Seminars in respiratory infections
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Histoplasma capsulatum, Coccidioides immitis, Blastomyces dermatitidis, and Cryptococcus neoformans can cause acute community-acquired pneumonia. All are soil-dwelling fungi and disturbance of contaminated soil is necessary for infection in man. Each has particular epidemiologic considerations that may offer a clue to diagnosis, but the clinical presentation is not sufficiently characteristic to be of diagnostic help. ⋯ Serodiagnosis also takes several weeks and is usually not helpful while the patient is symptomatic. Treatment may not be necessary unless the patient is immunosuppressed, seriously ill, or has life threatening complications. The primary pulmonary infection may disseminate to extrapulmonary sites, which always requires treatment.