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1

W, Denning David, Dupont Bertrand, and Pauw B. de, eds. Invasive fungal infection. Royal Society of Medicine Press, 1999.

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2

Kalkum, Markus, and Margarita Semis, eds. Vaccines for Invasive Fungal Infections. Springer New York, 2017. http://dx.doi.org/10.1007/978-1-4939-7104-6.

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3

Todd, Stacy, and Nick Beeching. Fungal infection. Edited by Patrick Davey and David Sprigings. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199568741.003.0315.

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Fungi, comprising yeasts, moulds, and higher fungi, have a worldwide distribution and are uncommon causes of disease in healthy individuals. However, over the last 20 years, invasive fungal disease (IFD) has become an increasing cause of morbidity and mortality. This is probably due to the increasing numbers of patients with underlying host conditions, which predispose to opportunistic IFD (e.g. transplant and anti-tumour necrosis factor immunosuppression, HIV, or chronic lung disease), and to increased recognition of endemic IFD (e.g. histoplasmosis), which cause disease in both immunocompete
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4

Invasive Fungal Infection (Round Table Series (RTS)). Royal Society of Medicine Press Ltd, 1999.

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5

Lester, Rebecca, and John Rex. Fungaemia and disseminated infection. Edited by Christopher C. Kibbler, Richard Barton, Neil A. R. Gow, Susan Howell, Donna M. MacCallum, and Rohini J. Manuel. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198755388.003.0025.

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Invasive fungal disease can present without localization or obvious target organ involvement. These disseminated mycoses occur predominantly in patients who are immunocompromised, particularly from haematological malignancy and HIV. Candidiasis and aspergillosis are the commonest forms of disseminated fungal infection worldwide, but an increasing number of non-Candida yeasts and non-Aspergillus moulds have emerged as important causes of invasive disease in recent years. Endemic fungi such as Histoplasma capsulatum are important causes of invasive disease within limited geographic regions. Feve
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6

Koehler, Philipp, and Oliver A. Cornely. Fungal infections in haemato-oncology. Edited by Christopher C. Kibbler, Richard Barton, Neil A. R. Gow, Susan Howell, Donna M. MacCallum, and Rohini J. Manuel. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198755388.003.0032.

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Invasive fungal infections on haemato-oncology wards present a major challenge. Patients at risk for invasive fungal infection usually have a compromised immune system due to bone marrow failure caused by underlying disease, prolonged neutropenia after intensive chemotherapy, or immunosuppression after haematopoietic stem cell transplantation to avoid graft-versus-host disease. Three major entities—invasive candidiasis, invasive aspergillosis, and mucormycosis—account for the majority of fungal infections. Here, we describe specific host and therapeutic factors predisposing to invasive fungal
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7

James, Darius Armstrong, Anand Shah, and Anna Reed. Fungal infections in solid organ transplantation. Edited by Christopher C. Kibbler, Richard Barton, Neil A. R. Gow, Susan Howell, Donna M. MacCallum, and Rohini J. Manuel. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198755388.003.0034.

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Fungal infections are a significant and life-threatening complication of organ transplantation, on a global scale. Risk varies according to transplant type, with liver, lung, and small bowel transplant recipients being at particular risk. Whilst invasive candidiasis is the most common fungal infection in organ transplantation overall, aspergillosis is a particular problem in lung transplantation. In addition, a wide spectrum of fungi may cause invasive disease in organ transplantation, consequently diagnosis and treatment can be challenging. Key challenges are to understand individual risk for
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8

Schelenz, Silke. Fungal diseases of the gastrointestinal tract. Edited by Christopher C. Kibbler, Richard Barton, Neil A. R. Gow, Susan Howell, Donna M. MacCallum, and Rohini J. Manuel. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198755388.003.0026.

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Fungal diseases of the gastrointestinal (GI) tract can occur because of an overgrowth of yeast in the gut, exposure to contaminated food and water, or as part of disseminated invasive fungal infections from other sites. The extent of the disease depends on the underlying risk factors, such as diabetes or immunosuppression, and ranges from colonization, localized infection, or fungaemia, to aggressive life-threatening GI tract infections. Candida spp. are the commonest cause of mucosal infection, although mould infections are increasingly reported. Serious invasive mould infections are difficul
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9

Chakrabarti, Arunaloke. Fungal diseases of the ear, nose, and throat. Edited by Christopher C. Kibbler, Richard Barton, Neil A. R. Gow, Susan Howell, Donna M. MacCallum, and Rohini J. Manuel. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198755388.003.0024.

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Fungal infection of the ear (otomycosis), nose (fungal rhinosinusitis), and throat (oropharyngeal candidiasis) are common diseases. Fungal laryngeal diseases and invasive otomycosis & acute fungal rhinosinusitis are much less common and occur in immunosuppressed hosts, including those with diabetes. Aspergillus and Candida spp. are the commonest causes of otomycosis, whilst Aspergillus spp. predominate in sinus disease, with members of the Mucorales also causing serious invasive infections. Management of the non-invasive conditions can be difficult, and otomycosis and rhinosinusitis often
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10

Mack, Damien, Simon Warren, Shara Palanivel, and Christopher P. Conlon. Fungal bone and joint infections. Edited by Christopher C. Kibbler, Richard Barton, Neil A. R. Gow, Susan Howell, Donna M. MacCallum, and Rohini J. Manuel. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198755388.003.0020.

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Although fungal infections of bones and joints are rare, the increasing incidence of invasive fungal disease, along with an increased population of immunosuppressed patients and individuals with multiple comorbidities, means that these infections are also increasing. The most common organisms are Candida and Aspergillus species, although the endemic dimorphic fungi are responsible for significant numbers of cases in some parts of the world. Most infections occur following haematogenous spread, but invasion from contiguous infection occurs, as does direct inoculation after trauma or surgery. Cl
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11

Jacobs, Samantha E., Catherine B. Small, and Thomas J. Walsh. Fungal diseases of the respiratory tract. Edited by Christopher C. Kibbler, Richard Barton, Neil A. R. Gow, Susan Howell, Donna M. MacCallum, and Rohini J. Manuel. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198755388.003.0030.

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Fungal respiratory infections are important causes of morbidity and mortality in immunocompromised patients. Invasive aspergillosis remains the most common invasive fungal infection whereas other filamentous fungi, such as Fusarium spp., Mucorales, and Scedosporium spp., are increasing in frequency, particularly in neutropenic hosts. Endemic mycoses, including those due to Histoplasma capsulatum, Coccidioides spp., and Talaromyces marneffei, are increasingly prevalent in patients with cell-mediated immunodeficiencies in respective geographic regions. Culture remains the gold standard of diagno
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12

Barnes, Rosemary A., and Matthijs Backx. Fungal infections in intensive therapy units. Edited by Christopher C. Kibbler, Richard Barton, Neil A. R. Gow, Susan Howell, Donna M. MacCallum, and Rohini J. Manuel. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198755388.003.0036.

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Invasive candidiasis remains the main cause of invasive fungal disease in the intensive care unit. The risk of infection is often overestimated and most units will have incidences of 1–2% or lower. Units with higher incidences may have specific geographical and epidemiological factors, or may need to address infection control issues contributing to transmission. Routine use of prophylaxis or empiric therapy is not warranted at this level of disease. Discriminatory risk factors for this low incidence of disease are poorly defined and Candida specific biomarkers have not been validated for pre-e
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13

Maziarz, Eileen K., and John R. Perfect. Fungal infections of the kidney and those associated with renal failure, dialysis, and renal transplantation. Edited by Christopher C. Kibbler, Richard Barton, Neil A. R. Gow, Susan Howell, Donna M. MacCallum, and Rohini J. Manuel. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198755388.003.0029.

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Fungal infections involving the kidney are often a manifestation of disseminated fungal infection, although primary renal fungal infections do occur, usually from a lower urinary tract source or in the setting of renal transplantation. Candida spp. cause the vast majority of these infections and are the representative pathogen for understanding the pathogenesis of these types of infections. The risk factors and mycology of acute renal candidiasis reflect those of invasive candidiasis. Unique risk factors are observed in chronic renal candidiasis, which manifests differently and requires distin
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14

Kocher, Ajar. Infective Endocarditis. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199976805.003.0018.

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Infectious endocarditis (IE) is an infection of the heart’s innermost layer, the endothelium. Most cases require a predisposing injury to the endocardium to serve as a nidus for thrombus development, which in turn acts as nidus for bloodstream microorganisms. These intravascular microorganisms can result from dental and other invasive procedures, infected vascular catheters, and skin lesions. However, most episodes of IE result from transient bacteremia during menial tasks, such as chewing and brushing one’s teeth. Blood cultures and echocardiograms are critical for IE diagnosis. Transesophage
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15

Cottom, Laura, and Brian L. Jones. Antifungal treatment guidelines. Edited by Christopher C. Kibbler, Richard Barton, Neil A. R. Gow, Susan Howell, Donna M. MacCallum, and Rohini J. Manuel. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198755388.003.0049.

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The management of invasive fungal infection remains challenging. Given the ever-expanding body of published data and advances to scientific knowledge and technology, clinical guidance plays a greater role in supporting clinicians in making patient-centred treatment decisions, and it is essential that the guidance has been subject to rigorous scrutiny to ensure that the recommendations are based upon sound evidence. Numerous guidelines on the treatment of invasive fungal infection are available; however, differences in their recommendations exist. The relative paucity of high-quality trials is
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16

Kosmidis, Chris, David W. Denning, and Eavan G. Muldoon. Fungal disease in cystic fibrosis and chronic respiratory disorders. Edited by Christopher C. Kibbler, Richard Barton, Neil A. R. Gow, Susan Howell, Donna M. MacCallum, and Rohini J. Manuel. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198755388.003.0037.

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A range of fungal disease syndromes affect patients with chronic respiratory diseases and cystic fibrosis (CF). Invasive aspergillosis is increasingly recognized in seriously ill patients with chronic obstructive pulmonary disease, especially after high-dose steroids. Chronic pulmonary aspergillosis affects patients with pre-existing cavities or bullae, such as those with previous tuberculosis or atypical mycobacterial disease, bullous emphysema, sarcoidosis, pneumothorax, or treated lung cancer. In addition, fungi have become one of the most important trigger agents for asthma, and allergic b
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17

Tunnicliffe, Georgia, and Matthew Wise. Pulmonary fungal infections. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199657742.003.0007.

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Pulmonary fungal infections remain relatively uncommon, although they are increasingly diagnosed as a consequence of a growing population of immunocompromised individuals, foreign travel, and improved diagnostic tools. Groups who were not previously thought to be at significant risk of invasive disease are also being recognized. The increasing incidence of fungal lung disease as a consequence of changing patient demographics means that clinicians will encounter cases in outpatient clinics, medical admission departments, and the intensive care unit with increasing frequency. As international tr
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18

Meunier, F. Invasive Fungal Infections in Cancer Patients (Bailliere's Clinical Infectious Diseases). Elsevier, 1995.

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19

Warris, Adilia. Fungal infections in neonates. Edited by Christopher C. Kibbler, Richard Barton, Neil A. R. Gow, Susan Howell, Donna M. MacCallum, and Rohini J. Manuel. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198755388.003.0035.

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Fungal infections in the neonatal population are caused predominantly by Candida species and invasive fungal disease mainly affects extremely low birth weight infants. The vast majority of Candida infections are due to C. albicans and C. parapsilosis, while the more fluconazole-resistant Candida species are only sporadically observed. Invasive candidiasis typically occurs during the first month of life and presents with non-specific signs of sepsis. Despite antifungal treatment, 20% of neonates developing invasive candidiasis die and neurodevelopmental impairment occurs in nearly 60% of surviv
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20

Singhi, Pratibha, Karthi Nallasamy, and Sunit Singhi. Fungal Infections of the Central Nervous System. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199937837.003.0162.

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Fungal infections of the central nervous system are important because of their increasing incidence and the growing population of at-risk individuals. CNS spread is usually hematogenous but rarely can be due to direct invasion from adjacent structures. Morphology of the infecting fungus may predict the regions affected and the lesion phenotype. Meningitis and mass lesions are the most frequent. This chapter reviews the current understanding of the neuropathogenesis of fungal infections with mention of histopathological and imaging correlations. Important aspects of management are also discusse
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21

Dambuza, Ivy M., Jeanette Wagener, Gordon D. Brown, and Neil A. R. Gow. Immunology of fungal disease. Edited by Christopher C. Kibbler, Richard Barton, Neil A. R. Gow, Susan Howell, Donna M. MacCallum, and Rohini J. Manuel. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198755388.003.0009.

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Advances in modern medicine, such as organ transplantations and the appearance of HIV (human immunodeficiency virus), have significantly increased the patient cohort at risk of developing chronic superficial and life-threatening invasive fungal infections. To tackle this major healthcare problem, there is an urgent need to understand immunity against fungal infections for the purposes of vaccine design or immune-mediated interventions. In this chapter, we give an overview of the components of the innate and adaptive immune system and how they contribute to host defence against fungi. The vario
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22

Beattie, R. Mark, Anil Dhawan, and John W.L. Puntis. Bacterial, fungal, and parasitic infections of the liver. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780198569862.003.0059.

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Bacterial sepsis 428Spirochaetal infections 431Rickettsial infections 432Fungal infections 432Parasitic infections 434Granulomatous hepatitis 437Infectious agents can affect the liver either via direct invasion or by release of toxins. The liver's dual blood supply renders it uniquely susceptible to infection, receiving blood from the intestinal tract via the hepatic portal system, and from the systemic circulation via the hepatic artery. Because of this unique perfusion, the liver is frequently exposed to systemic or intestinal infections or the mediators of toxaemia. The biliary tree provide
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23

Kalkum, Markus, and Magarita Semis. Vaccines for Invasive Fungal Infections: Methods and Protocols. Springer New York, 2017.

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24

Kalkum, Markus, and Margarita Semis. Vaccines for Invasive Fungal Infections: Methods and Protocols. Springer New York, 2018.

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25

MacCallum, Donna M. Antifungal agents. Edited by Christopher C. Kibbler, Richard Barton, Neil A. R. Gow, Susan Howell, Donna M. MacCallum, and Rohini J. Manuel. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198755388.003.0046.

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Although invasive fungal infections lead to significant morbidity and mortality, there remain limited numbers of antifungal drugs available to treat these infections. This chapter describes and discusses the therapeutic antifungal agent classes currently available clinically to treat invasive fungal infections. These include the polyenes, azoles, echinocandins, and flucytosine (5-fluorocytosine). For each drug class, those currently used clinically are listed and their modes of action described. The effectiveness of drugs against different fungal species is explored and any drawbacks to the us
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26

Johnson, Elizabeth M. Hyaline moulds. Edited by Christopher C. Kibbler, Richard Barton, Neil A. R. Gow, Susan Howell, Donna M. MacCallum, and Rohini J. Manuel. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198755388.003.0017.

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Hyaline moulds are fungi that grow predominantly in a filamentous form with colourless hyphae. This is not a taxonomic grouping and encompasses many thousands of different fungal genera. However, there is a small subset of environmental saprobes or plant pathogenic moulds, currently comprising at least 75 species from 30 different genera, that are opportunistic human pathogens and have been implicated in invasive infections referred to as hyalohyphomycosis. In addition they may cause less invasive cutaneous, subcutaneous, mucous membrane, and corneal infections. This group of organisms include
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27

Alexander, Kevin. Myocarditis and Pericarditis. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199976805.003.0019.

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Infectious myocarditis is a primary, inflammatory cardiomyopathy that can lead to cardiomyocyte toxicity via direct myocyte invasion, toxin production, and/or stimulation of a chronic inflammatory response through antigenic mimicry. Its incidence is difficult to determine due to significant disease heterogeneity and the lack of a noninvasive gold standard for diagnosis. Often, the causative pathogen is not identified; in cases where it is, appropriate anti-infective agents may be used. Treatment is primarily supportive. Acute infectious pericarditis involves inflammation of the parietal and vi
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28

White, P. Lewis, and Rosemary A. Barnes. Molecular diagnosis of fungal disease. Edited by Christopher C. Kibbler, Richard Barton, Neil A. R. Gow, Susan Howell, Donna M. MacCallum, and Rohini J. Manuel. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198755388.003.0043.

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Molecular techniques to aid in the diagnosis of fungal disease have been in use for over two decades. However, for polymerase chain reaction (PCR) to gain widespread acceptance outside of specialist centres, methodology must be standardized and in line with general microbiological molecular diagnostics assays, yet for infections other than fungal disease. Apart from Aspergillus PCR, standardized methodology is lacking. It is also essential to identify the optimal role for an assay. Whether this is to confirm a specific disease in symptomatic patients or to exclude disease and prevent the unnec
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29

Provan, Drew, Trevor Baglin, Inderjeet Dokal, Johannes de Vos, and Hassan Al-Sader. Haematopoietic stem cell transplantation. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199683307.003.0009.

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Haemopoietic stem cell transplantation (SCT) - Indications for haemopoietic SCT - Allogeneic SCT - Autologous STC - Investigations for BMT/PBSCT - Pretransplant investigation of donors - Bone marrow harvesting - Peripheral blood stem cell mobilization and harvesting - Microbiological screening for stem cell cryopreservation - Stem cell transplant conditioning regimens - Infusion of cryopreserved stem cells - Infusion of fresh non-cryopreserved stem cells - Blood product support for SCT - Graft-versus-host disease (GvHD) prophylaxis - Acute GvHD - Chronic GvHD - Veno-occlusive disease (syn. sin
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