Primary Mycoses

Primary mycoses are fungal infections of the immunocompetent. Primary mycoses:

Secondary mycoses are fungal infections of the immunocompromised, and include:

• Aspergillosis
• Candidiasis
• Cryptococcosis
• Penicillinosis
• Pneumocystosis
• Zygomycoses

• Occur in regions with high environmental spore loads
• Include a limited number of innately virulent organisms:
  • Blastomycosis
    • Confined largely to North America
    • Primary pulmonary infection
    • Secondary ARDS
  • Coccidiomycosis
    • Majority asymptomatic
    • Immunological sequelae:
      • Arthralgia
      • Erythema multiforme
      • Erythema nodosum
    • Pulmonary disease
      • Lobar pneumonia
      • ARDS
      • Chronic cavitating pulmonary disease
  • Cryptococcus
  • Histoplasmosis
  • Paracoccidiomycosis

Histoplasmosis

• Soil and bird droppings contain spores
• Leads to pulmonary granuloma formation
  • May be contained
  • May lead to disseminated disease
• 50% untreated mortality
• Amphotericin B

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References

1. Bersten, A. D., & Handy, J. M. (2018). Oh’s Intensive Care Manual. Elsevier Gezondheidszorg.