Category: Fungi

Basics of Pulmonary Valley Fever

Coccidioides (from now on, called Cocci) is an endemic fungi that exists in two forms, yeast and mold, that is endemic to the southeastern United States (1). It is related to both Histoplasma and Blastomyces with two species known to infect humans. C. immitis and C. posadasii. Arthroconidia can be transported in soil or fomites,

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Emergence of the New Menace! Candida Auris and the Rise of MDR Yeasts.

Ear yeast! That is the translation of Candida auris. It was discovered by isolation from an ear infection in an elderly patient in Japan in 2009 and since then it has been isolated in places such as India, southeast Asia and several parts of south America (1-4):  One of the defining characteristics is its resistance

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PJP in AIDS-Patients vs non-AIDS Patients

Consider this post a continuation of the prior one on prophylaxis. I mention a bit on the pathophysiology, where adaptive immunity seems to play a key role in the way the body deals with the fungus, with mice with SCID infected with pneumocystis not being able to mount an inflammatory response. As a result of

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PJP Prophylaxis in Rheumatological Disease – Do You Need it? Probably

First identified by Carlos Chagas (yes, that Chagas) back in 1909, pneumocystis was identified as a cause of plasma cell pneumonia in debilitated infants following WWII (1). Since then, it has been identified as a unicellular fungus that is of low virulence and unique amongst the other fungi in that it lacks ergosterol in its

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Tracking Disseminated Histoplasmosis Treatment

When I say bat poop, caves, and Indiana, the answer is Histoplasmosis. In general, most people will not get disease even when inhaling any conidia, however those who have decreased cellular immunity (i.e. solid organ transplant and HIV) are at risk of pulmonary or disseminated disease. One of the difficult issues in those patients is

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Bad Bug, Bad Bug – Or Mould? Meet Your Demise

Last week I talked about invasive pulmonary aspergillosis in influenza and COVID patients. This is not the first time I have talked about this topic. I have mentioned how the halo sign is not terribly specific for IPA, especially in hematological patients and the testing characteristics of galactomannan. I have also spoken about the other

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Influenza, COVID-19, Pulmonary Aspergillosis, Lions, Tigers, And Bears – Oh My!

Influenza season is right around the corner, and given the current circumstances, it is a terrifying thought to have both COVID and flu running around. Besides causing significant respiratory distress and subsequent ARDS, severe influenza leads to bacterial superinfection with organisms such as Staph aureus and Streptococcal pneumonia. This usually happens in 10-35% of cases

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Types of Amphotericin B – What I Didn’t Know

I’ve been reading quite a bit about antifungals lately and one of the things I realized is the many formulations of amphotericin. Actually, the realization I had was I didn’t know the differences between them. It is a polyene antifungal that has broad spectrum antifungal activity (including Leshmania spp) but it is limited by its

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Microbiological Diagnosis of PJP – PCR and Beta D glucan

This post will not cover the clinical course or risk factors. We’ll be going over the direct fluorescence antibody, PCR, as well as the elusive beta-D glucan as well as taking a brief look at the original ways we used to diagnose PJP (or in some places, how they still diagnose it. In the days

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