Diseases Of The Respiratory System

Fungal Diseases of the Lower Respiratory System

Fungal Diseases are easily inhaled; they may germinate in the lower respiratory tract.

The incidence of fungal diseases has been increasing in recent years.

The mycoses below can be treated with amphotericin B.

Histoplasmosis

Histoplasma capsulatum causes a subclinical infection that only occasionally progresses to a severe, generalized disease.

The disease is acquired by inhalation of airborne conidia.

Isolation of the fungus or identification of the fungus in tissue samples is necessary for diagnosis.

Histoplasma capsulatum

Histoplasmosis Distribution

Coccidioidomycosis

Inhalation of the airborne arthrospores of Coccidioides immitis can result in coccidioidomycosis.

Most cases are subclinical but predisposing factors such as fatigue and poor nutrition can contribute to a progressive disease (about 1% of the cases) that resembles tuberculosis.

Symptoms include chest pain, fever, coughing, and weight loss.

Life Cycle of Coccidioides immitis

U.S. Endemic Area for Coccidioidomycosis

Blastomycosis

Caused by Blastomyces dermatitidis.

The infection begins in the lungs and spreads to cause extensive abscesses.

Other Fungi Involved in Respiratory Disease

Occurs most often in immunosuppressed hosts.

Common causes:

Pneumocystis pneumonia

Caused by Pneumocystis jiroveci (carinii).

Pneumocystis jiroveci is an opportunistic pathogen that invades immunosuppressed or cancer patients.

The life cycle of organism is not well known.

Drug of choice: Trimethoprim-sulfamethoxazole

Untreated causes are usually fatal.

Life Cycle of Pneumocystis jiroveci

Pneumocystis jiroveci

Cyst stage in alveolus of a monkey lung