Discuss the pathogenesis of the systemic respiratory deep fungi.

The systemic respiratory endemic fungal infections include blastomycosis, histoplasmosis, coccidioidomycosis, paracoccidioidomycosis, and penicilliosis. These infections are all due to species that show dimorphism. As a group, they cause disease in both healthy immunocompetent individuals and the immunosuppressed. These diseases are similar in pathophysiology, but each has distinct clinical characteristics. The causative organisms are found in the soil, and infection occurs with inhalation of the organism into the lung. The primary infection is pulmonary. Dissemination occurs via the lymphohematogenous route, and each fungus has a predilection for particular organ systems.