November 1989

Nosocomial Amphotericin BCurrent Status

Author Affiliations

Department of Internal Medicine The University of Texas Health Science Center at Houston Medical School 1.122 Medical School Bldg PO Box 20708 Houston, TX 77225

Arch Intern Med. 1989;149(11):2402-2403. doi:10.1001/archinte.1989.00390110008002

Fungal diseases are relative newcomers among infectious diseases. Even though the major endemic mycoses, coccidioidomycosis, blastomycosis, See also p 2533. and histoplasmosis, were recognized around the turn of the 20th century, they remained medical curiosities until just after World War II. Our understanding of these extremely common infections continued to expand until, by the middle 1950s, both coccidioidomycosis and histoplasmosis became well understood, and only the natural history of the much more uncommon blastomycosis remained poorly charted.

Simultaneously with our expanding understanding of diseases caused by these usually pathogenic fungi, infections caused by fungi of low natural invasiveness began to appear in special patient populations.

Recognition of life-threatening illnesses caused by these saprophytic fungi closely followed the advent of the modern era of cancer chemotherapy. From the introduction of mechlorethamine hydrochloride (nitrogen mustard) into clinical practice, an ever increasing torrent of new, more and more potent antineoplastic agents appeared, ushering

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