Fundamental Medical Mycology

Medical mycology deals with those infections in humans, and animals resulting from pathogenic fungi. As a separate discipline, the concepts, methods, diagnosis, and treatment of fungal diseases of humans are specific. Incorporating the very latest information concerning this area of vital interest to research and clinical microbiologists,Fundamental Medical Mycology balances clinical and laboratory knowledge to provide clinical laboratory scientists, medical students, interns, residents, and fellows with in-depth coverage of each fungal disease and its etiologic agents from both the laboratory and clinical perspective. Richly illustrated throughout, the book includes numerous case presentations.

Preface xvii

Acknowledgments xix

Part One Introduction to Fundamental Medical Mycology, Laboratory Diagnostic Methods, and Antifungal Therapy

1. Introduction to Fundamental Medical Mycology 3

2. Laboratory Diagnostic Methods in Medical Mycology 31

3A. Antifungal Agents and Therapy 75

3B. Antifungal Susceptibility Tests 107

Part Two Systemic Mycoses Caused by Dimorphic Environmental Molds (Endemic Mycoses)

4. Blastomycosis 125

5. Coccidioidomycosis 141

6. Histoplasmosis 165

7. Paracoccidioidomycosis 187

8. Penicilliosis 201

9. Sporotrichosis 215

10A. Less Frequent Mycoses Caused by Dimorphic Environmental Molds: Adiaspiromycosis 233

10B. Less Frequent Mycoses Caused by Dimorphic Environmental Molds (Endemic Mycoses): Lobomycosis (Jorge Lôbo’s Disease) 241

Part Three Systemic Mycoses Caused by Opportunistic Yeasts and Pneumocystis

11. Candidiasis and Less Common Yeast Genera 251

12. Cryptococcosis 303

13. Pneumocystosis 333

Part Four Systemic Mycoses Caused by Opportunistic Hyaline Molds

14. Aspergillosis 357

15. Fusarium Mycosis 397

16. Pseudallescheria/Scedosporium Mycosis 413

17A. Mucormycosis 431

17B. Entomophthoramycosis Caused by Basidiobolus ranarum 457

17C. Entomophthoramycosis Caused by Conidiobolus Species 467

Part Five Mycoses of Implantation

18. Chromoblastomycosis 479

19. Phaeohyphomycosis 493

20. Eumycetoma (Madura Foot, Maduramycosis) 513

Part Six Dermatophytosis and Dermatomycoses (Superficial Cutaneous Mycoses)

21. Dermatophytosis 527

22. Dermatomycoses 567

22A. Major Nondermatophytic Fungi from Skin and Nails 567

22B. Superficial Mycosis of the Hair Caused by a Nondermatophyte Mold: Black Piedra 569

22C. Superficial Mycoses Caused by Yeasts and Yeast-like Fungi 571

22D. Chrysosporium and Other Nonpathogenic or Opportunistic Fungi Isolated from Skin and Resembling Dermatophytes in Culture 584

Glossary 589

Answer Key 607

Index 611

“The book does a superlative job in addressing recent advances in medical mycology, which include identifying emerging pathogens, new antifungal drugs and strategies for their use; progress in molecular diagnostics; and up-to- date knowledge about host defenses against fungi, especially opportunistic pathogens.” (Emerging Infectious Diseases, August 2012)

"This text provides the first book in almost 10 years for students and clinicians interested in the medical microbiology of fungi. This new book's scope is well balanced between medical and microbiological knowledge of the major fungi pathogenic for humans." (Clinical Laboratory International, 19 December 2011)

Errol Reiss, Ph.D., is Adjunct Professor of Microbiology at Emory University School of Medicine (EUSM), Atlanta, Georgia, and Research Microbiologist, Molecular Typing Unit, Mycotic Diseases Branch, Division of Bacterial and Mycotic Diseases in the Centers for Disease Control and Prevention, Atlanta, Georgia. Department of Microbiology and Immunology. Dr. Reiss previously published a single-author textbook in the field of medical mycology (see below) and has published several book chapters, review articiles and a total of? 87 primary research literature publications.

H. Jean Shadomy, Ph.D., is Adjunct Professor of Dermatology, EUSM, Atlanta. A career microbiologist, she has several book chapters and more than 40 published primary literature articles to her name.

Provides a solid foundation for both clinical laboratory and medical practice

Drawing from the most current research findings in mycology, immunology, and molecular biology, Fundamental Medical Mycology is an ideal textbook and general reference to the field. The authors' in-depth coverage of laboratory diagnostic methods, state-of-the-art infectious disease practice, and epidemiology creates a solid foundation for readers interested in clinical laboratory science, medical practice, and public health.

The text begins with three chapters that set the stage for the nineteen fungal disease-specific chapters that follow. The first chapter explores the broad spectrum of diseases, taxonomy, reproduction, physiology of the fungal cell, primary and opportunistic pathogens, and determinants of pathogenicity. The second chapter presents step-by-step classical and molecular laboratory diagnostic methods. The third chapter examines antifungal therapy as well as antifungal susceptibility testing.

Each one of the disease-specific chapters adheres to a uniform organization, making it easy to locate materials and compare the underlying causes, symptoms, and treatments for each fungal disease. Readers will find coverage of such critical topics as etiologic agents, epidemiology, risk factors, transmission, clinical and veterinary forms, therapies, and laboratory detection. Moreover, each chapter features:

• Case studies that help readers understand how fungal diseases are detected and treated
• Illustrations to support accurate identification of fungal agents and diagnosis of disease
• Questions and answers to gauge readers' grasp of key concepts as they progress in the text
• Selected references supporting further research of key concepts, fungal agents, and diseases

A glossary defines all the key terms used throughout the text.

This book serves as a current reference for clinical microbiologists and healthcare professionals and as a textbook for courses in medical mycology. No prior knowledge of mycology is assumed, making the text highly accessible to all readers who have a basic foundation in general biology and medical microbiology.