Journal of thoracic imaging
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Opportunistic fungal infection is a common cause of serious morbidity and mortality in immunocompromised patients. These infections occur primarily in patients with chemotherapy-induced neutropenia, acquired immunodeficiency syndrome. or immunosuppression after solid organ or bone marrow transplantation. The most important opportunistic fungal pathogens include Cryptococcus neoformans, Candida and Aspergillus species, and the fungi that cause mucormycosis. ⋯ Diagnosis requires knowledge of the various modes of presentation, radiologic manifestations, and epidemiology of these infections. Because many of these organisms can colonize the upper airway, sputum cultures are considered diagnostically unreliable. Instead, definitive diagnosis requires culture of the fungus from infected tissue or demonstration of the organism on microscopic examination.
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The endemic fungi Histoplasma capsulatum, Coccidioides immitis, and Blastomyces dermatitidis tend to reside in specific geographic regions. The organisms are pathogenic in that they are able to produce clinical disease in both immunocompromised patients and in patients with normal immunity. These organisms have a variety of clinical presentations, some of which typically are seen in the normal host and others that are primarily encountered in persons with abnormal immunity. Although most of the cases are seen in endemic regions, they may occur in persons who at some time either resided in or traveled to an endemic region.