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Chapter 122 : , , ,

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Abstract:

Several of the clinically important thermal dimorphic fungi are closely related and belong to the order , which includes the causal agents of histoplasmosis, blastomycosis, coccidioidomycosis, paracoccidioidomycosis, and adiaspiromycosis. This chapter provides a review, with updates on recent developments, of our understanding of the pathogenic fungi responsible for these diseases. Aspects relevant to their detection and characterization are emphasized, including taxonomy and genome sequencing updates, morphology of the pathogens at room temperature and at 37°C, epidemiology and transmission, clinical manifestations of the diseases, and diagnostic methods. Diagnostic topics covered include microscopy identification; special stains; immunological tests for detecting antibodies, antigen(s), and metabolites; nucleic acid detection using molecular methods; identification or typing via examination and phenotypic properties; and interpretation of reports. The chapter also describes isolation of the pathogens, including biosafety and biosecurity recommendations; briefly mentions the antifungal agents available for treatment; and reviews the pathogens’ antifungal susceptibilities.

Citation: Thompson G, GÓmez B. 2015. , , , , p 2109-2127. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch122
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Image of FIGURE 1
FIGURE 1

Mycelial phase of showing tuberculate macroconidia and microconidia. Lactophenol cotton blue stain. Magnification, ∼×245. doi:10.1128/9781555817381.ch122.f1

Citation: Thompson G, GÓmez B. 2015. , , , , p 2109-2127. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch122
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Image of FIGURE 2
FIGURE 2

GMS stain showing blastoconidia of . Magnification, ∼×290. doi:10.1128/9781555817381.ch122.f2

Citation: Thompson G, GÓmez B. 2015. , , , , p 2109-2127. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch122
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Image of FIGURE 3
FIGURE 3

(A) Calcofluor white wet mount of sputum showing blastoconidia of . Original magnification, ×475. Courtesy of the American Society of Clinical Pathology. (B) Calcofluor white wet mount of sputum showing blastoconidia of . Magnification, ∼×255. doi:10.1128/9781555817381.ch122.f3

Citation: Thompson G, GÓmez B. 2015. , , , , p 2109-2127. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch122
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Image of FIGURE 4
FIGURE 4

Mycelial phase of . Magnification, ∼×240. doi:10.1128/9781555817381.ch122.f4

Citation: Thompson G, GÓmez B. 2015. , , , , p 2109-2127. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch122
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Image of FIGURE 5
FIGURE 5

Blastoconidia of . GMS stain. Magnification, ∼×290. doi:10.1128/9781555817381.ch122.f5

Citation: Thompson G, GÓmez B. 2015. , , , , p 2109-2127. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch122
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Image of FIGURE 6
FIGURE 6

Mycelial phase of showing alternating arthroconidia. Lactofuchsin stain. Magnification, ∼×250. doi:10.1128/9781555817381.ch122.f6

Citation: Thompson G, GÓmez B. 2015. , , , , p 2109-2127. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch122
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Image of FIGURE 7
FIGURE 7

KOH preparation of pus from a lesion showing spherule and endospores. Magnification, ∼×290. Reprinted with permission of Oxford University Press from . doi:10.1128/9781555817381.ch122.f7

Citation: Thompson G, GÓmez B. 2015. , , , , p 2109-2127. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch122
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Image of FIGURE 8
FIGURE 8

Wet mount showing blastoconidia of . Magnification, ∼×290. doi:10.1128/9781555817381.ch122.f8

Citation: Thompson G, GÓmez B. 2015. , , , , p 2109-2127. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch122
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Image of FIGURE 9
FIGURE 9

adiaspore in mouse tissue. PAS stain. Magnification, ∼×280. doi:10.1128/9781555817381.ch122.f9

Citation: Thompson G, GÓmez B. 2015. , , , , p 2109-2127. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch122
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Tables

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TABLE 1

susceptibilities of dimorphic fungi to antifungal agents

Citation: Thompson G, GÓmez B. 2015. , , , , p 2109-2127. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch122

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