ABSTRACT
Fungi, like mammalian cells but unlike bacteria, are eukaryotic and possess nuclei, mitochondria and cell membranes. However, their membranes contain distinctive sterols, ergosterol and lanesterol. The very success of antibacterial therapy has created ecological situations in which opportunistic fungal infections can flourish. In addition, potent immunosuppressive and cytotoxic therapies produce patients with seriously impaired immune defences, in whom fungi that are nonpathogenic to healthy individuals become pathogenic and cause disease. Table 45.1 summarizes an approach to antifungal therapy in immunocompromised patients. Sites of action of antifungal drugs are summarized in Figure 45.1.
