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Fungal Infection: Diagnosis and Management, 4th Edition

ISBN: 978-1-4443-6100-1
480 pages
January 2012, Wiley-Blackwell
Fungal Infection: Diagnosis and Management, 4th Edition (1444361007) cover image
Fungal Infection: Diagnosis and Management, 4th Edition is a concise and up-to-date guide to the clinical manifestations, laboratory diagnosis and management of superficial, subcutaneous and systemic fungal infections.

This highly acclaimed book has been extensively revised and updated throughout to ensure all drug and dosage recommendations are accurate and in agreement with current guidelines. A new chapter on infections caused by Pneumocystis jirovecii has been added. The book has been designed to enable rapid information retrieval and to help clinicians make informed decisions about diagnosis and patient management. Each chapter concludes with a list of recent key publications which have been carefully selected to facilitate efficient access to further information on specific aspects of fungal infections.

Clinical microbiologists, infectious disease specialists, as well as dermatologists, hematologists and oncologists, can depend on this contemporary text for authoritative information and the background necessary to understand fungal infections.

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Preface to the fourth edition, xxvi

Preface to the first edition, xxviii

Acknowledgements, xxix

1 Introduction, 1

1.1 The nature of fungi, 1

1.2 Classification and nomenclature of fungi and fungal diseases, 3

1.3 Fungi as human pathogens, 5

1.4 The changing pattern of fungal infection, 7

1.5 New directions in diagnosis, 9

1.6 New directions in treatment and prevention, 10

2 Laboratory diagnosis of fungal infection, 12

2.1 Introduction, 12

2.2 Collection of specimens, 13

2.3 Specimens for serological tests, 18

2.4 Specimens for antifungal drug level determinations, 18

2.5 Transport of specimens, 18

2.6 Interpretation of laboratory test results, 18

2.7 Molecular diagnosis of fungal infection, 28

3 Antifungal drugs, 32

3.1 Introduction, 32

3.2 Allylamines, 32

3.4 Other allylamine compounds for topical administration, 35

3.5 Azoles, 35

3.6 Fluconazole, 40

3.7 Itraconazole, 44

3.8 Ketoconazole, 48

3.9 Posaconazole, 50

3.10 Voriconazole, 53

3.11 Other imidazole compounds for topical administration, 57

3.12 Echinocandins, 59

3.13 Anidulafungin, 60

3.14 Caspofungin, 61

3.15 Micafungin, 63

3.16 Polyenes, 65

3.17 Amphotericin B, 66

3.18 Other polyene compounds for topical administration, 76

3.19 Flucytosine, 76

3.20 Griseofulvin, 79

3.21 Other miscellaneous compounds for topical administration, 81

3.22 Prophylactic treatment for prevention of fungal infection, 82

3.23 Empirical treatment of suspected fungal infection in the neutropenic patient, 84

3.24 Pre-emptive antifungal treatment, 85

3.25 Combination antifungal treatment of invasive fungal infections, 85

3.26 Laboratory monitoring, 86

4 Dermatophytosis, 91

4.1 Introduction, 91

4.2 The causal organisms and their habitat, 92

4.3 Epidemiology, 93

4.4 Laboratory diagnosis of dermatophytosis, 94

4.5 Tinea capitis, 95

4.6 Tinea corporis, 102

4.7 Tinea cruris, 105

4.8 Tinea pedis, 107

4.9 Tinea manuum, 111

4.10 Tinea unguium, 113

5 Superficial candidosis, 121

5.1 Definition, 121

5.2 Geographical distribution, 121

5.3 The causal organisms and their habitat, 121

5.4 Epidemiology, 122

5.5 Clinical manifestations, 124

5.6 Essential investigations and their interpretation, 130

5.7 Management, 130

5.8 Prevention, 136

6 Other cutaneous fungal infections, 138

6.1 Pityriasis versicolor, 138

6.2 Other Malassezia infections, 142

6.3 Piedra, 143

6.4 White piedra, 144

6.5 Black piedra, 145

6.6 Tinea nigra, 147

6.7 Neoscytalidium infection, 148

6.8 Alternaria infection, 149

7 Mould infections of nails, 151

7.1 Definition, 151

7.2 Geographical distribution, 151

7.3 The causal organisms and their habitat, 151

7.4 Epidemiology, 152

7.5 Clinical manifestations, 152

7.6 Differential diagnosis, 153

7.7 Essential investigations and their interpretation, 153

7.8 Management, 154

7.9 Prevention, 155

8 Keratomycosis, 156

8.1 Definition, 156

8.2 Geographical distribution, 156

8.3 The causal organisms and their habitat, 156

8.4 Epidemiology, 157

8.5 Clinical manifestations, 158

8.6 Essential investigations and their interpretation, 159

8.7 Management, 160

9 Otomycosis, 162

9.1 Definition, 162

9.2 Geographical distribution, 162

9.3 The causal organisms and their habitat, 162

9.4 Epidemiology, 162

9.5 Clinical manifestations, 163

9.6 Differential diagnosis, 164

9.7 Essential investigations and their interpretation, 164

9.8 Management, 164

10 Aspergillosis, 166

10.1 Definition, 166

10.2 Geographical distribution, 166

10.3 The causal organisms and their habitat, 166

10.4 Epidemiology, 167

10.5 Clinical manifestations, 170

10.6 Essential investigations and their interpretation, 182

10.7 Management, 186

10.8 Empirical treatment of suspected invasive aspergillosis, 194

10.9 Prevention, 195

11 Invasive candidosis, 201

11.1 Definition, 201

11.2 Geographical distribution, 201

11.3 The causal organisms and their habitat, 201

11.4 Epidemiology, 202

11.5 Clinical manifestations, 208

11.6 Candidosis in special hosts, 217

11.7 Essential investigations and their interpretation, 217

11.8 Management, 221

11.9 Empirical treatment of suspected invasive candidosis, 232

11.10 Prevention, 232

12 Cryptococcosis, 236

12.1 Definition, 236

12.2 Geographical distribution, 236

12.3 The causal organisms and their habitat, 236

12.4 Epidemiology, 238

12.5 Clinical manifestations, 240

12.6 Essential investigations and their interpretation, 244

12.7 Management, 246

12.8 Prevention, 251

13 Mucormycosis, 253

13.1 Definition, 253

13.2 Geographical distribution, 253

13.3 The causal organisms and their habitat, 253

13.4 Epidemiology, 254

13.5 Clinical manifestations, 256

13.6 Differential diagnosis, 259

13.7 Essential investigations and their interpretation, 259

13.8 Management, 260

13.9 Prevention, 262

14 Pneumocystosis, 264

14.1 Definition, 264

14.2 Geographical distribution, 264

14.3 The causal organisms and their habitat, 264

14.4 Epidemiology, 265

14.5 Clinical manifestations, 268

14.6 Differential diagnosis, 269

14.7 Essential investigations and their interpretation, 270

14.8 Management, 271

14.9 Prevention, 274

15 Blastomycosis, 277

15.1 Definition, 277

15.2 Geographical distribution, 277

15.3 The causal organism and its habitat, 277

15.4 Epidemiology, 278

15.5 Clinical manifestations, 279

15.6 Differential diagnosis, 282

15.7 Essential investigations and their interpretation, 282

15.8 Management, 283

15.9 Prevention, 286

16 Coccidioidomycosis, 288

16.1 Definition, 288

16.2 Geographical distribution, 288

16.3 The causal organisms and their habitat, 288

16.4 Epidemiology, 289

16.5 Clinical manifestations, 291

16.6 Differential diagnosis, 294

16.7 Essential investigations and their interpretation, 294

16.8 Management, 297

16.9 Prevention, 301

17 Histoplasmosis, 304

17.1 Definition, 304

17.2 Geographical distribution, 304

17.3 The causal organism and its habitat, 305

17.4 Epidemiology, 305

17.5 Clinical manifestations, 307

17.6 Differential diagnosis, 312

17.7 Essential investigations and their interpretation, 313

17.8 Management, 316

17.9 Prevention, 320

18 Paracoccidioidomycosis, 322

18.1 Definition, 322

18.2 Geographical distribution, 322

18.3 The causal organism and its habitat, 322

18.4 Epidemiology, 323

18.5 Clinical manifestations, 324

18.6 Differential diagnosis, 327

18.7 Essential investigations and their interpretation, 327

18.8 Management, 329

18.9 Prevention, 331

19 Chromoblastomycosis, 332

19.1 Definition, 332

19.2 Geographical distribution, 332

19.3 The causal organisms and their habitat, 332

19.4 Epidemiology, 333

19.5 Clinical manifestations, 333

19.6 Differential diagnosis, 334

19.7 Essential investigations and their interpretation, 334

19.8 Management, 335

20 Entomophthoromycosis, 338

20.1 Introduction, 338

20.2 Basidiobolomycosis, 338

20.3 Conidiobolomycosis, 341

21 Mycetoma, 344

21.1 Definition, 344

21.2 Geographical distribution, 344

21.3 The causal organisms and their habitat, 344

21.4 Epidemiology, 346

21.5 Clinical manifestations, 346

21.6 Differential diagnosis, 347

21.7 Essential investigations and their interpretation, 348

21.8 Management, 349

22 Sporotrichosis, 352

22.1 Definition, 352

22.2 Geographical distribution, 352

22.3 The causal organism and its habitat, 352

22.4 Epidemiology, 353

22.5 Clinical manifestations, 354

22.6 Differential diagnosis, 356

22.7 Essential investigations and their interpretation, 357

22.8 Management, 358

22.9 Prevention, 360

23 Hyalohyphomycosis, 362

23.1 Introduction, 362

23.2 Fusarium infection, 362

23.3 Scedosporium infection, 369

23.4 Other agents of hyalohyphomycosis, 373

24 Penicillium marneffei infection, 376

24.1 Introduction, 376

24.2 Geographical distribution, 376

24.3 The causal organism and its habitat, 376

24.4 Epidemiology, 377

24.5 Clinical manifestations, 378

24.6 Differential diagnosis, 378

24.7 Essential investigations and their interpretation, 379

24.8 Management, 380

24.9 Prevention, 381

25 Phaeohyphomycosis, 383

25.1 Introduction, 383

25.2 Geographical distribution, 384

25.3 The causal organisms and their habitat, 384

25.4 Epidemiology, 385

25.5 Clinical manifestations, 387

25.6 Differential diagnosis, 390

25.7 Essential investigations and their interpretation, 391

25.8 Management, 392

26 Other invasive yeast infections, 396

26.1 Introduction, 396

26.2 Systemic Malassezia infection, 396

26.3 Trichosporonosis, 399

26.4 Other yeast infections, 402

27 Unusual fungal and pseudofungal infections, 405

27.1 Introduction, 405

27.2 Adiaspiromycosis, 405

27.3 Lacaziosis, 408

27.4 Pythiosis, 410

27.5 Rhinosporidiosis, 414

Further reading, 416

Select bibliography, 419

Index, 421

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Malcolm D. Richardson - University Hospital of South Manchester and Manchester Academic Health Science Centre, University of Manchester

David W. Warnock - National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia

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The third edition of this book has never been far away from my office phone and is now quite tatty, so I am delighted to review the new fourth edition, written by the same two experts. This book is an easy but detailed guide to fungal infections, ranging from those seen regularly by clinical microbiologists and infectious diseases specialists, such as Candida and Aspergillus, to exotic diseases seen only outside the UK such as Pythiosis. The emphasis of the book is on clinical presentation, specimen collection, interpretation of laboratory findings and management of the patient.
The new edition is a little larger than the previous one, but will still sit nicely on the desk. It has the same 27 chapters, most of which have been extensively revised and some new ones substituted. The chapters are based around clinical syndromes so, for example, there is quite a long chapter on dermatophyte infections and a shorter one on mycetoma. The chapter on antifungal drugs is much longer due to the addition of agents such as posaconazole and the newer echinocandins. New chapters have been added on Pneumocystosis, and ‘Unusual fungi and Pseudofungal infections’. At the end of each chapter is a useful guide to further reading.
Each chapter has a set of standard headings: definition, geographical distribution, causal organisms and habitat, epidemiology, clinical manifestations, differential diagnosis, essential investigations and their interpretation, management, prevention. This, coupled with the detailed index, makes it easy to find the bit of information you need. In particular, I found the chapter on histoplasma most helpful when working on an online clinical interpretation scenario!
As the authors say in the introduction, there have been a number of significant developments in the diagnosis and management of fungal infections since the last edition. Patients are now more complex by nature of their illness or their medical management, and the potential for opportunistic infection in the immunosuppressed has increased. Although the book was published in 2012, the basics of fungal infection such as microscopy and culture do not change. The extended chapter on laboratory diagnosis covers new techniques in serology and molecular diagnosis. At the moment, there is a lack of rapid and cost-effective tests in this area; many of the assays being performed are not standardised and some more trials are needed. I hope this section will be the one that goes out of date first, as more rapid or molecular tests are added to the diagnostic setting.
I will keep this book on my desk as quick reference during a phone call, but also as a more detailed guide to managing patients with invasive fungal infections. I recommend it to anyone who deals with fungal infections, whether in the laboratory or out on the wards, and to trainees and students as well. (Dr Fiona E. Donald, Consultant Medical Microbiologist, Nottingham University Hospitals, RCPATH Bulletin, October 2013)
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