Pathogenesis And Spectrum Of Disease


Aspergillus species are capable not only of causing disseminated infection, as is seen in immunocompromised patients, but also of causing a wide variety of other types of Infections, including a pulmonary or sinus fungus ball, allergic bronchopulmonary aspergillosis, external otomycosis (a fungus ball of the external auditory canal), mycotic keratitis, onychomycosis (infection of nail and surrounding tissue), sinusitis, endocarditis, and central nervous system infection. Most often, immunocompromised patients acquire a primary pulmonary infection that becomes rapidly progressive and may disseminate to virtually any organ.

Fusarium and Other Hyaline Septate Opportunistic Molds

Infection caused by species of Fusarium and other hyaline septate monomorphic molds is becoming more common, particularly in immunocompromised patients.42-96140'145 These organisms are common environmental flora and have long been known to cause mycotic keratitis after traumatic implantation into the cornea. Disseminated fusariosis is commonly accompanied by fungemia.

which are detected by routine blood culture systems-. This is in distinct contrast to the aspergilli, which are rarely recovered from blood culture, even in instances of endovascular infections. Necrotic skin lesions a common with disseminated fusariosis. Other types of infection caused by Fusarium include sinusitis, wound (bum) infection, allergic fungal sinusitis, and endophthalmitis. Fusarium spp. are commonly recovered from respiratory tract secretions, skin, and other sped? mens of patients having no evidence of infection; Interpretation of culture results that contain these rests with the clinician, and is often assisted by correlating with the histopathology. Geotrichum is an uncommon cause of infection but has been shown to cause wound» infections and oral thrush; it is an opportunistic patho* gen in the immunocompromised host.56 Acremomunk species are also recognized as important pathogens ib immunocompromised hosts; these have been associate^ with disseminated infection, fungemia, subcutaneous lesions, and esophagitis.40'48-120 Penitillium is one of tlif most common organisms recovered by the clinical laboratory. In North America, these are rarely associate^ with invasive fungal disease. They may, however, be " cause of allergic bronchopulmonary penicilliosis >r chronic allergic sinusitis. One spedes, Penicillium map-neffei, however, is an important and emerging pathogen in Southeast Asia and is discussed further in th4 section considering dimorphic pathogens.122 158 Of the Paecibmyces species, P. lilacinus appears to be the mo pathogenic species and has been associated with endo-' phthalmitis, cutaneous infections, and arthritis.^ Paecibmyces variotti has also been shown to be an impo*" tant pathogen, causing endocarditis, fungemia, invasive disease.147

A variety of other saprobic fungi not discussed here may be encountered in the clinical laboratory but are seen less commonly. Other references are recommended for further information regarding the identification of these organisms.27'67,121,126

Bacterial Vaginosis Facts

Bacterial Vaginosis Facts

This fact sheet is designed to provide you with information on Bacterial Vaginosis. Bacterial vaginosis is an abnormal vaginal condition that is characterized by vaginal discharge and results from an overgrowth of atypical bacteria in the vagina.

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