Histoplasma, Blastomyces, Coccidioides, and Other Dimorphic Fungi Causing Systemic Mycoses*

George R. Thompson; Beatriz L. GÓmez

doi:10.1128/9781555817381.ch122

Chapter 122 : Histoplasma, Blastomyces, Coccidioides, and Other Dimorphic Fungi Causing Systemic Mycoses*

Authors: George R. Thompson, Beatriz L. GÓmez

Content Type: Reference

Publication Year: 2015

Category: Clinical Microbiology

Book DOI: 10.1128/9781555817381

Chapter DOI: 10.1128/9781555817381.ch122

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Histoplasma, Blastomyces, Coccidioides, and Other Dimorphic Fungi Causing Systemic Mycoses*, Page 1 of 2

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Abstract:

Several of the clinically important thermal dimorphic fungi are closely related and belong to the order Onygenales, 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’ in vitro antifungal susceptibilities.

Citation: Thompson G, GÓmez B. 2015. Histoplasma, Blastomyces, Coccidioides, and Other Dimorphic Fungi Causing Systemic Mycoses*, 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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Histoplasma, Blastomyces, Coccidioides, and Other Dimorphic Fungi Causing Systemic Mycoses*

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FIGURE 1

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

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10.1128/9781555817381/9781555817381.ch122.f1.gif

FIGURE 1

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

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FIGURE 2

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

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FIGURE 2

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

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FIGURE 3

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

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FIGURE 3

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FIGURE 4

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

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10.1128/9781555817381/9781555817381.ch122.f4.gif

FIGURE 4

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

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FIGURE 5

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

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10.1128/9781555817381/9781555817381.ch122.f5.gif

FIGURE 5

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

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FIGURE 6

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

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10.1128/9781555817381/9781555817381.ch122.f6.gif

FIGURE 6

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

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FIGURE 7

KOH preparation of pus from a lesion showing Coccidioides spherule and endospores. Magnification, ∼×290. Reprinted with permission of Oxford University Press from reference 123 . doi:10.1128/9781555817381.ch122.f7

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FIGURE 7

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FIGURE 8

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

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10.1128/9781555817381/9781555817381.ch122.f8.gif

FIGURE 8

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

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FIGURE 9

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

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FIGURE 9

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

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Tables

Histoplasma, Blastomyces, Coccidioides, and Other Dimorphic Fungi Causing Systemic Mycoses*

/content/10.1128/9781555817381.mcm11.ch122.ch122.tab001

TABLE 1

In vitro susceptibilities of dimorphic fungi to antifungal agents

TABLE 1

In vitro susceptibilities of dimorphic fungi to antifungal agents