John Robert Perfect, MD

Professor of Medicine
James B. Duke Professor of Medicine
Chief, Division of Infectious Diseases
Professor in Molecular Genetics and Microbiology
Campus mail Duke Box 102359, Durham, NC 27710
Phone (919) 684-4016
Email address

Research in my laboratory focuses around several aspects of medical mycology. We are investigating antifungal agents (new and old) in animal models of candida and cryptococcal infections. We have examined clinical correlation of in vitro antifungal susceptibility testing and with in vivo outcome. Our basic science project examines the molecular pathogenesis of cryptococcal infections. We have developed a molecular foundation for C. neoformans, including transformation systems, gene disruptions, differential gene expression screens, and cloning pathogenesis genes. The goal of this work is to use C. neoformans as a model yeast system to identify molecular targets for antifungal drug development. There are a series of clinical trials in fungal infections which are being coordinated through this laboratory and my work also includes a series of antibiotic trials in various aspects of infections. Finally, we have now been awarded a NIH sponsored Mycology Unit for 5 years with 6 senior investigators which is focused on C. neoformans as a pathogenic model system, but will include multiple areas of medical mycology from diagnosis to treatment.

Education and Training

  • Fellow, Infectious Diseases, Duke University School of Medicine, 1977 - 1980
  • Resident, University of Michigan at Ann Arbor, 1975 - 1977
  • Intern, Riverside Methodist Hospital, 1974 - 1975
  • M.D., University of Toledo, 1974


Rhodes, Johanna, Christopher A. Desjardins, Sean M. Sykes, Mathew A. Beale, Mathieu Vanhove, Sharadha Sakthikumar, Yuan Chen, et al. “Tracing Genetic Exchange and Biogeography of Cryptococcus neoformans var. grubii at the Global Population Level..” Genetics 207, no. 1 (September 2017): 327–46.

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McCarthy, Matthew W., Dimitrios P. Kontoyiannis, Oliver A. Cornely, John R. Perfect, and Thomas J. Walsh. “Novel Agents and Drug Targets to Meet the Challenges of Resistant Fungi..” J Infect Dis 216, no. suppl_3 (August 15, 2017): S474–83.

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Miao, Yi, Jennifer L. Tenor, Dena L. Toffaletti, Stacey A. Maskarinec, Jiuyu Liu, Richard E. Lee, John R. Perfect, and Richard G. Brennan. “Structural and In Vivo Studies on Trehalose-6-Phosphate Synthase from Pathogenic Fungi Provide Insights into Its Catalytic Mechanism, Biological Necessity, and Potential for Novel Antifungal Drug Design..” Mbio 8, no. 4 (July 25, 2017).

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Desjardins, Christopher A., Charles Giamberardino, Sean M. Sykes, Chen-Hsin Yu, Jennifer L. Tenor, Yuan Chen, Timothy Yang, et al. “Population genomics and the evolution of virulence in the fungal pathogen Cryptococcus neoformans..” Genome Res 27, no. 7 (July 2017): 1207–19.

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Mourad, A., Melissa Johnson, and John Perfect. “A Decade of Voriconazole Use at Duke University Medical Center: What are the Challenges with Dosing?.” New Orleans, LA: American Society of Microbiology - Microbe, 2017.


Thammahong, Arsa, Srisombat Puttikamonkul, John R. Perfect, Richard G. Brennan, and Robert A. Cramer. “Central Role of the Trehalose Biosynthesis Pathway in the Pathogenesis of Human Fungal Infections: Opportunities and Challenges for Therapeutic Development..” Microbiol Mol Biol Rev 81, no. 2 (June 2017).

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Lestner, Jodi, Laura McEntee, Adam Johnson, Joanne Livermore, Sarah Whalley, Julie Schwartz, John R. Perfect, Thomas Harrison, and William Hope. “Experimental Models of Short Courses of Liposomal Amphotericin B for Induction Therapy for Cryptococcal Meningitis..” Antimicrob Agents Chemother 61, no. 6 (June 2017).

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