Many fungi cause pulmonary disease in HIV-infected patients. Major pathogens include
Pneumocystis jirovecii, Cryptococcus neoformans, Aspergillus species, Histoplasma capsulatum,
Coccidioides species, Blastomyces dermatitidis, Paracoccidioides brasiliensis, Talaromyces
marneffei, and Emmonsia species. Because symptoms are frequently non-specific, a high index of
suspicion for fungal infection is required for diagnosis. Clinical manifestations of fungal infection
in HIV-infected patients frequently depend on the degree of immunosuppression and the CD4
+ TH
cell count. Establishing definitive diagnosis is important because treatments differ. Primary and
secondary prophylaxis depends on CD4+ TH cell counts as well as geographic location and local
prevalence of disease
