Fungal diseases of the pleura: clinical manifestations, diagnosis, and treatment.
Fungal respiratory infections were once considered rare and limited to certain endemic areas in the southeastern United States or the western desert areas. With the development and increasing use of agents that alter host immunity, as well as the spread of human immune deficiency virus infections in this country, the incidence and clinical features of fungal infections are changing. Opportunistic fungi, ubiquitous in our environment, have become common infectious agents in hospitalized patients. The pathogenic fungi are no longer considered to be limited to certain geographic areas because of the increased mobility of the population and reports of infections outside the usual endemic areas. Both opportunistic and pathogenic fungi may infect the pleural space, and symptoms of pleural disease may be the presenting complaint in patients with respiratory mycoses. This review summarizes the common clinical findings in fungal infections of the pleura, including those findings that suggest a fungal etiology. Diagnostic studies used to define the etiologic agent and recommended therapeutic approaches are also discussed.
Lambert
R S
RS
Department of Medicine, Louisiana State University School of Medicine, Shreveport.
George
R B
RB
D000935:Antifungal Agents / Q000627:therapeutic use; D006801:Humans; D009181:Mycoses / Q000453:epidemiology; D010995:Pleural Diseases / Q000209:etiology*; D014481:United States
D000935:Antifungal Agents