candidiasis

Definition

Candidiasis is an infection caused by a species of the yeast Candida, usually Candida albicans. This is a common cause of vaginal infections in women. Also, Candida may cause mouth infections in people with reduced immune function, or in patients taking certain antibiotics. Candida can be found in virtually all normal people but causes problems in only a fraction. In recent years, however, several serious categories of candidiasis have become more common, due to overuse of antibiotics, the rise of AIDS, the increase in organ transplantations, and the use of invasive devices (catheters, artificial joints and valves)—all of which increase a patient's susceptibility to infection.

Description

Over one million women in the United States develop vaginal yeast infections each year. It is not life-threatening, but it can be uncomfortable and frustrating.

This disorder, also known as thrush, causes white, curd-like patches in the mouth or throat.

Also known as invasive candidiasis, deep organ candidiasis is a serious systemic infection that can affect the esophagus, heart, blood, liver, spleen, kidneys, eyes, and skin. Like vaginal and oral candidiasis, it is an opportunistic disease that strikes when a person's resistance is lowered, often due to another illness. There are many diagnostic categories of deep organ candidiasis, depending on the tissues involved.

— Richard H. Lampert

Infection with a fungus of the genus Candida, especially C. albicans, that usually occurs in the skin and mucous membranes of the mouth, respiratory tract, or vagina but may invade the bloodstream, especially in immunocompromised individuals. Also called candidosis, moniliasis.

An infection by Candida albicans.See also moniliasis; thrush.

Chronic hyperplastic candidiasis. (Ibsen/Phelan, 2000)

Definition

Candidiasis is an infection caused by a species of the yeast Candida, usually the Candida albicans fungus. Candida is found on various parts of the bodies of almost all normal people but causes problems in only a few. Candidiasis can affect the skin, nails, and mucous membranes throughout the body including the mouth (thrush), esophagus, vagina (yeast infection), intestines, and lungs.

Description

Candida may cause yeast mouth infections (also known as thrush) in children with reduced immune function or in children taking certain antibiotics. Antibiotics may upset the balance of microorganisms in the body and allow an overgrowth of Candida. The use of inhaled steroids for the treatment of asthma has also been shown to cause oral candidiasis. Many infants acquire candidiasis from their mothers during the process of birth, when the baby comes in contact with naturally existing Candida found in the mother's vagina. Candidiasis is not considered harmful to infants unless it lasts more than several weeks after birth. These yeast mouth infections cause creamy white, curd-like patches on the tongue, inside of the mouth, and on the back of the throat. Under the whitish material, there are red lesions that may bleed.

Candida also may infect an infant's diaper rash, as it grows rapidly on irritated and moist skin. Children who suck their thumbs or other fingers may also develop candidiasis around their fingernails, causing redness on the nail edges.

Candida is a common cause of vaginal infections in adolescent girls, especially when the normal populations of the bacteria Lactobacilli have been reduced due to antibiotic use, allowing the overgrowth of Candida. A candidiasis infection in the vagina results in itching, burning, soreness, and a thick, white vaginal discharge.

Other risk factors for candidiasis include obesity, heat, and excessive sweating that result in the formation of moist skin areas where the yeast organism can grow.

In the early 2000s, several serious categories of candidiasis have become more common, due to overuse of antibiotics, the rise of AIDS, the increase in incidence of organ transplantations, the use of chemotherapy in cancer treatment, and the implantation of invasive devices (e.g., nasogastric tubes, catheters, and artificial joints and valves) into the body—all of which increase a patient's susceptibility to infection. Diabetics are especially susceptible to candidiasis, as they have high levels of sugar in their blood and urine and a low resistance to infection, both of which are conditions that favor the growth of yeast. Also known as invasive candidiasis, deep organ candidiasis is a serious systemic infection that can affect the esophagus, heart, blood, liver, spleen, kidneys, eyes, and skin. Like vaginal and oral candidiasis, it is an opportunistic disease that strikes when a child's resistance is lowered, often due to another illness. Children with granulocytopenia (deficiency of white blood cells) are particularly at risk for deep organ candidiasis. There are many diagnostic categories of deep organ candidiasis, depending on the tissues involved.

In the past candidiasis was referred to as moniliasis.

Demographics

Candidiasis is an extremely common infection. Thrush occurs in approximately 2–5 percent of healthy newborns and occurs in a slightly higher percentage of infants during their first year of life.

Over 1 million adult women and adolescent girls in the United States develop vaginal yeast infections each year. It is not life-threatening, but the condition can be uncomfortable and frustrating.

Causes and Symptoms

Candidiasis is caused by a species of the yeast Candida, usually the Candida albicans fungus.

In oral candidiasis, the disease is characterized by whitish patches that appear on the tongue, inside of the cheeks, or on the palate. Pain or difficulty in swallowing may indicate a fungal infection in the throat, which is a potential complication of AIDS. Most adolescent girls with vaginal candidiasis experience severe vaginal itching and have a discharge that often looks like cottage cheese and has a sweet or bread-like odor. The vulva and vagina can be red, swollen, and painful. The infected skin in diaper rash that includes infection with Candida appears fiery red with areas that may have a raised red border.

Effects of deep organ or systematic candidiasis include meningitis, arthritis, fungemia (fungi in the blood, causing fever and possibly leading to sepsis), endocarditis (heart infection), endophthalmitis (infection and scarring in the eye that can affect vision), and renal or bladder bezoars (colonization and blockage of the urinary tract by Candida, which can cause urinary tract infections and kidney failure.

Diagnosis

Often clinical appearance and visual examination give a strong suggestion about the diagnosis. Generally, a doctor takes a sample of the vaginal discharge or swabs an area of oral or skin lesions, and then inspects this material under a microscope, where it is possible to see characteristic forms of yeasts at various stages in the lifecycle.

Fungal blood and stool cultures for detection of the Candida organism should be taken for patients suspected of having deep organ candidiasis. Tissue biopsy may be needed for a definitive diagnosis.

When to Call the Doctor

The doctor should be called if a child exhibits any symptoms of the various types of candidiasis.

Treatment

Treatment of candidiasis is primarily accomplished through the use of antifungal drugs. Oral candidiasis is usually treated with prescription lozenges or mouthwashes. Some of the most-used prescriptions are nystatin mouthwashes (Nilstat or Nitrostat) and clotrimazole lozenges. Skin infections can be treated with topical antifungal creams. Highly inflamed skin lesions can also be treated with corticosteroid creams.

For infants with oral candidiasis, pacifiers should be sterilized or discarded. Bottle nipples should be discarded and new ones used as the infant's mouth begins to heal.

The risk of diaper rash complicated with candidiasis can be reduced by preventing irritating dermatitis through the use of absorbent diapers and prevention of excessive exposure to urine or feces through frequent changing of diapers. The use of plastic pants that do not allow air circulation over the diaper area is not recommended. Children may still attend child care; however, childcare providers should follow good hygienic practices, including thorough hand washing and disposal of materials that may contain nasal and oral secretions of infected children, in order to prevent transmitting the infection to other children.

In most cases, vaginal candidiasis can be treated successfully with a variety of over-the-counter antifungal creams or suppositories, including Monistat, Gyne-Lotrimin, and Mycelex. However, infections often recur. If an adolescent girl has frequent recurrences, she should consult her doctor about prescription drugs such as Vagistat-1, Diflucan, and others.

The early 2000s increase in deep organ candidiasis has led to the creation of treatment guidelines, including, but not limited to, the following:

• Catheters should be removed from children with candidiasis.
• Antifungal therapy may be used during chemotherapy to prevent candidiasis.
• Drugs should be prescribed based on a child's specific history and immune defense status (this is especially critical for children with AIDS). Stronger antifungal drugs, such as ketoconazole or fluconazole, may be necessary.
• Diabetes mellitus should be controlled with appropriate medication and dietary changes.

Alternative Treatment

Home remedies for vaginal candidiasis include vinegar douches or insertion of a paste made from Lactobacillus acidophilus powder into the vagina. In theory, these remedies make the vagina more acidic and, therefore, less hospitable to the growth of Candida. Fresh garlic (Allium sativum) is believed to have antifungal action, so incorporating it into the diet or inserting a gauze-wrapped, peeled garlic clove into the vagina may be helpful. The insert should be changed twice daily. Some women report success with these remedies; however, they should try a conventional treatment if an alternative remedy is not effective.

Prognosis

Oral and skin candidiasis, though painful, are usually cured with the use of antifungal medications. However, in premature infants, in children with poor or compromised immune systems, or in children with deep organ or systematic infections, eradication of the infections may be more difficult to achieve. Mortality in low birth-weight premature infants with systemic candidiasis may reach 50 percent.

Prevention

Often candidiasis can be prevented through good sanitation procedures, such as keeping the body cool and dry, wearing natural fabric underclothes, changing underclothes frequently, wiping from front to back after bowel movements, and washing hands often. For children who are susceptible to candidiasis because of immune deficiencies, the regular use of antifungal drugs to prevent infections may be required.

Parental Concerns

Parents need to practice good hygienic procedures as they care for their children, in order to prevent the development of candidiasis.

Resources

Books

Martin, Jeanne Marie, and Rona P. Soltan. Complete Candida Yeast Guidebook: Everything You Need to Know about Prevention, Treatment, and Diet. New York: Prima Lifestyles, 2000.

The Official Patient's Sourcebook on Invasive Candidiasis. San Diego, CA: Icon Health Publications, 2002.

Web Sites

Greenberg, Michael E. "Candidiasis." eMedicine, September 1, 2004. Available online at www.emedicine.com/ped/topic312.htm (accessed December 7, 2004).

[Article by: Judith Sims Richard H. Lampert]

Candidiasis (thrush, monilia infection) is caused by a fungus that most commonly infects the mouth (usually of infants or persons with weakened immune systems), or the vagina (yeast infection). Another form of candidiasis causes painful inflammation under the fingernails (paronychia). It also occurs as an opportunistic infection in the late stages of HIV/AIDS (human immunodeficiency virus/acquired immunodeficiency syndrome), as a nosocomial infection after catheterization; and it can invade the spinal canal and meninges, where it is obviously much more serious.

Candidiasis is transmitted by close contact of an infected with an uninfected mucous membrane. Infants acquire it as they pass through the birth canal. Topical application of antifungal paint or ointment can usually eliminate the infection and thus prevent transmission. Management is more difficult in debilitated and immunocompromised patients, in whom the condition can be very stubborn.

(SEE ALSO: Fungal Infections; Fungicides)

— JOHN M. LAST

Candidiasis
Classification and external resources
Agar plate culture of Candida albicans
ICD-10	B37.
ICD-9	112
DiseasesDB	1929
MedlinePlus	001511
eMedicine	med/264  emerg/76 ped/312 derm/67
MeSH	D002177

Candidiasis or thrush is a fungal infection (mycosis) of any of the Candida species, of which Candida albicans is the most common.^[1][2] Candidiasis encompasses infections that range from superficial, such as oral thrush and vaginitis, to systemic and potentially life-threatening diseases. Candida infections of the latter category are also referred to as candidemia and are usually confined to severely immunocompromised persons, such as cancer, transplant, and AIDS patients.

Superficial infections of skin and mucosal membranes by Candida causing local inflammation and discomfort are however common in many human populations.^[2][3][4] While clearly attributable to the presence of the opportunistic pathogens of the genus Candida, candidiasis describes a number of different disease syndromes that often differ in their causes and outcomes.^[2][3] Commonly referred to as a yeast infection, it is also technically known as candidosis, moniliasis, and oidiomycosis.^[5]:308

Contents 1 Manifestations 2 Types 3 Causes 4 Symptoms 5 Diagnosis 6 Treatment 7 History and taxonomic classification 8 Alternative views 9 References 10 External links

Manifestations

Most candidial infections are treatable and result in minimal complications such as redness, itching and discomfort, though complication may be severe or fatal if left untreated in certain populations. In immunocompetent persons, candidiasis is usually a very localized infection of the skin or mucosal membranes, including the oral cavity (thrush), the pharynx or esophagus, the gastrointestinal tract, the urinary bladder, or the genitalia (vagina, penis).^[1]

Candidiasis is a very common cause of vaginal irritation, or vaginitis, and can also occur on the male genitals. In immunocompromised patients, Candida infections can affect the esophagus with the potential of becoming systemic, causing a much more serious condition, a fungemia called candidemia.^[3][4]

Children, mostly between the ages of three and nine years of age, can be affected by chronic mouth yeast infections, normally seen around the mouth as white patches. However, this is not a common condition.^{[citation needed]}

Types

Candidiasis may be divided into the following types:^[5]:308-311

• Oral candidiasis
• Perlèche
• Candidal vulvovaginitis
• Candidal intertrigo
• Diaper candidiasis
• Congenital cutaneous candidiasis
• Perianal candidiasis
• Candidal paronychia
• Erosio interdigitalis blastomycetica
• Chronic mucocuntaneous candidiasis
• Systemic candidiasis
• Candidid
• Antibiotic candidiasis

Causes

Oral candidiasis on the tongue and soft palate.

Candida yeasts are commonly present in humans, and their growth is normally limited by the human immune system and by other microorganisms, such as bacteria occupying the same locations (niches) in the human body ^[6]

In a study of 1009 women in New Zealand, C. albicans was isolated from the vaginas of 19% of apparently healthy women, i.e., those that experienced few or no symptoms of infection. External use of detergents or douches or internal disturbances (hormonal or physiological) can perturb the normal vaginal flora, consisting of lactic acid bacteria, such as lactobacilli, and result in an overgrowth of Candida cells causing symptoms of infection, such as local inflammation.^[7] Pregnancy and the use of oral contraceptives have been reported as risk factors,^[8] while the roles of engaging in vaginal sex immediately and without cleansing after anal sex and using lubricants containing glycerin remain controversial.^{[citation needed]} Diabetes mellitus and the use of anti-bacterial antibiotics are also linked to an increased incidence of yeast infections.^[8] Diet has been found to affect rates of symptomatic Candidiases in some animal infection models, ^[9] and hormone replacement therapy and infertility treatments may also be predisposing factors.^[10]

A weakened or undeveloped immune system or metabolic illnesses such as diabetes are significant predisposing factors of candidiasis.^[11] Diseases or conditions linked to candidiasis include HIV/AIDS, mononucleosis, cancer treatments, steroids, stress, and nutrient deficiency. Almost 15% of people with weakened immune systems develop a systemic illness caused by Candida species.^{[citation needed]} In extreme cases, these superficial infections of the skin or mucous membranes may enter into the bloodstream and cause systemic Candida infections.

In penile candidiasis, the causes include sexual intercourse with an infected individual, low immunity, antibiotics, and diabetes. Male genital yeast infection is less common, and incidence of infection is only a fraction of that in women; however, yeast infection on the penis from direct contact via sexual intercourse with an infected partner is not uncommon.^[12]

Symptoms

Symptoms of candidiasis may vary depending on the area affected. Infection of the vagina or vulva may cause severe itching, burning, soreness, irritation, and a whitish or whitish-gray cottage cheese-like discharge, often with a curd-like appearance. These symptoms are also present in the more common bacterial vaginosis^{[citation needed]}. In a 2002 study published in the Journal of Obstetrics and Gynecology,^[where?] only 33 percent of women who were self-treating for a yeast infection actually had a yeast infection, while most had either bacterial vaginosis or a mixed-type infection. Symptoms of infection of the male genitalia include red patchy sores near the head of the penis or on the foreskin, severe itching, or a burning sensation. Candidiasis of the penis can also have a white discharge, although uncommon.^{[citation needed]} However, having no symptoms at all is common, and a more severe form of the symptoms may emerge later.^{[citation needed]}

Diagnosis

Micrograph of esophageal candidiasis. Biopsy specimen; PAS stain.

Medical professionals may use two primary methods to diagnose yeast infections: microscopic examination and culturing.

For identification by light microscopy, a scraping or swab of the affected area is placed on a microscope slide. A single drop of 10% potassium hydroxide (KOH) solution is then added to the specimen. The KOH dissolves the skin cells but leaves the Candida cells intact, permitting visualization of pseudohyphae and budding yeast cells typical of many Candida species.

For the culturing method, a sterile swab is rubbed on the infected skin surface. The swab is then streaked on a culture medium. The culture is incubated at 37 °C for several days, to allow development of yeast or bacterial colonies. The characteristics (such as morphology and colour) of the colonies may allow initial diagnosis of the organism that is causing disease symptoms.

Treatment

Candida species are frequently part of the human body's normal oral and intestinal flora. Treatment with antibiotics can lead to eliminating the yeast's natural competitors for resources, and increase the severity of the condition.

In clinical settings, candidiasis is commonly treated with antimycotics—the antifungal drugs commonly used to treat candidiasis are topical clotrimazole, topical nystatin, fluconazole, and topical ketoconazole. For example, a one-time dose of fluconazole (as Diflucan 150-mg tablet taken orally) has been reported as being 90% effective in treating a vaginal yeast infection.^[13] This dose is only effective for vaginal yeast infections, and other types of yeast infections may require different treatments. In severe infections (generally in hospitalized patients), amphotericin B, caspofungin, or voriconazole may be used. Local treatment may include vaginal suppositories or medicated douches. Gentian violet can be used for breastfeeding thrush, but pediatrician William Sears recommends using it sparingly,^[14] since in large quantities it can cause mouth and throat ulcerations in nursing babies, and has been linked to mouth cancer in humans and to cancer in the digestive tract of other animals.^[15]

Treating candidiasis solely with medication may not give desired results, and other underlying conditions may be the cause. Oral candidiasis can be the sign of a more serious condition, such as HIV infection or other immunodeficiency diseases. Maintaining vulvovaginal health can help prevent vaginal candidiasis.

C. albicans can develop resistance to antimycotic drugs, ^[16] such as fluconazole, one of the drugs that is often used to treat candidiasis. Recurring infections may be treatable with other anti-fungal drugs, but resistance to these alternative agents may also develop.

History and taxonomic classification

See also: Candida albicans

The genus Candida and species C. albicans was described by botanist Christine Marie Berkhout in her doctoral thesis at the University of Utrecht in 1923. Over the years, the classification of the genera and species has evolved. Obsolete names for this genus include Mycotorula and Torulopsis. The species has also been known in the past as Monilia albicans and Oidium albicans. The current classification is nomen conservandum, which means the name is authorized for use by the International Botanical Congress (IBC).^[17]

The genus Candida includes about 150 different species, however, only a few are known to cause human infections: C. albicans is the most significant pathogenic species. Other Candida species pathogenic in humans include C. tropicalis, C. glabrata, C. krusei, C. parapsilosis, C. dubliniensis, and C. lusitaniae.

Alternative views

Some alternative medicine proponents postulate a widespread occurrence of "systemic candidiasis" (or candida hypersensitivity syndrome, yeast allergy, or gastrointestinal candida overgrowth). The view was most widely promoted in a book published by Dr. William Crook,^[18] which hypothesized that a variety of common symptoms such as fatigue, PMS, sexual dysfunction, asthma, psoriasis, digestive and urinary problems, multiple sclerosis, and muscle pain, could be caused by subclinical infections of Candida albicans.^{[citation needed]} Crook suggested a variety of remedies to treat these symptoms, ranging from dietary modification, prescription antifungals, to colonic irrigation. With the exception of the few dietary studies in the urinary tract infection section conventional medicine has not used most of these alternatives, since there is limited scientific evidence to prove their effectiveness, or that subclinical "systemic candidiasis" is a viable diagnosis.^[19][20]

References

1. ^ ^{a b} Walsh TJ, Dixon DM (1996). "Deep Mycoses". in Baron S et al. eds. (via NCBI Bookshelf). Baron's Medical Microbiology (4th ed.). Univ of Texas Medical Branch. ISBN 0-9631172-1-1. http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=mmed.section.4006. 
2. ^ ^{a b c} MedlinePlus Encyclopedia Vaginal yeast infection
3. ^ ^{a b c} Fidel PL (2002). "Immunity to Candida". Oral Dis. 8: 69–75. doi:10.1034/j.1601-0825.2002.00015.x. PMID 12164664. 
4. ^ ^{a b} Pappas PG (2006). "Invasive candidiasis". Infect. Dis. Clin. North Am. 20 (3): 485–506. doi:10.1016/j.idc.2006.07.004. PMID 16984866. 
5. ^ ^{a b} James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier. ISBN 0-7216-2921-0. 
6. ^ Mulley, A. G.; Goroll, A. H. (2006). Primary Care Medicine: office evaluation and management of the adult patient. Philadelphia: Wolters Kluwer Health. pp. 802–3. ISBN 0-7817-7456-X. http://books.google.com/books?id=aWQhTbwoM9EC&pg=RA1-PA802&lpg=RA1-PA802. Retrieved on 2008-11-23. 
7. ^ Mårdh P A, Novikova N, Stukalova E (October 2003). "Colonisation of extragenital sites by Candida in women with recurrent vulvovaginal candidosis". BJOG 110 (10): 934–7. PMID 14550364. http://www.blackwell-synergy.com/openurl?genre=article&sid=nlm:pubmed&issn=1470-0328&date=2003&volume=110&issue=10&spage=934. 
8. ^ ^{a b} Schiefer HG (1997). "Mycoses of the urogenital tract". Mycoses 40 Suppl 2: 33–6. PMID 9476502. 
9. ^ Yamaguchi N, Sonoyama K, Kikuchi H, Nagura T, Aritsuka T, Kawabata J (January 2005). "Gastric colonization of Candida albicans differs in mice fed commercial and purified diets". J. Nutr. 135 (1): 109–15. PMID 15623841. http://jn.nutrition.org/cgi/pmidlookup?view=long&pmid=15623841. 
10. ^ Nwokolo N C, Boag F C (May 2000). "Chronic vaginal candidiasis. Management in the postmenopausal patient". Drugs Aging 16 (5): 335–9. PMID 10917071. 
11. ^ Odds FC (1987). "Candida infections: an overview". Crit. Rev. Microbiol. 15 (1): 1–5. PMID 3319417. 
12. ^ David LM, Walzman M, Rajamanoharan S (October 1997). "Genital colonisation and infection with candida in heterosexual and homosexual males". Genitourin Med 73 (5): 394–6. PMID 9534752. 
13. ^ Moosa MY, Sobel JD, Elhalis H, Du W, Akins RA (2004). "Fungicidal activity of fluconazole against Candida albicans in a synthetic vagina-simulative medium". Antimicrob. Agents Chemother. 48 (1): 161–7. doi:10.1128/AAC.48.1.161-167.2004. PMID 14693534. 
14. ^ "Thrush". www.askdrsears.com. http://www.askdrsears.com/html/8/T083100.asp. 
15. ^ Craigmill A (December 1991). "Gentian Violet Policy Withdrawn". Cooperative Extension University of California -- Environmental Toxicology Newsletter 11 (5). http://extoxnet.orst.edu/newsletters/n115_91.htm. 
16. ^ Cowen LE, Nantel A, Whiteway MS, et al. (July 2002). "Population genomics of drug resistance in Candida albicans". Proc. Natl. Acad. Sci. U.S.A. 99 (14): 9284–9. doi:10.1073/pnas.102291099. PMID 12089321. 
17. ^ "International Code of Botanical Nomenclature". Königstein. 2000. http://www.bgbm.org/iapt/nomenclature/code/SaintLouis/0000St.Luistitle.htm. Retrieved on 2008-11-23. 
18. ^ Crook, William G. (1986). The yeast connection: a medical breakthrough. New York: Vintage Books. ISBN 0394747003. 
19. ^ Weil A (2002-10-25). "Concerned About Candidiasis?". Weil Lifestyle. http://www.drweil.com/u/QA/QA125503/. Retrieved on 2008-02-21. 
20. ^ Barrett S (2005-10-08). "Dubious "Yeast Allergies"". QuackWatch. http://www.quackwatch.org/01QuackeryRelatedTopics/candida.html. Retrieved on 2008-02-21. 

External links

• Candidiasis at the Open Directory Project

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v • d • e Infectious diseases · Mycoses and Mesomycetozoea (B35-B49, 110-118) Superficial and cutaneous (dermatomycosis): Tinea=skin; Piedra (exothrix/endothrix)=hair Ascomycota Dermatophytosis By location Tinea barbae/Tinea capitis (Kerion) · Tinea corporis (Ringworm) · Tinea cruris · Tinea manuum · Tinea pedis (Athlete's foot) · Tinea unguium/Onychomycosis By organism Epidermophyton · Microsporum · Trichophyton Other Exophiala werneckii (Tinea nigra) · Piedraia hortae (Black piedra) Basidiomycota Malassezia furfur (Tinea versicolor) · Trichosporon beigelii (White piedra) Subcutaneous, systemic, and opportunistic Ascomycota Dimorphic (yeast+mold) Onygenales Coccidioides immitis/Coccidioides posadasii (Coccidioidomycosis) · Histoplasma capsulatum (Histoplasmosis) · Lacazia loboi (Lobo's disease) · Paracoccidioides brasiliensis (Paracoccidioidomycosis) Other Blastomyces dermatitidis (Blastomycosis) · Sporothrix schenckii (Sporotrichosis) · Penicillium marneffei (Penicilliosis) Yeast-like Candida albicans (Candidiasis, Oral, Esophageal, Chronic mucocutaneous) · C. glabrata · C. tropicalis · C. lusitaniae · Pneumocystis jirovecii (Pneumocystis pneumonia) Mold-like Aspergillus (Aspergillosis, Aspergilloma, Allergic bronchopulmonary aspergillosis) · Exophiala jeanselmei (Maduromycosis, Mycetoma, Eumycetoma) · Fonsecaea pedrosoi/Fonsecaea compacta/Phialophora verrucosa (Chromoblastomycosis) · Geotrichum candidum (Geotrichosis) · Pseudallescheria boydii (Allescheriasis) Basidiomycota Cryptococcus neoformans (Cryptococcosis) Zygomycota (Zygomycosis) Mucorales (Mucormycosis) Rhizopus oryzae · Mucor indicus · Absidia corymbifera · Syncephalastrum racemosum Entomophthorales (Entomophthoramycosis) Basidiobolus ranarum (Basidiobolomycosis) · Conidiobolus coronatus/Conidiobolus incongruus (Conidiobolomycosis) Microsporidia (Microsporidiosis) Enterocytozoon bieneusi/Encephalitozoon intestinalis Mesomycetozoea Rhinosporidium seeberi (Rhinosporidiosis) see also drugs

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