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TitleCreatorDescription
276 Walsh & Hoyt: Aspergillus (Aspergillosis)Joel M. Weinstein, MD, Penn State Milton S. Hershey Medical CenterAspergillus is a ubiquitous mold that is found throughout the world and that not uncommonly produces human disease. The fungus grows particularly well on stored hay, grain, decaying vegetation, soil, and dung. Patients may become infected simply by inhaling or chewing infected grain seeds, by being ...
277 Walsh & Hoyt: Chromomycosis (Chromoblastomycosis) and Cerebral PhaeohypomycosisJoel M. Weinstein, MD, Penn State Milton S. Hershey Medical CenterChromomycosis is a chronic cutaneous and subcutaneous fungal infection that occurs throughout the world, particularly in tropical and subtropical regions. A number of fungi may cause this condition, including Cladosporium carrionii, Cladosporium trichoides, Exophiala dermatitidis, Fonsecaea pedrosoi...
278 Walsh & Hoyt: Paracoccidioides BrasiliensisJoel M. Weinstein, MD, Penn State Milton S. Hershey Medical CenterParacoccidioides brasiliensis (Paracoccidioidomycosis, South American blastomycosis) is a dimorphic fungus that exists in nature as a mycelium and in mammalian tissue as a yeast form. It thus appears as an oval-to-round cell that varies in size from 440 micrometers in diameter in tissues and exudate...
279 Walsh & Hoyt: Cryptococcus Neoformans (Cryptococcosis)Joel M. Weinstein, MD, Penn State Milton S. Hershey Medical CenterThere are 19 known species of the genus Cryptococcus, but the etiologic agent in almost all cases of human infection is a single species, Cryptococcus neoformans. Although rare cases of infection fromother cryptococcal species occur, such infections usually do not affect either the eye or the CNS. W...
280 Walsh & Hoyt: Candida Species (Candidiasis)Joel M. Weinstein, MD, Penn State Milton S. Hershey Medical CenterCandida organisms are small (46 micrometers), thin-walled, ovoid cells that reproduce by budding. They exist primarily in a unicellular form, although they occasionally form hyphae and pseudohyphae. There are more than 150 species of Candida, of which 10 are considered important pathogens for humans...
281 Walsh & Hoyt: Sporothrix Schenckii (Sporotrichosis)Joel M. Weinstein, MD, Penn State Milton S. Hershey Medical CenterSporothrix schenckii is a dimorphic fungus. Its mold form consists of clusters of pyriformconidia measuring 23 micrometers x 26 micrometers formed sympodially from the tips of distally tapering conidiophores, whereas its yeast form consists of cells that may be round, oval, or cigar-shaped and that ...
282 Walsh & Hoyt: Trichosporon Beigelii (Trichosporonosis)Joel M. Weinstein, MD, Penn State Milton S. Hershey Medical CenterThis fungus is part of the normal human flora. It often grows in cultures of stool, skin, and urine. Patients with acute leukemia or other hematologic malignancies, patients receiving immunosuppressive agents after organ transplantation, patients who have received prosthetic cardiac valves, and pati...
283 Walsh & Hoyt: Coccidioides Immitis (Coccidioidomycosis)Joel M. Weinstein, MD, Penn State Milton S. Hershey Medical CenterThis organism initially was thought to be a protozoan, and its name derives from the Greek Coccidioides, meaning ""resembling the protozoan Coccidia."" The term immitis, from the Latin, meaning ""not mild,"" refers to the potentially severe nature of the disease produced by the organism.
284 Walsh & Hoyt: Prototheca WickerhamiiJoel M. Weinstein, MD, Penn State Milton S. Hershey Medical CenterPrototheca wickerhamii is a unicellular, achlorophyllic alga that cannot be classified as a mold or yeast but acts as a fungus. Prototheca cells range from 8 to 20 micrometers in diameter, stain well with Gomori methenamine silver or PAS, and often contain two to eight endospores in each cell or spo...
285 Walsh & Hoyt: Fusarium SpeciesJoel M. Weinstein, MD, Penn State Milton S. Hershey Medical CenterFungi of the genus Fusarium have a worldwide distribution in soil. These fungi appear as septate hyphae with rare branching, and they thus may be confused with Aspergillus. A definitive diagnosis can be made only by culture, although it may be suspected by the presence of typical banana-shaped, mult...
286 Walsh & Hoyt: Mucorales (Mucormycosis)Joel M. Weinstein, MD, Penn State Milton S. Hershey Medical CenterMucormycosis is the common name given to several different diseases caused by fungi of the order Mucorales in the class Zygomycetes. The group of diseases known as mucormycosis has been known by other names throughout the years, including ""phycomycosis"" and ""zygomycosis."" Many different species ...
287 Walsh & Hoyt: Blastoschizomyces Capitatus (Blastoschozomycosis)Joel M. Weinstein, MD, Penn State Milton S. Hershey Medical CenterBlastoschizomyces capitatus is a fungus previously called Trichosporon capitatum or Geotrichum capitatum. It is a rare cause of invasive disease in immunosuppressed patients, especially those with leukemia. Some of these patients develop cerebritis or meningitis as part of disseminated disease.
288 Walsh & Hoyt: Pseudallescheria Boydii (Pseudallescheriasis)Joel M. Weinstein, MD, Penn State Milton S. Hershey Medical CenterThis fungus also is called Petriellidium boydii or Allescheria boydii when in the perfect (sexual) state and Monosporium or Scedosporium apiospermum when in the imperfect (asexual) state. Microscopically, the fungus appears as septate hyphae with oval or club-shaped, pale or golden-brown conidia.
289 Walsh & Hoyt: Blastomyces Dermatitidis (Blastomycosis)Joel M. Weinstein, MD, Penn State Milton S. Hershey Medical CenterBlastomyces dermatitidis is a dimorphic fungus. It causes a systemic disease called blastomycosis (or North American blastomycosis) that is characterized by the formation of inflammatory masses that are part abscess and part granuloma, i.e., pyogranulomas. The mycelial form of the fungus produces br...
290 Walsh & Hoyt: FlucytosineJoel M. Weinstein, MD, Penn State Milton S. Hershey Medical CenterFlucytosine (5-fluorocytosine) is the fluorine analogue of the naturally occurring nucleic acid pyrimidine base, cytosine. Flucytosine inhibits deoxyribonucleic acid (DNA) synthesis within fungi by acting as a noncompetitive inhibitor of thymidylate synthetase. Penetration of flucytosine into most t...
291 Walsh & Hoyt: YeastsJoel M. Weinstein, MD, Penn State Milton S. Hershey Medical CenterNumerous yeastlike fungi are pathogenic to humans. The most common of these are Blastomyces dermatitidis, Candida species, the organisms that produce chromomycosis, Coccidioides immitis, Cryptococcus neoformans, Fusarium species, Histoplasma capsulatum, Paracoccidioides brasiliensis, and Sporothrixs...
292 Walsh & Hoyt: CaspofunginJoel M. Weinstein, MD, Penn State Milton S. Hershey Medical CenterCaspofungin is the first approved agent from a class of antifungal agents called the echinocandins. Its mechanism of action is unique in that it attacks the cell wall of the fungus, as opposed to its cell membrane. Some fungal infections, particularly candidiasis, are associated with biofilm formati...
293 Walsh & Hoyt: Drugs Used to Treat Fungal InfectionsJoel M. Weinstein, MD, Penn State Milton S. Hershey Medical CenterThere are far fewer drugs used to treat systemic fungal diseases than there are to treat bacterial diseases. The reader must realize, however, that new antifungal agents are being developed, and treatment of any patient with fungal disease should be carried out with the help of an expert in infectio...
294 Histoplasma Capsulatum (Histoplasmosis)Joel M. Weinstein, MD, Penn State Milton S. Hershey Medical CenterHistoplasma capsulatum exists in the soil in the mycelial phase but converts to a yeast phase at the body temperature of mammals.
295 Fungi and Mycotic DiseasesJoel M. Weinstein, MD, Penn State Milton S. Hershey Medical CenterOpportunistic fungal infections are common and continue to increase in frequency and severity as a consequence of the use of immunosuppressive therapy after solid-organ transplantation and for a variety of diseases, particularly cancer, and because of the increasing prevalence of the acquired immuno...
296 Aspergillosis, Meningitis, and Thrombosis of the Cavernous SinusJoel M. Weinstein, MD, Penn State Milton S. Hershey Medical CenterTrue fungal mycotic aneurysms typically are large and fusiform in shape, as opposed to the more common smaller, round ‘‘mycotic'' aneurysms related to bacterial endocarditis.
297 Walsh & Hoyt: Kawasaki Disease (Mucocutaneous Lymph Node Syndrome)Jacqueline Winterkorn, MD, PhD (1947-2015), Clinical Professor, Department of Ophthalmlogy, Weill Cornell Medicine; Rochelle S. Zak, MD, UCSF Medical CenterKawasaki disease (KD), also called acute febrile mucocutaneous lymph node syndrome, is an acute exanthematous illness with multisystem involvement that occurs almost exclusively in young children.
298 Walsh & Hoyt: PathologyJacqueline Winterkorn, MD, PhD (1947-2015), Clinical Professor, Department of Ophthalmlogy, Weill Cornell Medicine; Rochelle S. Zak, MD, UCSF Medical CenterThe pathologic findings in VE depend on the form of the disease and the stage at which death occurred. Patients with the rapid form of VE show thickening and clouding of the meninges, which are infiltrated with mononuclear cells and, to a lesser extent, plasma cells and polymorphonuclear leukocytes....
299 Walsh & Hoyt: PathologyJacqueline Winterkorn, MD, PhD (1947-2015), Clinical Professor, Department of Ophthalmlogy, Weill Cornell Medicine; Rochelle S. Zak, MD, UCSF Medical CenterThe neuropathologic findings in acute EL include inflammation, vasculopathy, and necrosis, consistent with viral infection. The leptomeninges show vascular congestion, with hyperemia and petechiae. Cerebral edema is present. Microscopic features of the acute infection are diffuse perivascular cuffin...
300 Walsh & Hoyt: TreatmentJacqueline Winterkorn, MD, PhD (1947-2015), Clinical Professor, Department of Ophthalmlogy, Weill Cornell Medicine; Rochelle S. Zak, MD, UCSF Medical CenterThere is no consistently effective treatment for the acute stages of EL, in part owing to its rarity and the difficulty making the diagnosis. Nevertheless, some patients experience improvement with intravenous methylprednisolone when the drug is given early in the course of the illness and others re...
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