Advertisement

Advertisement

Advertisement

Advertisement

Mycology

Fungi belong to the eukaryote domain and, like plants Plants Cell Types: Eukaryotic versus Prokaryotic, have cell walls and vacuoles, exhibit cytoplasmic streaming, and are immobile. Almost all fungi, however, have cell walls composed of chitin Chitin A linear polysaccharide of beta-1->4 linked units of acetylglucosamine. It is the second most abundant biopolymer on earth, found especially in insects and fungi. When deacetylated it is called chitosan. Echinocandins and not cellulose. Fungi do not carry out photosynthesis but obtain their substrates for metabolism as saprophytes (obtain their food from dead matter). Mycosis is an infection caused by fungi.

Last updated: Sep 22, 2022

Editorial responsibility: Stanley Oiseth, Lindsay Jones, Evelin Maza

Advertisement

Advertisement

Advertisement

Advertisement

Advertisement

Advertisement

Growth Forms and Reproduction

Growth forms

Structure

  • Fungal cells have characteristics similar to both plant and animal cells:
    • Characteristics that are common with animal cells:
      • Presence of a membrane-bound nucleus Nucleus Within a eukaryotic cell, a membrane-limited body which contains chromosomes and one or more nucleoli (cell nucleolus). The nuclear membrane consists of a double unit-type membrane which is perforated by a number of pores; the outermost membrane is continuous with the endoplasmic reticulum. A cell may contain more than one nucleus. The Cell: Organelles
      • Organelles Organelles A cell is a complex unit that performs several complex functions. An organelle is a specialized subunit within a cell that fulfills a specific role or function. Organelles are enclosed within their own lipid bilayers or are unbound by membranes. The Cell: Organelles such as mitochondria Mitochondria Semiautonomous, self-reproducing organelles that occur in the cytoplasm of all cells of most, but not all, eukaryotes. Each mitochondrion is surrounded by a double limiting membrane. The inner membrane is highly invaginated, and its projections are called cristae. Mitochondria are the sites of the reactions of oxidative phosphorylation, which result in the formation of ATP. They contain distinctive ribosomes, transfer RNAs; amino Acyl tRNA synthetases; and elongation and termination factors. Mitochondria depend upon genes within the nucleus of the cells in which they reside for many essential messenger RNAs. Mitochondria are believed to have arisen from aerobic bacteria that established a symbiotic relationship with primitive protoeukaryotes. The Cell: Organelles
      • Lack of chloroplasts
    • Characteristics that are common with plant cells:
      • Presence of a cell wall Cell wall The outermost layer of a cell in most plants; bacteria; fungi; and algae. The cell wall is usually a rigid structure that lies external to the cell membrane, and provides a protective barrier against physical or chemical agents. Cell Types: Eukaryotic versus Prokaryotic
      • Contain vacuoles
  • Fungi have unique properties that distinguish them from animals Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, animalia was one of the kingdoms. Under the modern three domain model, animalia represents one of the many groups in the domain eukaryota. Cell Types: Eukaryotic versus Prokaryotic and plants Plants Cell Types: Eukaryotic versus Prokaryotic:
    • Cell walls contain chitin Chitin A linear polysaccharide of beta-1->4 linked units of acetylglucosamine. It is the second most abundant biopolymer on earth, found especially in insects and fungi. When deacetylated it is called chitosan. Echinocandins, unlike plant cell walls that contain cellulose.
    • Cell membranes contain ergosterol Ergosterol A steroid occurring in fungi. Irradiation with ultraviolet rays results in formation of ergocalciferol (vitamin d2). Azoles, unlike animal cell membranes that contain cholesterol Cholesterol The principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. Cholesterol Metabolism.

Reproduction

Reproduction is either sexual or asexual.

  • Types of asexual reproduction: 
  • Sexual reproduction:
    • Merging of 2 haploid Haploid The chromosomal constitution of cells, in which each type of chromosome is represented once. Symbol: n. Basic Terms of Genetics cells:
      • Self-fertilization: 2 cells from the same organism
      • Cross-fertilization: cells from different organisms
    • The emerging diploid Diploid The chromosomal constitution of cells, in which each type of chromosome is represented twice. Symbol: 2n or 2x. Basic Terms of Genetics zygote Zygote The fertilized ovum resulting from the fusion of a male and a female gamete. Fertilization and First Week undergoes meiosis Meiosis The creation of eukaryotic gametes involves a DNA replication phase followed by 2 cellular division stages: meiosis I and meiosis II. Meiosis I separates homologous chromosomes into separate cells (1n, 2c), while meiosis II separates sister chromatids into gametes (1n, 1c). Meiosis to form haploid Haploid The chromosomal constitution of cells, in which each type of chromosome is represented once. Symbol: n. Basic Terms of Genetics spores Spores The reproductive elements of lower organisms, such as bacteria; fungi; and cryptogamic plants. Anthrax.
    • Spores Spores The reproductive elements of lower organisms, such as bacteria; fungi; and cryptogamic plants. Anthrax germinate to create more haploid Haploid The chromosomal constitution of cells, in which each type of chromosome is represented once. Symbol: n. Basic Terms of Genetics mycelia.
Budding in fungus

Budding in fungus:
Budding yeasts divide, asymmetrically. There are haploid and diploid states (2 mating types, a and α). Each mating type secretes its own type of pheromone.
1: Budding: Mitotic cell division can occur in the haploid and diploid states, resulting in genetically identical daughter cells.
2: Mating: Each mating type secretes its own type of pheromone, initiating the mating process. This results in a diploid cell.
3: Sporulation: Diploid cells can undergo meiosis, which results in spore formation. These spores can germinate into haploid cells.

Image: “Yeast lifecycle” by Masur. License: Public Domain

Toxic Products of Fungi

Table: Toxic products of fungi
Toxin Fungus Effect
Aflatoxin Aflatoxin A potent hepatotoxic and hepatocarcinogenic mycotoxin produced by the aspergillus flavus group of fungi. It is also mutagenic, teratogenic, and causes immunosuppression in animals. It is found as a contaminant in peanuts, cottonseed meal, corn, and other grains. The mycotoxin requires epoxidation to aflatoxin b1 2, 3-oxide for activation. Microsomal monooxygenases biotransform the toxin to the less toxic metabolites aflatoxin m1 and q1. Hepatocellular Carcinoma (HCC) and Liver Metastases
  • Aspergillus Aspergillus A genus of mitosporic fungi containing about 100 species and eleven different teleomorphs in the family trichocomaceae. Echinocandins flavus
  • A. parasiticus
Highly carcinogenic and often the cause of food poisoning Food poisoning Acute illnesses, usually affecting the gastrointestinal tract, brought on by consuming contaminated food or beverages. Most of these diseases are infectious, caused by a variety of bacteria, viruses, or parasites that can be foodborne. Sometimes the diseases are caused by harmful toxins from the microbes or other chemicals present in the food. Especially in the latter case, the condition is often called food poisoning. Clostridia (traces on nuts, grain, spices)
Amanitin Amanitin Cyclic peptides extracted from carpophores of various mushroom species. They are potent inhibitors of RNA polymerases in most eukaryotic species, blocking the production of mRNA and protein synthesis. These peptides are important in the study of transcription. Alpha-amanitin is the main toxin from the species amanita phalloides, poisonous if ingested by humans or animals. Toxicology of Plants Amanita phalloides Amanita Phalloides Toxicology of Plants (death cap mushroom) Inhibition of RNA RNA A polynucleotide consisting essentially of chains with a repeating backbone of phosphate and ribose units to which nitrogenous bases are attached. RNA is unique among biological macromolecules in that it can encode genetic information, serve as an abundant structural component of cells, and also possesses catalytic activity. RNA Types and Structure polymerase II, lethal even in small doses
Muscarine Muscarine A toxic alkaloid found in amanita muscaria (fly fungus) and other fungi of the inocybe species. It is the first parasympathomimetic substance ever studied and causes profound parasympathetic activation that may end in convulsions and death. The specific antidote is atropine. Cholinomimetic Drugs A. muscaria (toadstool or fly agaric mushroom) Impacts the parasympathetic regulation of the nervous system Nervous system The nervous system is a small and complex system that consists of an intricate network of neural cells (or neurons) and even more glial cells (for support and insulation). It is divided according to its anatomical components as well as its functional characteristics. The brain and spinal cord are referred to as the central nervous system, and the branches of nerves from these structures are referred to as the peripheral nervous system. Nervous System: Anatomy, Structure, and Classification
Ergotamine Ergotamine A vasoconstrictor found in ergot of central europe. It is a serotonin agonist that has been used as an oxytocic agent and in the treatment of migraine disorders. Triptans and Ergot Alkaloids Ergot fungus (Claviceps purpurea) Impacts the autonomic nervous system Autonomic nervous system The ANS is a component of the peripheral nervous system that uses both afferent (sensory) and efferent (effector) neurons, which control the functioning of the internal organs and involuntary processes via connections with the CNS. The ANS consists of the sympathetic and parasympathetic nervous systems. Autonomic Nervous System: Anatomy, causes hallucinations Hallucinations Subjectively experienced sensations in the absence of an appropriate stimulus, but which are regarded by the individual as real. They may be of organic origin or associated with mental disorders. Schizophrenia, and affects uterine contractions
Cyclosporine Cyclosporine A cyclic undecapeptide from an extract of soil fungi. It is a powerful immunosupressant with a specific action on T-lymphocytes. It is used for the prophylaxis of graft rejection in organ and tissue transplantation. Immunosuppressants A
  • Cylindrocarpon
  • Tolypocladium
Immunosuppressant (clinical use: after organ transplantation Organ Transplantation Transplantation is a procedure that involves the removal of an organ or living tissue and placing it into a different part of the body or into a different person. Organ transplantations have become the therapeutic option of choice for many individuals with end-stage organ failure. Organ Transplantation)

Pathogenic Effect of Fungi

  • Mycoses: infectious diseases caused by fungi:
    • Usually do not pose problems in healthy individuals
    • May cause opportunistic infections Infections Invasion of the host organism by microorganisms or their toxins or by parasites that can cause pathological conditions or diseases. Chronic Granulomatous Disease in individuals who are immunocompromised immunocompromised A human or animal whose immunologic mechanism is deficient because of an immunodeficiency disorder or other disease or as the result of the administration of immunosuppressive drugs or radiation. Gastroenteritis
  • Classes:
    • Superficial mycoses:
      • Oropharynx Oropharynx The middle portion of the pharynx that lies posterior to the mouth, inferior to the soft palate, and superior to the base of the tongue and epiglottis. It has a digestive function as food passes from the mouth into the oropharynx before entering esophagus. Pharynx: Anatomy: commonly seen in infants, elderly, or immunocompromised immunocompromised A human or animal whose immunologic mechanism is deficient because of an immunodeficiency disorder or other disease or as the result of the administration of immunosuppressive drugs or radiation. Gastroenteritis individuals
      • Anogenital area: Vaginal yeast infections Infections Invasion of the host organism by microorganisms or their toxins or by parasites that can cause pathological conditions or diseases. Chronic Granulomatous Disease are commonly seen even in healthy individuals.
      • Skin Skin The skin, also referred to as the integumentary system, is the largest organ of the body. The skin is primarily composed of the epidermis (outer layer) and dermis (deep layer). The epidermis is primarily composed of keratinocytes that undergo rapid turnover, while the dermis contains dense layers of connective tissue. Skin: Structure and Functions: keratinophilic fungi (also known as dermatophytes Dermatophytes Tinea infections are a group of diseases caused by fungi infecting keratinized tissue (hair, nails, and skin). These infections are termed dermatomycoses and are caused by the dermatophyte fungi. There are approximately 40 dermatophyte fungi that are part of 3 genera, including Trichophyton, Epidermophyton, and Microsporum. These infections can affect any part of the body but occur most often in warm, moist regions like the groin and the feet. Dermatophytes/Tinea Infections) that affect human skin Skin The skin, also referred to as the integumentary system, is the largest organ of the body. The skin is primarily composed of the epidermis (outer layer) and dermis (deep layer). The epidermis is primarily composed of keratinocytes that undergo rapid turnover, while the dermis contains dense layers of connective tissue. Skin: Structure and Functions, hair, and nails
    • Systemic mycoses: 
      • Develop when fungal spores Spores The reproductive elements of lower organisms, such as bacteria; fungi; and cryptogamic plants. Anthrax are inhaled or introduced into the bloodstream
      • Can manifest in different inner organs, resulting in severe lethal infections Infections Invasion of the host organism by microorganisms or their toxins or by parasites that can cause pathological conditions or diseases. Chronic Granulomatous Disease
      • Patients Patients Individuals participating in the health care system for the purpose of receiving therapeutic, diagnostic, or preventive procedures. Clinician–Patient Relationship who are HIV HIV Anti-HIV Drugs positive or immunosuppressed are susceptible to systemic mycoses.
  • Examples:
    • Thrush: infection of the oral mucosa Oral mucosa Lining of the oral cavity, including mucosa on the gums; the palate; the lip; the cheek; floor of the mouth; and other structures. The mucosa is generally a nonkeratinized stratified squamous epithelium covering muscle, bone, or glands but can show varying degree of keratinization at specific locations. Stomatitis; Candida Candida Candida is a genus of dimorphic, opportunistic fungi. Candida albicans is part of the normal human flora and is the most common cause of candidiasis. The clinical presentation varies and can include localized mucocutaneous infections (e.g., oropharyngeal, esophageal, intertriginous, and vulvovaginal candidiasis) and invasive disease (e.g., candidemia, intraabdominal abscess, pericarditis, and meningitis). Candida/Candidiasis species
    • Dermatophytosis: infection of the skin Skin The skin, also referred to as the integumentary system, is the largest organ of the body. The skin is primarily composed of the epidermis (outer layer) and dermis (deep layer). The epidermis is primarily composed of keratinocytes that undergo rapid turnover, while the dermis contains dense layers of connective tissue. Skin: Structure and Functions ( tinea pedis Tinea pedis Dermatological pruritic lesion in the feet, caused by Trichophyton rubrum, T. mentagrophytes, or Epidermophyton floccosum. Dermatophytes/Tinea Infections, corporis, or cruris)
      • Microsporum Microsporum A mitosporic oxygenales fungal genus causing various diseases of the skin and hair. The species microsporum canis produces tinea capitis and tinea corporis, which usually are acquired from domestic cats and dogs. Teleomorphs includes arthroderma (nannizzia). Dermatophytes/Tinea Infections canis, M. audouinii, M. gypseum
      • Epidermophyton Epidermophyton A fungal genus which grows in the epidermis and is the cause of tinea. Dermatophytes/Tinea Infections floccosum
      • Trichophyton Trichophyton A mitosporic fungal genus and an anamorphic form of arthroderma. Various species attack the skin, nails, and hair. Dermatophytes/Tinea Infections tonsurans, T. mentagrophytes, T. verrucosum, T. schoenlenii
    • Coccidioidomycosis Coccidioidomycosis Coccidioidomycosis, commonly known as San Joaquin Valley fever, is a fungal disease caused by Coccidioides immitis or Coccidioides posadasii. When Coccidioides spores are inhaled, they transform into spherules that result in infection. Coccidioidomycosis is also a common cause of community-acquired pneumonia and can cause severe disease in the immunocompromised. Coccidioides/Coccidioidomycosis: a pulmonary or disseminated fungal infection
Tinea pedis

Tinea pedis is also known as athlete’s foot.

Image: “Tinea pedis interdigitalis” by Falloonb. License: Public Domain

Synthesis of Antimicrobials

Some fungi are capable of producing substances that are effective as antimicrobials:

  • Penicillin Penicillin Rheumatic Fever from Penicillium notatum
  • Cephalosporin Cephalosporin Multidrug-resistant Organisms and Nosocomial Infections from Acremonium
  • Streptomycin from Streptomyces griseus
  • Griseofulvin Griseofulvin In addition to the 3 other major classes of antifungal agents (azoles, polyenes, and echinocandins), several other clinically important antifungal agents are used, including flucytosine, griseofulvin, and terbinafine. Griseofulvin acts within the stratum corneum of the skin and are used to treat dermatophyte infections of the skin, hair, and nails. Flucytosine, Griseofulvin, and Terbinafine from P. griseofulvum
  • 50 of approximately 2,000 substances characterized as antibiotics are used as chemotherapeutics.

Clinical Relevance

Opportunistic fungal infections Infections Invasion of the host organism by microorganisms or their toxins or by parasites that can cause pathological conditions or diseases. Chronic Granulomatous Disease

Many fungi are opportunists and are especially pathogenic in patients Patients Individuals participating in the health care system for the purpose of receiving therapeutic, diagnostic, or preventive procedures. Clinician–Patient Relationship who are immunocompromised immunocompromised A human or animal whose immunologic mechanism is deficient because of an immunodeficiency disorder or other disease or as the result of the administration of immunosuppressive drugs or radiation. Gastroenteritis. Opportunistic systemic fungal infections Infections Invasion of the host organism by microorganisms or their toxins or by parasites that can cause pathological conditions or diseases. Chronic Granulomatous Disease (mycoses) include candidiasis Candidiasis Candida is a genus of dimorphic, opportunistic fungi. Candida albicans is part of the normal human flora and is the most common cause of candidiasis. The clinical presentation varies and can include localized mucocutaneous infections (e.g., oropharyngeal, esophageal, intertriginous, and vulvovaginal candidiasis) and invasive disease (e.g., candidemia, intraabdominal abscess, pericarditis, and meningitis). Candida/Candidiasis, aspergillosis Aspergillosis Aspergillosis is an opportunistic fungal infection caused by Aspergillus species, which are common spore-forming molds found in our environment. As Aspergillus species are opportunistic, they cause disease primarily in patients who are immunocompromised. The organs that are most commonly involved are the lungs and sinuses. Aspergillus/Aspergillosis, mucormycosis Mucormycosis Mucormycosis is an angioinvasive fungal infection caused by multiple fungi within the order, Mucorales. The fungi are ubiquitous in the environment, but mucormycosis is very rare and almost always occurs in patients who are immunocompromised. Inhalation of fungal spores can cause rhinocerebral or pulmonary mucormycosis, direct inoculation can cause cutaneous mucormycosis, and ingestion can cause gastrointestinal mucormycosis. Mucorales/Mucormycosis, and fusariosis, and typically manifest with rapidly progressive pneumonia Pneumonia Pneumonia or pulmonary inflammation is an acute or chronic inflammation of lung tissue. Causes include infection with bacteria, viruses, or fungi. In more rare cases, pneumonia can also be caused through toxic triggers through inhalation of toxic substances, immunological processes, or in the course of radiotherapy. Pneumonia or fungemia Fungemia The presence of fungi circulating in the blood. Opportunistic fungal sepsis is seen most often in immunosuppressed patients with severe neutropenia or in postoperative patients with intravenous catheters and usually follows prolonged antibiotic therapy. Chronic Granulomatous Disease.

Primary fungal infections Infections Invasion of the host organism by microorganisms or their toxins or by parasites that can cause pathological conditions or diseases. Chronic Granulomatous Disease

Caused by inhalation of fungal spores Spores The reproductive elements of lower organisms, such as bacteria; fungi; and cryptogamic plants. Anthrax, which results in pneumonia Pneumonia Pneumonia or pulmonary inflammation is an acute or chronic inflammation of lung tissue. Causes include infection with bacteria, viruses, or fungi. In more rare cases, pneumonia can also be caused through toxic triggers through inhalation of toxic substances, immunological processes, or in the course of radiotherapy. Pneumonia. Different infections Infections Invasion of the host organism by microorganisms or their toxins or by parasites that can cause pathological conditions or diseases. Chronic Granulomatous Disease have specific geographic distribution: 

  • Coccidioidomycosis Coccidioidomycosis Coccidioidomycosis, commonly known as San Joaquin Valley fever, is a fungal disease caused by Coccidioides immitis or Coccidioides posadasii. When Coccidioides spores are inhaled, they transform into spherules that result in infection. Coccidioidomycosis is also a common cause of community-acquired pneumonia and can cause severe disease in the immunocompromised. Coccidioides/Coccidioidomycosis: Southwestern US, Washington, Northern Mexico, and Central and South America
  • Histoplasmosis Histoplasmosis Histoplasmosis is an infection caused by Histoplasma capsulatum, a dimorphic fungus. Transmission is through inhalation, and exposure to soils containing bird or bat droppings increases the risk of infection. Most infections are asymptomatic; however, immunocompromised individuals generally develop acute pulmonary infection, chronic infection, or even disseminated disease. Histoplasma/Histoplasmosis: Eastern and Midwestern US and parts of Central and South America, Africa, Asia ASIA Spinal Cord Injuries, and Australia
  • Blastomycosis Blastomycosis Blastomycosis is an infection caused by inhalation of the spores of the fungus, Blastomyces. Blastomyces species thrive in moist soil and decaying material and are common in the Ohio and Mississippi River valleys and the Great Lakes regions of the United States and Canada. Although most patients are asymptomatic, some can develop pneumonia. Blastomyces/Blastomycosis: confined to North America and Africa
  • Paracoccidioidomycosis Paracoccidioidomycosis Paracoccidioidomycosis (PCM) is an endemic fungal infection caused by Paracoccidioides brasiliensis and P. lutzii. The fungus is geographically distributed across Mexico and South and Central America. Transmission is by inhalation, and most infections are asymptomatic. Paracoccidioides/Paracoccidioidomycosis: South America

References

  1. Centers for Disease Control and Prevention. (2019). Types of Fungal Diseases. http://www.cdc.gov/fungal/diseases/index.html
  2. Blackwell, M. (2011). The fungi: 1, 2, 3 … 5.1 million species? American Journal of Botany. 98(3), 426–438. https://pubmed.ncbi.nlm.nih.gov/21613136/
  3. Centers for Disease Control and Prevention. (2015). Candidiasis. http://www.cdc.gov/fungal/diseases/candidiasis/index.html
  4. Centers for Disease Control and Prevention. (2014). Vaginal Candidiasis. http://www.cdc.gov/fungal/diseases/candidiasis/genital/index.html
  5. Centers for Disease Control and Prevention. (2015). Invasive Candidiasis. http://www.cdc.gov/fungal/diseases/candidiasis/invasive/index.html
  6. Delaloye, J., Thierry, C. (2014). Invasive candidiasis as a cause of sepsis in the critically ill patient. Virulence. 5(1), 161–169. https://pubmed.ncbi.nlm.nih.gov/24157707/
  7. Centers for Disease Control and Prevention. (2015). Ringworm. http://www.cdc.gov/fungal/diseases/ringworm/index.html
  8. Centers for Disease Control and Prevention. (2014). Sporotrichosis. http://www.cdc.gov/fungal/diseases/sporotrichosis/index.html
  9. Centers for Disease Control and Prevention. (2015). Aspergillosis. http://www.cdc.gov/fungal/diseases/aspergillosis/index.html
  10. Centers for Disease Control and Prevention. (2015). Blastomycosis. http://www.cdc.gov/fungal/diseases/blastomycosis/index.html
  11. van de Peppel, R.J., et al. (2018). The burden of invasive aspergillosis in patients with haematological malignancy: A meta-analysis and systematic review. The Journal of Infection. 76(6), 550–562. https://pubmed.ncbi.nlm.nih.gov/29727605/
  12. Fernández-Cruz, A., et al. (2018). Bronchoalveolar lavage fluid cytology in culture-documented invasive pulmonary aspergillosis in patients with hematologic diseases: Analysis of 67 episodes. Journal of Clinical Microbiology. 56(10), e00962–e00918. https://pubmed.ncbi.nlm.nih.gov/30021823/
  13. Mohedano Del Pozo, R.B., et al. (2018). Diagnosis of invasive fungal disease in hospitalized patients with chronic obstructive pulmonary disease. Revista Iberoamericana de Micología. 35(3), 117–122. https://pubmed.ncbi.nlm.nih.gov/30078525/
  14. Alanio, A., Bretagne, S. (2017). Challenges in microbiological diagnosis of invasive Aspergillus infections. F1000Res. 6(F1000) Faculty Rev-157. https://pubmed.ncbi.nlm.nih.gov/28299183/
  15. Zilberberg, M.D., et al. (2018). Epidemiology and outcomes of hospitalizations with invasive aspergillosis in the United States, 2009-2013. Clinical Infectious Diseases. 67(5), 727–735. https://pubmed.ncbi.nlm.nih.gov/29718296/
  16. Kanj, A., et al. (2018). The spectrum of pulmonary aspergillosis. Respiratory Medicine. 141, 121–131. https://pubmed.ncbi.nlm.nih.gov/30053957/
  17. Davda, S., et al. (2018). The development of pulmonary aspergillosis and its histologic, clinical, and radiologic manifestations. Clinical Radiology. 73(11), 913–921. https://pubmed.ncbi.nlm.nih.gov/30075854/
  18. Hoenigl, M., et al. (2018). Global guidelines and initiatives from the European Confederation of Medical Mycology to improve patient care and research worldwide: New leadership is about working together. Mycoses. 61(11), 885–894. https://pubmed.ncbi.nlm.nih.gov/30086186/
  19. Jenks, J.D., Hoenigl, M. (2018). Treatment of aspergillosis. Journal of Fungi (Basel). 4(3), 98. https://pubmed.ncbi.nlm.nih.gov/30126229/
  20. Fang, J., et al. (2021). Efficacy of antifungal drugs in the treatment of oral candidiasis: A Bayesian network meta-analysis. The Journal of Prosthetic Dentistry. 125(2), 257–265. https://pubmed.ncbi.nlm.nih.gov/32165010/
  21. Valente, P., et al. (2020). Management of laryngeal candidiasis: An evidence-based approach for the otolaryngologist. European Archives of Otorhinolaryngology. 277(5), 1267–1272. https://pubmed.ncbi.nlm.nih.gov/32107617/
  22. Hurvitz, A.Z., et al. (2020). Palatal erythema with histological psoriasiform pattern: An enigmatic oral finding shared by a range of conditions. Head and Neck Pathology 14(4), 1111–1116. https://pubmed.ncbi.nlm.nih.gov/31989432/
  23. Willems, H.M.E., et al. (2020). Vulvovaginal candidiasis: A current understanding and burning questions. Journal of Fungi (Basel). 6(1), 27. https://pubmed.ncbi.nlm.nih.gov/32106438/
  24. Dubey, A.K., Singla, R.K. (2019). Current trends in anti-Candida drug development. Current Topics in Medicinal Chemistry. 19(28), 2525–2526. https://pubmed.ncbi.nlm.nih.gov/31876267/
  25. Hashemi, S.E., et al. (2019). Species distribution and susceptibility profiles of Candida species isolated from vulvovaginal candidiasis, emergence of C. lusitaniae. Current Medical Mycology. 5(4), 26–34. https://pubmed.ncbi.nlm.nih.gov/32104741/
  26. Bertolini, M., Dongari-Bagtzoglou, A. (2019). The relationship of Candida albicans with the oral bacterial microbiome in health and disease. Advances in Experimental Medicine and Biology. 1197, 69–78. https://pubmed.ncbi.nlm.nih.gov/31732935/
  27. Raesi Vanani, A., et al. (2019). Antifungal effect of the effect of Securigera securidaca L. vaginal gel on Candida species. Current Medical Mycology. 5(3), 31–35. https://pubmed.ncbi.nlm.nih.gov/31850394/

Create your free account or log in to continue reading!

Sign up now and get free access to Lecturio with concept pages, medical videos, and questions for your medical education.

User Reviews

Details