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


Tiro, A. V., D. J. Springer, R. Irby, F. Averill, A. Ottaviani, J. Heitman, and J. R. Perfect. “A case of cryptococcus gattii in Western Florida: An aggressive pathogen in an immunocompetent host.” Infectious Diseases in Clinical Practice 23, no. 2 (March 12, 2015): 105–8.

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Davies, Marie L., Melissa D. Johnson, Jamie N. Brown, William E. Bryan, and Mary L. Townsend. “Predictors of glycaemic control among HIV-positive veterans with diabetes..” In Int J Std Aids, 26:262–67, 2015.

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Davies, Marie L., Melissa D. Johnson, Jamie N. Brown, William E. Bryan, and Mary L. Townsend. “Predictors of glycaemic control among HIV-positive veterans with diabetes.” International Journal of Std & Aids 26, no. 4 (March 2015): 262–67.

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Chen, Yuan, Aubrey E. Frazzitta, Anastasia P. Litvintseva, Charles Fang, Thomas G. Mitchell, Deborah J. Springer, Yun Ding, George Yuan, and John R. Perfect. “Next generation multilocus sequence typing (NGMLST) and the analytical software program MLSTEZ enable efficient, cost-effective, high-throughput, multilocus sequencing typing..” Fungal Genet Biol 75 (February 2015): 64–71.

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Molefi, M., A. A. Chofle, S. F. Molloy, S. Kalluvya, J. M. Changalucha, F. Cainelli, T. Leeme, et al. “AMBITION-cm: Intermittent high dose AmBisome on a high dose fluconazole backbone for cryptococcal meningitis induction therapy in sub-Saharan Africa: Study protocol for a randomized controlled trial.” Trials, 2015.

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Mandegari, E., L. Fu, C. Arambú, S. Montoya, A. Peña, K. M. Johnson, J. R. Perfect, and M. A. Caniza. “Mucormycosis rhinosinusitis at diagnosis of acute lymphoblastic leukemia: Diagnostics and management challenges in a low-middle-income country.” Journal of Pediatric Hematology/Oncology 37, no. 3 (January 1, 2015): e173–77.

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Vehreschild, Maria J. G. T., J Janne Vehreschild, Francisco M. Marty, John R. Perfect, Luis Ostrosky-Zeichner, Galia Rahav, Bernhardt Zeiher, et al. “Primary Treatment of Invasive Mucormycosis (IM) with Isavuconazole (VITAL Study) or Amphotericin Formulations (FungiScope (TM)): Case Matched Analysis.” In Blood, Vol. 124. AMER SOC HEMATOLOGY, 2014.


Ten Oever, Jaap, Matthijs Kox, Frank L. van de Veerdonk, Khutso M. Mothapo, Adriana Slavcovici, Tim L. Jansen, Lieke Tweehuysen, et al. “The discriminative capacity of soluble Toll-like receptor (sTLR)2 and sTLR4 in inflammatory diseases..” Bmc Immunol 15 (November 19, 2014).

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Perfect, John R., Ray Hachem, and John R. Wingard. “Update on epidemiology of and preventive strategies for invasive fungal infections in cancer patients..” Clin Infect Dis 59 Suppl 5 (November 15, 2014): S352–55.

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