Title Details

Errol Reiss, Ph.D., is Adjunct Professor of Microbiology at Emory University School of Medicine (EUSM), Atlanta, Georgia, and Research Microbiologist, Molecular Typing Unit, Mycotic Diseases Branch, Division of Bacterial and Mycotic Diseases in the Centers for Disease Control and Prevention, Atlanta, Georgia. Department of Microbiology and Immunology. Dr. Reiss previously published a single-author textbook in the field of medical mycology (see below) and has published several book chapters, review articiles and a total of? 87 primary research literature publications.

H. Jean Shadomy, Ph.D., is Adjunct Professor of Dermatology, EUSM, Atlanta. A career microbiologist, she has several book chapters and more than 40 published primary literature articles to her name.

Acknowledgments xix

Part One Introduction to Fundamental Medical Mycology, Laboratory Diagnostic Methods, and Antifungal Therapy

1. Introduction to Fundamental Medical Mycology3

1.1 Topics not Covered, or Receiving Secondary Emphasis 3

1.2 Biosafety Considerations: Before You Begin Work with Pathogenic Fungi... 3

1.3 Fungi Defined: Their Ecologic Niche 5

1.4 Medical Mycology 5

1.5 A Brief History of Medical Mycology 6

1.6 Rationale for Fungal Identification 9

1.7 Sporulation 11

1.8 Dimorphism 11

1.9 Sex in Fungi 13

1.10 Classification of Mycoses Based on the Primary Site of Pathology 13

1.11 Taxonomy/Classification: Kingdom Fungi 14

1.12 General Composition of the Fungal Cell 21

1.13 Primary Pathogens 25

1.14 Endemic Versus Worldwide Presence 26

1.15 Opportunistic Fungal Pathogens 26

1.16 Determinants of Pathogenicity 27

2. Laboratory Diagnostic Methods in Medical Mycology 31

2.1 Who Is Responsible for Identifying Pathogenic Fungi? 31

2.2 What Methods are Used to Identify Pathogenic Fungi? 31

2.3 Laboratory Detection, Recovery, and Identification of Fungi in the Clinical Microbiology Laboratory 33

2.4 Genetic Identification of Fungi 64

3A. Antifungal Agents and Therapy 75

3B. Antifungal Susceptibility Tests 107

Part Two Systemic Mycoses Caused by Dimorphic Environmental Molds (Endemic Mycoses)

4. Blastomycosis 125

4.1 Blastomycosis-at-a-Glance 125

4.2 Introduction/Disease Definition 125

4.3 Case Presentations 126

4.4 Diagnosis 127

4.5 Etiologic Agent 127

4.6 Geographic Distribution/Ecologic Niche 128

4.7 Epidemiology 129

4.8 Risk Groups/Factors 129

4.9 Transmission 129

4.10 Determinants of Pathogenicity 130

4.11 Clinical Forms 131

4.12 Veterinary Forms 133

4.13 Therapy 133

4.14 Laboratory Detection, Recovery, and Identification 134

5. Coccidioidomycosis 141

5.1 Coccidioidomycosis-at-a-Glance 141

5.2 Introduction/Disease Definition 141

5.3 Case Presentations 142

5.4 Diagnosis 143

5.5 Etiologic Agents 143

5.6 Geographic Distribution / Ecologic Niche 144

5.7 Epidemiology 147

5.7.1 Incidence and Prevalence 147

5.8 Risk Groups / Factors 149

5.9 Transmission 150

5.10 Determinants of Pathogenicity and Pathogenesis 151

5.11 Clinical Forms 155

5.12 Veterinary Forms 156

5.13 Therapy 156

5.14 Laboratory Detection, Recovery, and Identification 158

6. Histoplasmosis 165

6.1 Histoplasmosis-at-a-Glance 165

6.2 Introduction / Disease Definition 165

6.3 Case Presentations 166

6.4 Etiologic Agents 169

6.5 Geographic Distribution/Ecologic Niche 170

6.6 Epidemiology 171

6.7 Transmission 171

6.8 Determinants of Pathogenicity 172

6.9 Clinical Forms 175

6.10 Veterinary Forms 178

6.11 Therapy 179

6.12 Laboratory Detection, Recovery, and

7. Paracoccidioidomycosis 187

7.1 Paracoccidioidomycosis-ata-Glance 187

7.2 Introduction/Disease Definition 187

7.3 Case Presentation 188

7.4 Etiologic Agent 188

7.5 Geographic Distribution/Ecologic Niche 189

7.6 Epidemiology 189

7.7 Transmission 191

7.8 Determinants of Pathogenicity 191

7.9 Clinical Forms 192

7.10 Veterinary Forms 193

7.11 Therapy 194

7.12 Laboratory Detection, Recovery, and Identification 195

8. Penicilliosis 201

8.1 Penicilliosis-at-a-Glance 201

8.2 Introduction/Disease Definition 201

8.3 Case Presentation 202

8.4 Diagnosis 203

8.5 Etiologic Agents 203

8.6 Geographic Distribution / Ecologic Niche 203

8.7 Epidemiology 204

8.8 Risk Groups/Factors 205

8.9 Transmission 205

8.10 Determinants of Pathogenicity 205

8.11 Clinical Forms 206

8.12 Veterinary Forms 208

8.13 Therapy 208

8.14 Laboratory Detection, Recovery, and Identification 208

9. Sporotrichosis 215

9.1 Sporotrichosis-at-a-Glance 215

9.2 Introduction/Disease Definition 215

9.3 Case Presentations 216

9.4 Diagnosis 218

9.5 Etiologic Agents 218

9.6 Geographic Distribution/Ecologic Niche 219

9.7 Epidemiology 219

9.8 Transmission 220

9.9 Determinants of Pathogenicity 220

9.10 Clinical Forms 223

9.11 Human–Animal Interface 224

9.12 Therapy 225

9.13 Laboratory Detection, Recovery, and Identification 227

10A. Less Frequent Mycoses Caused by Dimorphic Environmental Molds: Adiaspiromycosis 233

10B. Less Frequent Mycoses Caused by Dimorphic Environmental Molds (Endemic Mycoses): Lobomycosis (Jorge Lobo's Disease) 241

Part Three Systemic Mycoses Caused by Opportunistic Yeasts andPneumocystis

11. Candidiasis and Less Common Yeast Genera251

11.1 Candidiasis-at-a-Glance 251

11.2 Introduction/Disease Definition 251

11.3 Case Presentations 252

11.4 Diagnosis 255

11.5 Etiologic Agents and their Ecologic Niches 255

11.6 Epidemiology 258

11.7 Risk Groups/Factors 264

11.8 Transmission 265

11.9 Clinical Forms 266

11.10 Determinants of Pathogenicity 273

11.11 Therapy 282

11.12 Laboratory Detection, Recovery, and Identification 286

11.13 Less Common Opportunistic Yeast Genera 292

12. Cryptococcosis 303

12.1 Cryptococcosis-at-a-Glance 303

12.2 Introduction/Disease Definition 303

12.3 Case Presentations 304

12.4 Etiologic Agents 307

12.5 Geographic Distribution/Ecologic Niche 311

12.6 Epidemiology 312

12.7 Risk Groups/Factors 315

12.8 Transmission 316

12.9 Determinants of Pathogenicity 316

12.10 Clinical Forms 321

12.11 Veterinary Forms 323

12.12 Therapy 324

12.13 Laboratory Detection, Recovery, and Identification 326

13. Pneumocystosis 333

13.1 Pneumocystosis-at-a-Glance 333

13.2 Introduction/Disease Definition 333

13.3 Case Presentation 334

13.4 Etiologic Agent 335

13.5 Geographic Distribution/Ecologic Niche 336

13.6 Epidemiology 337

13.7 Risk Groups/Factors 339

13.8 Transmission 340

13.9 Determinants of Pathogenicity 340

13.10 Clinical Forms 343

13.11 Therapy 346

13.12 Laboratory Detection, Recovery, and Identification 348

Part Four Systemic Mycoses Caused by Opportunistic Hyaline Molds

14. Aspergillosis 357

14.1 Aspergillosis at-a-Glance 357

14.2 Introduction/Disease Definition 358

14.3 Case Presentations 358

14.4 Etiologic Agents 361

14.5 Geographic Distribution/Ecologic Niche 362

14.6 Epidemiology and Risk Groups/Factors 363

14.7 Transmission 369

14.8 Determinants of Pathogenicity 370

14.9 Clinical Forms 375

14.10 Veterinary Forms 378

14.11 Therapy 379

14.12 Laboratory Detection, Recovery, and Identification 383

15. Fusarium Mycosis 397

15.1 Fusarium Mycosis-at-a-Glance 397

15.2 Introduction/Disease Definition 398

15.3 Case Presentation 398

15.4 Etiologic Agents 399

15.5 Geographic Distribution/Ecologic Niche 399

15.6 Epidemiology 399

15.7 Transmission 401

15.8 Determinants of Pathogenicity 401

15.9 Clinical Forms 402

15.10 Veterinary Forms 404

15.11 Therapy 405

15.12 Laboratory Detection, Recovery, and Identification 407

16. Pseudallescheria/Scedosporium Mycosis 413

16.1 Pseudallescheria/Scedosporium Mycosis-at-a-Glance 413

16.2 Introduction/Disease Definition 414

16.3 Case Presentations 414

16.4 Diagnosis 416

16.5 Etiologic Agents 416

16.6 Geographic Distribution/Ecologic Niche 418

16.7 Epidemiology 419

16.8 Transmission 421

16.9 Determinants of Pathogenicity 421

16.10 Clinical Forms 422

16.11 Veterinary Forms 423

16.12 Therapy 424

16.13 Laboratory Detection, Recovery, and Identification 426

17A. Mucormycosis 431

17B. Entomophthoramycosis Caused by Basidiobolus ranarum 457

17C. Entomophthoramycosis Caused by Conidiobolus Species 467

Part Five Mycoses of Implantation

18. Chromoblastomycosis 479

18.1 Chromoblastomycosis-at-a-Glance 479

18.2 Introduction/Disease Definition 479

18.3 Case Presentation 480

18.4 Diagnosis 480

18.5 Etiologic Agents 481

18.6 Geographic Distribution/Ecologic Niche 482

18.7 Epidemiology and Risk Groups/Factors 482

18.8 Transmission 483

18.9 Determinants of Pathogenicity 483

18.10 Clinical Forms 485

18.11 Therapy 485

18.12 Laboratory Detection, Recovery, and Identification 487

19. Phaeohyphomycosis 493

19.1 Phaeohyphomycosis-at-a-Glance 493

19.2 Introduction 493

19A Cutaneous–Subcutaneous Phaeohyphomycosis 494

19B Cerebral Phaeohyphomycosis 499

19C Fungal Sinusitis 503

19.3 Laboratory Detection, Recovery, and Identification 506

20. Eumycetoma (Madura Foot, Maduramycosis) 513

20.1 Eumycetoma at-a-Glance 513

20.2 Introduction/Disease Definition 513

20.3 Case Presentation 514

20.4 Diagnosis 514

20.5 Etiologic Agent(s) 514

20.6 Geographic Distribution/Ecologic Niche 515

20.7 Epidemiology 515

20.8 Risk Groups/Factors 516

20.9 Transmission 516

20.10 Determinants of Pathogenicity 516

20.11 Clinical Forms (Fahal, 2004) 517

20.12 Veterinary Forms 518

20.13 Therapy 518

20.14 Laboratory Detection, Recovery, and Identification 520

Part Six Dermatophytosis and Dermatomycoses (Superficial Cutaneous Mycoses)

21. Dermatophytosis 527

21.1 Dermatophytosis-at-a-Glance 527

21.2 Introduction/Disease Definition 528

21.3 Case Presentations 529

21.4 Diagnosis 530

21.5 Etiologic Agents 530

21.6 Geographic Distribution/Ecologic Niche 534

21.7 Epidemiology 534

21.8 Risk Groups/Factors 537

21.9 Transmission 539

21.10 Determinants of Pathogenicity 540

21.11 Clinical Forms 542

21.12 Veterinary Forms 550

21.13 Therapy 552

21.14 Laboratory Detection, Recovery, and Identification 554

22. Dermatomycoses 567

22A Major Nondermatophytic Fungi from Skin and Nails 567

22B Superficial Mycosis of the Hair Caused by a Nondermatophyte Mold: Black Piedra 569

22C Superficial Mycoses Caused by Yeasts and Yeast-like Fungi 571

22D Chrysosporium and Other Nonpathogenic or Opportunistic Fungi Isolated from Skin and Resembling Dermatophytes in Culture 584

Selected References for

Dermatomycoses 585

Website Cited 587

Questions 587

Glossary 589

Answer Key 607

Index 611

“The book does a superlative job in addressing recent advances in medical mycology, which include identifying emerging pathogens, new antifungal drugs and strategies for their use; progress in molecular diagnostics; and up-to- date knowledge about host defenses against fungi, especially opportunistic pathogens.” (Emerging Infectious Diseases, August 2012)

"This text provides the first book in almost 10 years for students and clinicians interested in the medical microbiology of fungi. This new book's scope is well balanced between medical and microbiological knowledge of the major fungi pathogenic for humans." (Clinical Laboratory International, 19 December 2011)