Which two fungal pneumonias are common in patients with structural lung damage?

• A. Coccidioidomycosis and Histoplasmosis
• B. Aspergillus (Aspergillosis) and Cryptococcus
• C. Histoplasma and Blastomyces
• D. Pneumocystis and Histoplasma

Answer: (B)

Structural lung damage creates cavities and scarred airways that invite certain fungi to colonize and cause infection. Aspergillus is the classic example: it readily grows in preexisting cavities from prior infections or chronic lung disease, leading to aspergilloma or chronic/invasive aspergillosis in damaged lungs. Cryptococcus can also involve the lungs in people with underlying lung pathology or mild immunosuppression, producing pulmonary nodules or cavitary lesions in this setting. The other fungi listed are more typically linked to different contexts—dissemination in immunocompromised hosts or exposure risks—rather than being specifically associated with preexisting lung damage. Thus, Aspergillus and Cryptococcus are the two fungal pneumonias commonly seen in patients with structural lung damage.