ABSTRACT

Fungal pathogens are rare but important causes of pneumonia. Acute infections can mimic typical and atypical pneumonias caused by other pathogens. Chronic forms of infection can mimic tuberculosis and lung cancer. Involvement of hilar and mediastinal nodes can cause special problems. Consideration of a fungal etiology for a specific illness depends either on specific clinical features of the illness, factors relating to the host, or a progressive course of illness that drives aggressive diagnostic testing. Sometimes a diagnostic test such as a lung biopsy confirms a fungal diagnosis even when it was not the prime consideration. The main focus here is on symptoms and signs that suggest a fungal pulmonary disease, diagnostic approaches likely to be helpful, and basic principles of treatment. Only histoplas­ mosis, blastomycosis, coccidiodomycosis, and aspergillosis are covered in any detail.