Table 2.
Summary of lung infections causing fungus and their management.
| Organism | Characteristics | Recommended medicine |
|---|---|---|
| Histoplasma capsulatum | 1. It is associated with bird or bat droppings. 2. It can spread to various organs through blood |
Mainly with Itraconazole, fluconazole, and amphotericin B. Sometimes moxifloxacin, linezolid, azithromycin, levofloxacin, and hydroxychloroquine |
| Coccidioides immitis and Coccidioides posadasii | 1. Coccidioidal infections are caused due to airborne transmission 2. It is not contagious but spreads to other body parts like bone, joints, and skin resulting in an extrapulmonary infection. |
Fluconazole, voriconazole, itraconazole, and amphotericin B |
| Pneumocystis jirovecii | 1. Commonly affects immunocompromised patients and can be severely life-threatening in some cases. 2. This microorganism primarily resides in the lungs' alveoli and concentrates mainly in the lower respiratory tract in higher concentrations than upper respiratory tract specimens |
Co-trimoxazole (trimethoprim/sulfamethoxazole) |
| Aspergillus fumigatus | 1. This organism is almost ubiquitous in the environment and is the primary cause of the disease 2. Inhaled conidia are engulfed by alveolar macrophages and killed in a phagocyte oxidase-dependent fashion |
Voriconazole andAmphotericin B |
| Cryptococcus neoformans | 1. This microorganism can produce harmless colonies in the airways, leading to meningitis or disseminated disease. 2. Complicates reticuloendothelial malignancy, organ transplantation, corticosteroid treatment, or sarcoidosis |
Amphotericin B |
| Scedosporium prolificans and S. apiospermum | 1. S. apiospermum causes severe disease in immunocompromised patients with a higher mortality rate 2. One of the critical clinical manifestations of this infection is pneumonia. |
Amphotericin B, voriconazole |
| Blastomyces dermatitidis | 1. It attacks immunocompromised and normal immunity persons 2. It can also spread to other common sites like skin and bone and causes extrapulmonary disease |
Itraconazole, Ketoconazole and fluconazole |
| Sporothrix schenckii | 1. This organism is not a primary pathogen in the pulmonary system 2. The microorganism can produce cavitary disease in the form of a single lesion. |
Amphotericin B, caspofungin, Itraconazole, fluconazole and ketoconazole |
| Penicilliosis marneffei | 1. This fungus can infect humans in relatively rare circumstances. 2. It can produce a disseminated infection in healthy and immunocompromised hosts |
Amphotericin B and itraconazole |
| C. pneumonia | 1. It is rare and often noticed in immunocompromised patients admitted to the intensive care unit. 2. This microorganism is aspirating from a heavily colonized or infected oropharynx |
Azole antifungal agents, amphotericin B, and echinocandin |