Fungal Pneumonia Symptoms

• Fever: In persons who are either immunocompromised or neutropenic, persistent fever that is not responding to broad spectrum antibiotics (even prior to pulmonary diagnosis) could be an early sign of infection.
• Non productive cough
• Dull discomfort in chest or pleuritic chest pain
• Dyspnea that leads to respiratory failure
• Obstructive symptoms resulting from enlarged mediastinal adenopathy in the endemic mycoses
• Mucormycosis or hemoptysis in invasive aspergillosis
• Exposure or history of travel to areas with endemic mycoses
• Symptoms resulting from infection in extrapulmonary systems (may indicate disease)
• Rheumatologic syndromes (very common among endemic mycoses)
  • Arthritis and arthralgia
  • Erythema nodosum
  • Erythema multiforme
  • Pericarditis

• Endemic mycoses are related with dissemination to the following:
  • Skin (eg, papules, ulcers, plaques, abscesses, pustules, proliferative lesions)- may show symptoms similar to skin cancer as in B dermatidis)
  • Bone and joints
  • Brain and meninges – meningitis with poor prognosis of only about 10-20%
  • Septicemia or sepsis syndrome

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

• In persons with weakened immunity, extra pulmonary sites could be affected
• Meningocephalitis in patients suffering from AIDS and crytococcosis
• Skin (often an ideal site for biopsy)
• CNS (Brain abscess in mucor and aspergillus species)
• Kidneys
• Spleen and liver (hepatosplenic candidiasis)
• Muscle (Candida species)
• Eye (endophthalamitis) in Candida species
• Nasal passages and sinuses (mucor and aspergillus species)
• Bloodstream and bone marrow (sepsis syndrome)

  Physical:

  • Temperature elevation and tachycardia
  • Respiratory distress, signs of pulmonary consolidation, rales and pleural rub
  • Acknowledge extrapulmonary findings indicating meningitis (neck stiffness, headaches, mental status change)
  • Skin lacerations (papules, plaques, pustules, ulcers, abscesses, nodules, hemorrhagic lesions)
  • Nasal passage and sinuses (aspergillus and mucor species)
  • Allergic and rheumatologic findings