | Fungal diseases guest ed. Kenneth S. Knox ; George A. Sarosi Philadelphia, Pa. Saunders 2009 XII S., S. 203 - 413 Ill., graph. Darst., Kt. 27 cm txt rdacontent n rdamedia nc rdacarrier Clinics in chest medicine 30,2 Knox, Kenneth S. Sonstige oth Clinics in chest medicine 30,2 (DE-604)BV000001084 30,2 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=017622580&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Fungal diseases Clinics in chest medicine |
| title | Fungal diseases |
| title_auth | Fungal diseases |
| title_exact_search | Fungal diseases |
| title_full | Fungal diseases guest ed. Kenneth S. Knox ; George A. Sarosi |
| title_fullStr | Fungal diseases guest ed. Kenneth S. Knox ; George A. Sarosi |
| title_full_unstemmed | Fungal diseases guest ed. Kenneth S. Knox ; George A. Sarosi |
| title_short | Fungal diseases |
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