Nancy E. Madinger, MD

Immunocompromised hosts are at high risk for opportunisticinfections caused by endemic fungi such as Cryptococcus,Histoplasma, and Coccidioides. Moulds other than Aspergillusalso are being implicated in opportunistic fungal infections inimmunocompromised patients. Infections attributed toZygomycetes and Fusarium and Scedosporium species are beingreported with increased frequency. Because infection with theseorganisms cannot be distinguished from aspergillosis onradiographic imaging or histological examination, culture isrequired to confirm the diagnosis. Therapeutic success mayhinge on correct identification of the infectious organism.

Morbidity and mortality attributed to Candida and Aspergillusinfections can be quite high in immunocompromised hosts.The epidemiology and clinical manifestations as well as clinicalpearls on prevention of infections caused by Candida and Aspergillus are discussed in this second installment of a 3-partseries on opportunistic infections in immunosuppressedpatients. [Infect Med. 2008;25:498-505]

Fungal infections are a major cause of morbidity and mortalityin immunosuppressed hosts, such as patients with HIV-1 infectionand those who are otherwise neutropenic. Thus, antifungalprophylaxis has become important in the care of patients withAIDS, transplant recipients, persons receiving chemotherapy,and other at-risk persons. This first installment in a 3-part serieson opportunistic fungal infections in the immunocompromisedperson reviews the pathogenesis of opportunistic fungal infectionsin select at-risk populations and the pharmacotherapeuticarmamentarium available for prophylaxis and treatment.[Infect Med. 2008;25:448-456, 473]