Epidemiology and management of invasive fungal infections in immunocompromised hosts
Year: 1999
Type: dissertation
Abstract: Fungal infections in man usually are divided into three categories based upon\ntheir major pathophysiological characteristics: superficial and cutaneous, subcutaneous\nand, systemic infections. The last category consists of two separate entities.\nFirst there are the so called "endemic mycoses" caused by dimorphic fungi\nincluding Coccidioides immiiis, Paracoccidioides brasiliensis, Histoplasma\ncapsula tum and Blastomyces dermatitidis which occur in patients who live in, or\nhave travelled through geographical regions in which these pathogenic fungi have\ntheir habitat. Although the consequences of endemic mycoses are sometimes\nvery severe, these infections were not viewed as a very major subject in the field\nof infectious diseases, probably due to their relatively rare and geographically\nrestricted occurrence. The second entity consists of opportunistic infections\ncaused by fungi that are ubiquitously present around the globe. The number of\nthese infections has increased dramatically during the last three decades. For\nexample, in 1966 invasive aspergillosis was called a disease of medical progress,\nand world literature on this subject was reviewed in a paper only six pages in\nlength. In contrast in 1990, Denning et al. used 55 pages only to review the\nliterature on the treatment of such infections. Several factors have been recognized\nto be responsible for this rapid increase, all of which are the consequence of\nadvances in medicine. The use of antibacterial agents, the use of cytotoxic\nchemotherapy, organ transplantation combined with the use of immunosuppressive\ntherapy, the use of indwelling catheters all one way or the other,\ncompromise the defence mechanisms of the human host (Table 1 ) Some of\nthese factors disrupt more than one line of defence; for example, longterm use of\nsteroids, influences cellular immunity, macrophage function and neutrophil\nfunction, whereas the integrity of the skin and mucous membranes is little\naffected.
Author: Alexander C. A. P. Leenders
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W1515361401