Fungal Infection

The third edition of this book has never been far away from my office phone and is now quite tatty, so I am delighted to review the new fourth edition, written by the same two experts. This book is an easy but detailed guide to fungal infections, ranging from those seen regularly by clinical microbiologists and infectious diseases specialists, such as Candida and Aspergillus, to exotic diseases seen only outside the UK such as Pythiosis. The emphasis of the book is on clinical presentation, specimen collection, interpretation of laboratory findings and management of the patient.
The new edition is a little larger than the previous one, but will still sit nicely on the desk. It has the same 27 chapters, most of which have been extensively revised and some new ones substituted. The chapters are based around clinical syndromes so, for example, there is quite a long chapter on dermatophyte infections and a shorter one on mycetoma. The chapter on antifungal drugs is much longer due to the addition of agents such as posaconazole and the newer echinocandins. New chapters have been added on Pneumocystosis, and ‘Unusual fungi and Pseudofungal infections’. At the end of each chapter is a useful guide to further reading.
Each chapter has a set of standard headings: definition, geographical distribution, causal organisms and habitat, epidemiology, clinical manifestations, differential diagnosis, essential investigations and their interpretation, management, prevention. This, coupled with the detailed index, makes it easy to find the bit of information you need. In particular, I found the chapter on histoplasma most helpful when working on an online clinical interpretation scenario!
As the authors say in the introduction, there have been a number of significant developments in the diagnosis and management of fungal infections since the last edition. Patients are now more complex by nature of their illness or their medical management, and the potential for opportunistic infection in the immunosuppressed has increased. Although the book was published in 2012, the basics of fungal infection such as microscopy and culture do not change. The extended chapter on laboratory diagnosis covers new techniques in serology and molecular diagnosis. At the moment, there is a lack of rapid and cost-effective tests in this area; many of the assays being performed are not standardised and some more trials are needed. I hope this section will be the one that goes out of date first, as more rapid or molecular tests are added to the diagnostic setting.
I will keep this book on my desk as quick reference during a phone call, but also as a more detailed guide to managing patients with invasive fungal infections. I recommend it to anyone who deals with fungal infections, whether in the laboratory or out on the wards, and to trainees and students as well. (Dr Fiona E. Donald, Consultant Medical Microbiologist, Nottingham University Hospitals, RCPATH Bulletin, October 2013)