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Systemic Mycoses (Dimorphic Fungi):
| • | immunocompetent; respiratory; 99% subclinical; develop strong specific immunity after infection; tissue dimorphs; limited geographic distribution |
| • | all cause primary pulmonary infection |
| • | can produce cutaneous manifestations with or without systemic involvement |
| • | generally, mold spores are inhaled and convert in lungs to yeast phase |
| • | otherwise, some can inoculate skin via trauma and produce verrucous “deep fungal” lesions; (more “ulcerative” when on mucous membranes) |
Opportunistic Fungi:
| • | host immunocompromised by therapy or disease |
| • | no particular endemic area; most of these organisms seem to be ubiquitous in nature, with world-wide distribution (especially in soil and decaying material = saprophytes) |
| • | organisms are of minimal virulence; disease is not contagious |
| • | no immunity follows infection; not dimorphic |
| 3. | cryptococcus neoformans |
| 4. | zygomycosis (mucormycosis) |
patterns of immune dysfunction:
| 1. | decreased cell-mediated immunity |
| • | oral/esophageal candidiasis |
| • | endemic mycoses – histoplasmosis, coccidioides, penicillium marneffei (take good work/travel history) |
| • | pheaohyphomycosis (e.g. alterneria spp.) |
| • | hyalohyphomycosis (e.g. fusarium spp.) |
#1 opportunistic fungus for burns = fusarium (mnemonic: with a short "fuse" you get burned)
OTHER
dermatiaceous – fungi which produce intrinsic melanin-like pigmentation (primarily chromoblastomycosis and pheaohyphomycosis)
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