Fungal Pnemonia Symptoms

• Fever: In individuals who are neutropenic or immunocompromised, persistent fever (even before pulmonary findings) may be an early sign of infection, especially if the fever is unresponsive to broad-spectrum antibiotics.
• Cough, usually nonproductive
• Pleuritic chest pain or dull discomfort
• Dyspnea leading to respiratory failure
• Obstructive symptoms from enlarged mediastinal adenopathy in the endemic mycoses
• Hemoptysis in invasive aspergillosis or mucormycosis
• History of travel to or exposure in areas containing endemic mycoses
• Symptoms from involvement of extrapulmonary systems (may suggest disease)
• Rheumatologic syndromes (common among endemic mycoses)
  • Arthritis and arthralgia
  • Erythema nodosum
  • Erythema multiforme
  • Pericarditis

• Endemic mycoses are associated with dissemination to the following:
  • Skin (eg, papules, pustules, plaques, ulcers, abscesses, proliferative lesions) - May mimic skin cancer as in B dermatitidis
  • Bone and joints
  • Brain and meninges - Meningitis with poor prognosis (10-20%)
  • Septicemia or sepsis syndrome

• Hypersensitivity or allergic reactions
  • Allergic bronchial asthma (Aspergillus species, Candida species)
  • Allergic bronchopulmonary mycoses (Aspergillus species, Candida species)
  • Bronchocentric granulomatosis (necrotizing granulomatous replacement and eosinophilic infiltration of bronchial mucosa in Aspergillus species)
  • Extrinsic allergic alveolitis (malt worker's lung, farmer's lung)

• Extrapulmonary sites in individuals who are immunocompromised
• Meningoencephalitis in patients with AIDS and cryptococcosis
• Skin (often a good site for biopsy)
• CNS (Brain abscess in Aspergillus and Mucor species)
• Kidneys
• Liver and spleen (hepatosplenic candidiasis)
• Muscle (Candida species)
• Eye (endophthalmitis) in Candida species
• Nasal passages and sinuses (Aspergillus and Mucor species)
• Bloodstream and bone marrow (sepsis syndrome)

  Physical:

  • Temperature elevation and tachycardia
  • Respiratory distress, rales, signs of pulmonary consolidation, and pleural rub
  • Acknowledge extrapulmonary findings suggesting the following:
  • Meningitis (neck stiffness, headaches, mental status change)
  • Skin lesions (pustules, papules, plaques, nodules, ulcers, abscesses, hemorrhagic lesions)
  • Nasal passage and sinuses (Mucor and Aspergillus species)
  • Rheumatologic and allergic findings