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School of Biological Sciences
The University of Adelaide

Dr David Ellis

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 spp.
(a lipophilic yeast)
Tinea nigra Hortaea werneckii     Rare
White piedra Trichosporon spp. 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
Ringworm of the scalp,
glabrous skin and nails.
Dermatophytes (Arthroderma, Lophophyton, Microsporum, Nannizzia, Trichophyton, Epidermophyton) Common
Candidiasis of skin,
mucous membranes
and nails.
Candida, Debaryomyces, Kluyveromyces,Meyerozyma, Pichia, etc. Common

Non-dermatophyte moulds



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 spp. Rare
Chromoblastomycosis Fonsecaea, Phialophora,
Phaeohyphomycosis Cladophialophora, Exophiala, 
Bipolaris, Exserohilum
Mycotic mycetoma Scedosporium, Madurella, 
Trematosphaeria, Acremonium, Exophiala
Subcutaneous zygomycosis
Basidiobolus ranarum
Conidiobolus coronatus
Subcutaneous zygomycosis
Rhizopus, Mucor, Rhizomucor,
Lichtheimia, Saksenaea
Rhinosporidiosis Rhinosporidium seeberi Rare
Lobomycosis   Loboa loboi Rare


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, Debaryomyces, Kluyveromyces,Meyerozyma, Pichia, etc. Common
Cryptococcosis Cryptococcus neoformans  Rare/Common
Aspergillosis Aspergillus fumigatus etc.   Rare
Pseudallescheriasis Scedosporium, Lomentospora Rare
Rhizopus, Mucor, Rhizomucor,
Hyalohyphomycosis   Penicillium, Paecilomyces,
Beauveria, Fusarium,
Phaeohyphomycosis  Cladophialophora, Exophiala, Bipolaris, Exserohilum etc. Rare

Disclaimer: The National Mycology Reference Centre does not provide patient consultations or referrals. Individuals with concerns about fungal infection should seek advice from a registered healthcare professional. Information is provided for education and scientific purposes only and is not intended to replace advice from a registered healthcare professional. Information about a service, product or treatment does not imply endorsement.