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Deep Fungal Infections

»	What is a deep fungal infection?
Subcutaneous Fungal Infections
»	Discuss the characteristics of subcutaneous mycotic infections.
»	What is a dimorphic fungus?
»	What occupations are at increased risk of sporotrichosis?
»	Describe the clinical manifestations of sporotrichosis.
»	How is the diagnosis of cutaneous sporotrichosis made?
»	How do you treat cutaneous sporotrichosis?
»	What other organisms may present with lymphocutaneous disease?
»	What are dematiaceous fungi?
»	How do you differentiate chromomycosis from phaeohyphomycosis?
»	Which organisms may cause chromoblastomycosis?
»	Which organisms cause phaeohyphomycosis?
»	How does chromomycosis present?
»	Describe the clinical features of phaeohyphomycosis.
»	What is Madura foot?
»	What are the clinical features of Madura foot?
Systemic Fungal Infections
»	Discuss the pathogenesis of the systemic respiratory deep fungi.
»	Where is blastomycosis endemic?
»	What are the clinical manifestations of blastomycosis?
»	Describe the cutaneous findings in disseminated blastomycosis.
»	Are immunosuppressed patients at increased risk of disseminated disease with blastomycosis?
»	What is the treatment of blastomycosis?
»	Where is histoplasmosis endemic?
»	What factors are necessary for production of the disease histoplasmosis?
»	Discuss the clinical manifestations of histoplasmosis.
»	How common are mucocutaneous findings in disseminated histoplasmosis?
»	Are there any other cutaneous manifestations of histoplasmosis?
»	Where is coccidioidomycosis endemic?
»	What are the clinical manifestations of coccidioidomycosis?
»	Where is paracoccidioidomycosis endemic?
»	Why is paracoccidioidomycosis more common in men?
»	What is the most common presenting complaint of paracoccidioidomycosis?
»	Which organism is responsible for penicilliosis?
»	Where is penicilliosis endemic?
»	How does penicilliosis present clinically?
»	What is a parasitized histocyte?
Opportunistic Fungal Infections
»	Define opportunistic infection.
»	What are the common fungal pathogens in HIV infection?
»	Discuss the fungal infections seen in organ transplant recipients.
»	Discuss the important epidemiologic factors of cryptococcosis.
»	How is an infection with cryptococcosis acquired?
»	What are the cutaneous manifestations of disseminated cryptococcosis?
»	What patient population is at increased risk of aspergillosis?
»	How common are cutaneous lesions in aspergillosis?
»	Describe the cutaneous lesions in aspergillosis.
»	What opportunistic fungus is clinically and histologically similar to Aspergillus?
»	What are the most important predisposing factors for acquiring mucormycosis?
»	Discuss the clinical manifestations of rhinocerebral mucormycosis.
»	Can mucormycosis be acquired from contaminated dressings?
»	What is the treatment of mucormycosis?
»	For what fungal infections might patients on biologic therapies be at risk?
»	What fungal species are considered potential agents of bioterrorism?

What is a parasitized histocyte?

Several species of bacteria and fungi infect and proliferate and actually thrive within the cytoplasm of macrophages rather than being killed by the macrophage (Table 32-2).

Table 32-2. Organisms That Parasitize Histiocytes
	RARE	RHINOSCLEROMA
	Lesions try to grow in parasitized histiocytes	Leishmaniasis Trypanosomiasis Toxoplasmosis Granuloma inguinale Peniciliosis Histoplasmosis