Mycology Online

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Fungal Jungle

Mycoses

	Superficial

	Cutaneous

	Subcutaneous

	Dimorphic Systemic

	Opportunistic

Fungal Descriptions

Laboratory Methods

School of Molecular & Biomedical Science
THE UNIVERSITY OF ADELAIDE
AUSTRALIA 5005

Contact:
Dr David Ellis

Email

Telephone:
+61 8 8161 6459
Facsimile:
+61 8 8161 7589

Clinical Groupings for Fungal Infections

The following clinical groupings may be recognized:

Skin Mycology

The Superficial Mycoses

These are superficial cosmetic fungal infections of the skin or hair shaft. No living tissue is invaded and there is no cellular response from the host. Essentially no pathological changes are elicited. These infections are often so innocuous that patients are often unaware of their condition.

Disease	Causative organisms	Incidence
Pityriasis versicolor Seborrhoeic dermatitis including Dandruff and Follicular pityriasis	Malassezia furfur (a lipophilic yeast)	Common
Tinea nigra	Exophiala werneckii	Rare
White piedra	Trichosporon beigelii	Common
Black piedra	Piedraia hortae	Rare

The Cutaneous Mycoses

These are superficial fungal infections of the skin, hair or nails. No living tissue is invaded, however a variety of pathological changes occur in the host because of the presence of the infectious agent and its metabolic products.

Disease	Causative organisms	Incidence
Dermatophytosis Ringworm of the scalp, glabrous skin and nails.	Dermatophytes (Microsporum, Trichophyton, Epidermophyton)	Common
Candidiasis of skin, mucous membranes and nails.	Candida albicans and related species.	Common
Dermatomycosis	Non-dermatophyte moulds Hendersonula toruloidea Scytalidium hyalium Scopulariopsis brevicaulis	Rare

The Subcutaneous Mycoses

These are chronic, localized infections of the skin and subcutaneous tissue following the traumatic implantation of the aetiologic agent. The causative fungi are all soil saprophytes of regional epidemiology whose ability to adapt to the tissue environment and elicit disease is extremely variable.

Disease	Causative organisms	Incidence
Sporotrichosis	Sporothrix schenckii	Rare
Chromoblastomycosis	Fonsecaea, Phialophora, Cladosporium etc.	Rare
Phaeohyphomycosis	Cladosporium, Exophiala, Wangiella, Bipolaris, Exserohilum, Curvularia	Rare
Mycotic mycetoma	Pseudallescheria, Madurella, Acremonium, Exophiala etc.	Rare
Subcutaneous zygomycosis (Entomophthoromycosis)	Basidiobolus ranarum Conidiobolus coronatus	Rare
Subcutaneous zygomycosis (Mucormycosis)	Rhizopus, Mucor, Rhizomucor, Absidia, Saksenaea etc.	Rare
Rhinosporidiosis	Rhinosporidium seeberi	Rare
Lobomycosis	Loboa loboi	Rare

Infectious Disease Mycology

Australian Guidelines for use of antifungal agents
in treatment of invasive fungal infection (July 2003).

Dimorphic Systemic Mycoses

These are fungal infections of the body caused by dimorphic fungal pathogens which can overcome the physiological and cellular defences of the normal human host by changing their morphological form. They are geographically restricted and the primary site of infection is usually pulmonary, following the inhalation of conidia.

Disease	Causative organisms	Incidence
Histoplasmosis	Histoplasma capsulatum	Rare*
Coccidioidomycosis	Coccidioides immitis	Rare*
Blastomycosis	Blastomyces dermatitidis	Rare*
Paracoccidioidomycosis	Paracoccidioides brasiliensis	Rare*

*more common in endemic areas.

Opportunistic Systemic Mycoses

These are fungal infections of the body which occur almost exclusively in debilitated patients whose normal defence mechanisms are impaired. The organisms involved are cosmopolitan fungi which have a very low inherent virulence. The increased incidence of these infections and the diversity of fungi causing them, has parallelled the emergence of AIDS, more aggressive cancer and post-transplantation chemotherapy and the use of antibiotics, cytotoxins, immunosuppressives, corticosteroids and other macro disruptive procedures that result in lowered resistance of the host.

Disease	Causative organisms	Incidence
Candidiasis	Candida albicans and related species.	Common
Cryptococcosis	Cryptococcus neoformans	Rare/Common
Aspergillosis	Aspergillus fumigatus etc.	Rare
Pseudallescheriasis	Pseudallescheria boydii	Rare
Zygomycosis (Mucormycosis)	Rhizopus, Mucor, Rhizomucor, Absidia etc.	Rare
Hyalohyphomycosis	Penicillium, Paecilomyces, Beauveria, Fusarium, Scopulariopsis etc.	Rare
Phaeohyphomycosis	Cladosporium, Exophiala, Wangiella, Bipolaris, Exserohilum, Curvularia.	Rare