LARONE's Medically Important Fungi. A Guide to Identification

List of Tables 

Preface to the Seventh Edition 

Preface to the First Edition 

Acknowledgments 

About the Authors 

Basics

How To Use the Guide 

Use of Reference Laboratories and Regulations for Transport

Safety Precautions

Taxonomy and Nomenclature

PART I

• Direct Microscopic Examination of Clinical Specimens
• Introduction
• Histological Terminology
• Tissue Reactions to Fungal Infections
• Stains

TABLE 1.1 Histochemical stains for fungi and/or filamentous bacteria in tissue

• Guide to Interpretation of Direct Microscopic Examination
• Detailed Descriptions
• Actinomycosis
• Mycetoma (Actinomycotic or Eumycotic)
• Nocardiosis
• Mucormycosis (Zygomycosis)
• Aspergillosis
• Miscellaneous Hyalohyphomycoses (Other than Aspergillosis)
• Dermatophytosis (Tinea, Ringworm)
• Tinea versicolor
• Tinea nigra
• Phaeohyphomycosis
• Chromoblastomycosis
• Sporotrichosis
• Histoplasmosis
• Emergomycosis
• Talaromycosis (Penicilliosis)
• Blastomycosis
• Paracoccidioidomycosis
• Lobomycosis
• Candidiasis
• Trichosporonosis
• Cryptococcosis
• Pneumocystosis
• Protothecosis
• Coccidioidomycosis
• Rhinosporidiosis
• Adiaspiromycosis

PART II

• Identification of Fungi in Culture
• Guide to Identification of Fungi in Culture
• Detailed Descriptions
• Filamentous Bacteria
• Introduction to Filamentous Bacteria

TABLE 2.1 Differentiation of filamentous aerobic actinomycetes encountered in clinical specimens

• Nocardia spp.
• Streptomyces spp.
• Actinomadura spp.
• Nocardiopsis dassonvillei
• Yeasts and Yeastlike Organisms
• Introduction to Yeasts and Yeastlike Organisms
• Candida albicans

TABLE 2.2 Characteristics of the genera of clinically encountered yeasts and yeastlike organisms

• Candida dubliniensis

TABLE 2.3 Characteristics of Candida spp. most commonly encountered in the clinical laboratory

TABLE 2.4 Characteristics that assist in differentiating Candida dubliniensis from Candida albicans

• Candida tropicalis
• Candida parapsilosis species complex
• Candida lusitaniae
• Candida krusei

TABLE 2.5 Differentiating characteristics of Geotrichum capitatum (formerly Blastoschizomyces capitatus) versus Candida krusei

TABLE 2.6 Differentiating characteristics of Candida krusei, Candida inconspicua, and Candida norvegensis

• Candida kefyr
• Candida rugosa species complex
• Candida guilliermondii species complex
• Thermally Monomorphic Moulds
• Mucormycetes
• Introduction to Mucormycetes

TABLE 2.11 Differential characteristics of similar organisms in the class Mucormycetes

TABLE 2.12 Differential characteristics of the clinically encountered Rhizopus spp.

• Rhizopus spp.
• Mucor spp.
• Rhizomucor spp.
• Lichtheimia corymbifera species complex
• Apophysomyces elegans species complex
• Saksenaea vasiformis
• Cokeromyces recurvatus
• Cunninghamella bertholletiae
• Syncephalastrum racemosum
• Basidiobolus spp.
• Dermatophytes
• Introduction to Dermatophytes
• Latin Terms for Dermatophyte Infections
• Microsporum audouinii
• Microsporum canis
• Paraphyton cookei species complex (formerly Microsporum cookei species complex)
• Nannizzia gypsea species complex (formerly Microsporum gypseum species complex)
• Lophophyton gallinae (formerly Microsporum gallinae [zoophilic form] and Microsporum vanbreuseghemii [geophilic form])
• Nannizzia nana (formerly Microsporum nanum)
• Microsporum ferrugineum
• Hyaline Hyphomycetes
• Introduction to Hyaline Hyphomycetes
• Fungi in Which Arthroconidia Predominate

TABLE 2.21 Differential characteristics of fungi in which arthroconidia predominate

• Malbranchea spp.
• Pseudogymnoascus pannorum (formerly Geomyces pannorum)
• Arthrographis kalrae
• Hormographiella aspergillata
• Common Species of Aspergillus
• The genus Aspergillus
• Aspergillus fumigatus species complex
• Aspergillus niger species complex
• Aspergillus flavus species complex

PART III

• Basics of Molecular Methods for Fungal Identification
• Introduction
• Fungal Targets

TABLE 3.1 Frequently used fungal gene targets and primers for sequence-based species identification

TABLE 3.2 Examples of fungal gene targets and primers for multilocus sequence-based species identification

• Classic Molecular Identification Methods
• Polymerase Chain Reaction
• Non-Sequencing-Based Identification Methods
• MALDI-TOF
• Mass Spectrometry
• Signal Amplification Methods
• PNA FISH
• Nucleic Acid Amplification Methods
• T2 Magnetic Resonance
• Broad-Panel Molecular Testing and Other Emerging Sample-to-Answer Technologies
• Sequencing-Based Identification Methods
• Sanger Sequencing

TABLE 3.3 Lane construction for traditional bidirectional Sanger sequencing

• Massive Parallel or Next-Generation Sequencing
• Applications of DNA Sequencing
• Accurate Molecular Identification

TABLE 3.4 Commonly used databases for identification of medically-important fungi

• Phylogenetic Analysis
• Organism Typing
• Detection of Genetic Determinants of Resistance

PART IV

• Laboratory Technique
• Laboratory Procedures
• Collection and Preparation of Specimens

TABLE 4.1 Common clinical sites for laboratory recovery of pathogenic fungi

• Methods for Direct Microscopic Examination of Specimens
• Primary Isolation

TABLE 4.2 Media for primary isolation of fungi

• Macroscopic Examination of Cultures
• Microscopic Examination of Growth
• Procedure for Identification of Yeasts
• Isolation of Yeast When Mixed with Bacteria
• Germ Tube Test for the Presumptive Identification of Candida albicans
• Rapid Enzyme Tests for the Presumptive Identification of Candida albicans
• Caffeic Acid Disk Test
• Olive Oil Disks for Culturing Malassezia spp.
• Conversion of Thermally Dimorphic Fungi in Culture
• Sporulation Inducement Method for Apophysomyces and Saksenaea
• In vitro Hair Perforation Test (for Differentiation of Trichophyton mentagrophytes and Trichophyton rubrum)
• Temperature Tolerance Testing
• Maintenance of Stock Fungal Cultures
• Controlling Mites
• Staining Methods
• Acid-Fast
• Modified Kinyoun Stain for Nocardia spp.
• Acid-Fast Stain for Ascospores
• Ascospore Stain
• Calcofluor White Stain
• Giemsa Stain
• Gomori Methenamine Silver (GMS) Stain
• Gram Stain (Hucker Modification)
• Lactophenol Cotton Blue
• Lactophenol Cotton Blue with Polyvinyl Alcohol (PVA) (Huber’s PVA Mounting Medium, Modified)
• Rehydration of Paraffin-Embedded Tissue (Deparaffination)
• Media
• Ascospore Media
• Assimilation Media (for Yeasts)
• Birdseed Agar (Niger Seed Agar; Staib Agar)
• Brain Heart Infusion (BHI) Agar
• Buffered Charcoal-Yeast Extract (BCYE) Agar
• Canavanine Glycine Bromothymol Blue (CGB) Agar
• Casein Agar
• Sabouraud Dextrose Agar with 15% NaCl
• Sabouraud Dextrose Broth
• Starch Hydrolysis Agar
• Trichophyton Agars
• Tyrosine Agar
• Urea Agar
• Water Agar

Image Appendix

Glossary

References Cited

Index

The definitive guide for identifying fungi from clinical specimens

With a new team of authors, Larone's Medically Important Fungi, Seventh Edition, continues the longstanding tradition of high-quality content to expand your knowledge and support your work in clinical mycology by:

• Providing detailed descriptions of the major mycoses as viewed in patients' specimens by direct microscopic examination of stained slides
• Offering a logical step-by-step process for identification of cultured organisms, utilizing detailed descriptions, images, pointers on organisms' similarities and distinctions, and selected references for further information
• Covering more than 150 of the fungi most commonly encountered in the clinical mycology laboratory, including new entries for Emergomyces, Metarhizium anisopliae, Rasamsonia argillacea, Rhinocladiella mackenziei, Schizophyllum commune, and Thermothelomyces thermophilus
• Presenting details on each organism's pathogenicity, growth characteristics, relevant biochemical reactions, and microscopic morphology, illustrated with photomicrographs, unique and elegant drawings, and color photos of colony morphology and various test results
• Explaining changes in fungal taxonomy and nomenclature that are due to information acquired through molecular taxonomic studies of evolutionary fungal relationships
• Providing basic information on molecular diagnostic methods, e.g., nucleic acid amplification and sequencing, MALDI-TOF mass spectrometry, and other commercial platforms
• Including an extensive section of easy-to-follow lab protocols, a comprehensive list of media and stain procedures, guidance on collection and preparation of patient specimens, and an illustrated glossary

With Larone's Medically Important Fungi: A Guide to Identification, both novices and experienced professionals in clinical microbiology laboratories can confidently identify commonly encountered fungi.

ABOUT THE AUTHOR

Lars F. Westblade, PhD, D(ABMM) is the Director of the Clinical Microbiology Service at NewYork-Presbyterian/Weill Cornell Medical Center and Associate Professor at Weill Cornell Medicine with a primary appointment in the Department of Pathology and Laboratory Medicine and a secondary appointment in the Division of Infectious Diseases, Department of Medicine. He earned his doctoral degree from the University of Birmingham in the United Kingdom, and completed a fellowship in medical and public health laboratory microbiology at Washington University School of Medicine in St. Louis.

Eileen M. Burd, PhD, D(ABMM) is the Director of the Clinical Microbiology Laboratory at Emory University Hospital and Professor at Emory University School of Medicine with a primary appointment in the Department of Pathology and Laboratory Medicine and a secondary appointment in the Department of Medicine, Division of Infectious Diseases. She earned her doctoral degree from the Medical College of Wisconsin in Milwaukee and was the Division Head of Microbiology at Henry Ford Hospital in Detroit, Michigan prior to joining the faculty at Emory University in 2007.

Shawn R. Lockhart, PhD, D(ABBM) FAAM is the Senior Clinical Laboratory Advisor in the Mycotic Diseases Branch at the Centers for Disease Control and Prevention. He earned his doctoral degree from the University of Kentucky and completed his clinical microbiology fellowship at the University of Iowa Hospitals and Clinics. He directs the CDC training course in mold identification.

Gary W. Procop, MD, MS is the CEO of the American Board of Pathology and Professor of Pathology at the Cleveland Clinic Lerner School of Medicine. He remains a Consulting Staff for the Institute of Pathology and Laboratory Medicine, where he served as Medical Director for the Mycology Laboratory for more than two decades. He earned his doctoral degree from the Marshall University School of Medicine. His residency in anatomic and clinical pathology was completed at Duke University and his medical microbiology fellowship at the Mayo Clinic.