Fungal Respiratory Infections: Spore Inhalation, Opportunistic Infections, Allergic Reactions, and Invasive Disease
Fungi cause respiratory disease via multiple mechanisms:
1. Spore Inhalation
Aspergillus, Candida, Cryptococcus, Histoplasma, Coccidioides, Blastomyces spores → lungs.
2. Opportunistic Infections
Immunocompromised (HIV/AIDS, transplant, chemo, steroids): Pneumocystis jirovecii (PCP), invasive aspergillosis, mucormycosis.
3. Allergic Reactions
Allergic bronchopulmonary aspergillosis (ABPA): asthma + IgE to Aspergillus → central bronchiectasis, mucus plugs.
4. Direct Invasion
Invasive pulmonary aspergillosis (IPA): angioinvasion, hemorrhage, high mortality in neutropenic.
5. Sinusitis/Otitis
Fungal sinusitis (allergic, invasive), otomycosis (Aspergillus, Candida).
Diagnosis & Treatment
Culture, PCR, galactomannan/β-D-glucan antigens, imaging. Antifungals: azoles, echinocandins, amphotericin B. Immune reconstitution critical.
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