SYSTEMIC MYCOSES IN THE 21st CENTURY

Chronic Cough Due to Tuberculosis and Other Infections

BACKGROUND

Although tuberculosis (TB) and other lung infections are common throughout the developing world, they are not among the most common causes of chronic cough.

METHODS

Articles were selected from a MEDLINE search from 1966 through 2003 (using medical subject heading words "cough," "tuberculosis," and "lung infection"), and World Health Organization and Centers for Disease Control and Prevention web sites.

RESULTS

Because of the contagious nature of TB and its potential for devastating morbidity and mortality for individual patients and society, TB should be considered early on in the workup of patients with chronic cough when the likelihood of active TB is high. On a worldwide basis, many cases of chronic cough are caused by infection including TB, and endemic fungi and parasites are important causes of cough in specific geographic regions. The convergence of the AIDS epidemic with the high prevalence of TB in the developing world has fueled the marked increase in cases of TB. Persons who live and work in facilities like prisons and nursing homes are also susceptible to tuberculous infection, and they spread it to others. Infection with endemic fungi and parasites should be considered in patients with chronic cough who live, or have lived, in these areas.

CONCLUSION

Patients with unexplained chronic cough who have resided in areas having endemic infection with TB, fungi, or parasites should undergo diagnostic evaluation for these pathogens when more common causes of cough have been ruled out.

A clinical perspective for the management of invasive fungal infections: focus on IDSA guidelines. Infectious Diseases Society of America

Invasive fungal infections, especially candidiasis and aspergillosis, are a major cause of morbidity and mortality. Many controversies surround the management of these infections. A critical overview of the recent Infectious Diseases Society of America practice guidelines is provided, as are comments on both the conundrums and future perspectives in medical mycology.