Pulmonary fungal infections

Abstract Fungi are a major pathogen not only in critically ill patients in intensive care units but also in immunocompromised hosts or susceptible hosts. Susceptible hosts are increasing continuously in the present era of organ transplants, biologic immune suppressant agents for inflammatory conditions, and widespread use of prophylactic antimicrobial regimens in various immune suppressed hosts. Larger use of broad spectrum antibiotics in critical care setting leads to fungal overgrowth syndrome and infections. Literature strongly indicates that the clinician must remain vigilant for invasive and serious fungal lung infections and expand diagnostic consideration, even to individuals who were once considered only moderately immunocompromised. Emergence of various fungi as deadly bugs in ever increasing subset of patients with compromised immunity is a matter of concern. Preventive measures are of limited use, as most fungi are ubiquitous in environment and enter through inhalation. Early suspicion and aggressive treatment in the susceptible host is the only answer to these newer enemies. In this review, we discuss the opportunistic and endemic fungi, their disease process, evaluation, and treatment options. The newer treatment modalities and surgical approach where applicable are discussed here.