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Fungal infection, also known as mycosis, is a disease caused by
fungi A fungus (: fungi , , , or ; or funguses) is any member of the group of eukaryotic organisms that includes microorganisms such as yeasts and mold (fungus), molds, as well as the more familiar mushrooms. These organisms are classified as one ...
. Different types are traditionally divided according to the part of the body affected: superficial, subcutaneous, and systemic. Superficial fungal infections include common tinea of the skin, such as tinea of the
body Body may refer to: In science * Physical body, an object in physics that represents a large amount, has mass or takes up space * Body (biology), the physical material of an organism * Body plan, the physical features shared by a group of anim ...
,
groin In human anatomy, the groin, also known as the inguinal region or iliac region, is the junctional area between the torso and the thigh. The groin is at the front of the body on either side of the pubic tubercle, where the lower part of the abdom ...
,
hands A hand is a prehensile, multi-fingered appendage located at the end of the forearm or forelimb of primates such as humans, chimpanzees, monkeys, and lemurs. A few other vertebrates such as the koala (which has two opposable thumbs on each "han ...
,
feet The foot (: feet) is an anatomical structure found in many vertebrates. It is the terminal portion of a limb which bears weight and allows locomotion. In many animals with feet, the foot is an organ at the terminal part of the leg made up of ...
and
beard A beard is the hair that grows on the jaw, chin, upper lip, lower lip, cheeks, and neck of humans and some non-human animals. In humans, beards are most commonly seen on pubescent or adult males, though women have been observed with beards ...
, and yeast infections such as
pityriasis versicolor Pityriasis commonly refers to flaking (or scaling) of the skin. The word comes from the Greek πίτυρον 'bran'. Classification Types include: * Pityriasis alba, dry, fine-scaled, pale patches on the face * Pityriasis lichenoides chronica, c ...
. Subcutaneous types include
eumycetoma Eumycetoma, also known as Madura foot, is a persistent Mycoses, fungal infection of the skin and the tissues subcutaneous tissue, just under the skin, affecting most commonly the feet, although it can occur in hands and other body parts. It s ...
and
chromoblastomycosis Chromoblastomycosis is a long-term mycosis, fungal infection of the skin and subcutaneous tissue (a chronic (medicine), chronic subcutaneous mycosis). It can be caused by many different types of fungi which become implanted under the skin, ofte ...
, which generally affect tissues in and beneath the skin. Systemic fungal infections are more serious and include
cryptococcosis Cryptococcosis is a potentially fatal fungal infection of mainly the lungs, presenting as a pneumonia, and in the brain, where it appears as a meningitis. Coughing, difficulty breathing, chest pain and fever are seen when the lungs are infect ...
,
histoplasmosis Histoplasmosis is a fungal infection caused by ''Histoplasma capsulatum''. Symptoms of this infection vary greatly, but the disease affects primarily the lungs. Occasionally, other organs are affected; called disseminated histoplasmosis, it can ...
,
pneumocystis pneumonia ''Pneumocystis'' pneumonia (PCP), also known as ''Pneumocystis jirovecii'' pneumonia (PJP), is a form of pneumonia that is caused by the yeast-like fungus '' Pneumocystis jirovecii''. ''Pneumocystis'' specimens are commonly found in the lungs o ...
,
aspergillosis Aspergillosis is a fungal infection of usually the lungs, caused by the genus ''Aspergillus'', a common mold that is breathed in frequently from the air, but does not usually affect most people. It generally occurs in people with lung diseases su ...
and
mucormycosis Mucormycosis, also known as black fungus, is a severe fungal infection that comes under fulminant fungal sinusitis, usually in people who are immunocompromised. It is curable only when diagnosed early. Symptoms depend on where in the body the ...
. Signs and symptoms range widely. There is usually a rash with superficial infection. Fungal infection within the skin or under the skin may present with a lump and skin changes.
Pneumonia Pneumonia is an Inflammation, inflammatory condition of the lung primarily affecting the small air sacs known as Pulmonary alveolus, alveoli. Symptoms typically include some combination of Cough#Classification, productive or dry cough, ches ...
-like symptoms or
meningitis Meningitis is acute or chronic inflammation of the protective membranes covering the brain and spinal cord, collectively called the meninges. The most common symptoms are fever, intense headache, vomiting and neck stiffness and occasion ...
may occur with a deeper or systemic infection. Fungi are everywhere, but only some cause disease. Fungal infection occurs after
spore In biology, a spore is a unit of sexual reproduction, sexual (in fungi) or asexual reproduction that may be adapted for biological dispersal, dispersal and for survival, often for extended periods of time, in unfavourable conditions. Spores fo ...
s are either breathed in, come into contact with skin or enter the body through the skin such as via a
cut Cut or CUT may refer to: Common uses * The act of cutting, the separation of an object into two through acutely directed force ** A type of wound ** Cut (archaeology), a hole dug in the past ** Cut (clothing), the style or shape of a garment ** ...
,
wound A wound is any disruption of or damage to living tissue, such as skin, mucous membranes, or organs. Wounds can either be the sudden result of direct trauma (mechanical, thermal, chemical), or can develop slowly over time due to underlying diseas ...
or
injection Injection or injected may refer to: Science and technology * Injective function, a mathematical function mapping distinct arguments to distinct values * Injection (medicine), insertion of liquid into the body with a syringe * Injection, in broadca ...
. It is more likely to occur in people with a weak immune system. This includes people with illnesses such as
HIV/AIDS The HIV, human immunodeficiency virus (HIV) is a retrovirus that attacks the immune system. Without treatment, it can lead to a spectrum of conditions including acquired immunodeficiency syndrome (AIDS). It is a Preventive healthcare, pr ...
, and people taking medicines such as
steroids A steroid is an organic compound with four fused rings (designated A, B, C, and D) arranged in a specific molecular configuration. Steroids have two principal biological functions: as important components of cell membranes that alter mem ...
or
cancer treatments Cancer treatments are a wide range of treatments available for the many different types of cancer, with each cancer type needing its own specific treatment. Treatments can include surgery, chemotherapy, radiation therapy, hormonal therapy, targe ...
.
Fungi A fungus (: fungi , , , or ; or funguses) is any member of the group of eukaryotic organisms that includes microorganisms such as yeasts and mold (fungus), molds, as well as the more familiar mushrooms. These organisms are classified as one ...
that cause infections in people include
yeast Yeasts are eukaryotic, single-celled microorganisms classified as members of the fungus kingdom (biology), kingdom. The first yeast originated hundreds of millions of years ago, and at least 1,500 species are currently recognized. They are est ...
s,
mold A mold () or mould () is one of the structures that certain fungus, fungi can form. The dust-like, colored appearance of molds is due to the formation of Spore#Fungi, spores containing Secondary metabolite#Fungal secondary metabolites, fungal ...
s and fungi that are able to exist as both a mold and yeast. The yeast ''
Candida albicans ''Candida albicans'' is an opportunistic pathogenic yeast that is a common member of the human gut flora. It can also survive outside the human body. It is detected in the gastrointestinal tract and mouth in 40–60% of healthy adults. It is usu ...
'' can live in people without producing symptoms, and is able to cause both superficial mild candidiasis in healthy people, such as oral thrush or
vaginal yeast infection Vaginal yeast infection, also known as candidal vulvovaginitis and vaginal thrush, is excessive growth of yeast in the vagina that results in irritation. The most common symptom is vaginal itching, which may be severe. Other symptoms include Dysur ...
, and severe systemic candidiasis in those who cannot fight infection themselves. Diagnosis is generally based on signs and symptoms,
microscopy Microscopy is the technical field of using microscopes to view subjects too small to be seen with the naked eye (objects that are not within the resolution range of the normal eye). There are three well-known branches of microscopy: optical mic ...
,
culture Culture ( ) is a concept that encompasses the social behavior, institutions, and Social norm, norms found in human societies, as well as the knowledge, beliefs, arts, laws, Social norm, customs, capabilities, Attitude (psychology), attitudes ...
, sometimes requiring a
biopsy A biopsy is a medical test commonly performed by a surgeon, interventional radiologist, an interventional radiologist, or an interventional cardiology, interventional cardiologist. The process involves the extraction of sampling (medicine), sample ...
and the aid of
medical imaging Medical imaging is the technique and process of imaging the interior of a body for clinical analysis and medical intervention, as well as visual representation of the function of some organs or tissues (physiology). Medical imaging seeks to revea ...
. Some superficial fungal infections of the skin can appear similar to other skin conditions such as
eczema Dermatitis is a term used for different types of skin inflammation, typically characterized by itchiness, redness and a rash. In cases of short duration, there may be small blisters, while in long-term cases the skin may become thickened ...
and
lichen planus Lichen planus (LP) is a chronic inflammatory and autoimmune disease that affects the skin, nails, hair, and mucous membranes. It is not an actual lichen, but is named for its appearance. It is characterized by polygonal, flat-topped, violaceous p ...
. Treatment is generally performed using antifungal medicines, usually in the form of a
cream Cream is a dairy product composed of the higher-fat layer skimmed from the top of milk before homogenization. In un-homogenized milk, the fat, which is less dense, eventually rises to the top. In the industrial production of cream, this proces ...
or by mouth or injection, depending on the specific infection and its extent. Some require surgically cutting out infected tissue. Fungal infections have a world-wide distribution and are common, affecting more than one billion people every year. An estimated 1.7 million deaths from fungal disease were reported in 2020. Several, including sporotrichosis,
chromoblastomycosis Chromoblastomycosis is a long-term mycosis, fungal infection of the skin and subcutaneous tissue (a chronic (medicine), chronic subcutaneous mycosis). It can be caused by many different types of fungi which become implanted under the skin, ofte ...
and
mycetoma Mycetoma is a chronic infection Subcutaneous tissue, in the skin caused by either bacteria (actinomycetoma) or fungi (eumycetoma), typically resulting in a triad of painless firm skin lumps, the formation of weeping sinus (anatomy), sinuses, and ...
are
neglected ''Xestia castanea'', the grey rustic or neglected, is a moth of the family Noctuidae. It is found from central Europe to Morocco, Turkey, Lebanon, Israel, Jordan and Syria. Technical description and variation The wingspan is 36–42 mm. F ...
. A wide range of fungal infections occur in other animals, and some can be transmitted from animals to people.


Classification

Mycoses are traditionally divided into
superficial Superficial may refer to: *Superficial anatomy, is the study of the external features of the body *Superficiality, the discourses in philosophy regarding social relation * Superficial charm, the tendency to be smooth, engaging, charming, slick and ...
, subcutaneous, or systemic, where infection is deep, more widespread and involving internal body organs. They can affect the nails,
vagina In mammals and other animals, the vagina (: vaginas or vaginae) is the elastic, muscular sex organ, reproductive organ of the female genital tract. In humans, it extends from the vulval vestibule to the cervix (neck of the uterus). The #Vag ...
,
skin Skin is the layer of usually soft, flexible outer tissue covering the body of a vertebrate animal, with three main functions: protection, regulation, and sensation. Other animal coverings, such as the arthropod exoskeleton, have different ...
and
mouth A mouth also referred to as the oral is the body orifice through which many animals ingest food and animal communication#Auditory, vocalize. The body cavity immediately behind the mouth opening, known as the oral cavity (or in Latin), is also t ...
. Some types such as
blastomycosis Blastomycosis, also known as Gilchrist's disease, is a fungal infection, typically of the lungs, which can spread to brain, stomach, intestine and skin, where it appears as crusting purplish warty plaques with a roundish bumpy edge and central ...
,
cryptococcus ''Cryptococcus'' is a genus of fungi in the family Cryptococcaceae that includes both yeasts and filamentous species. The filamentous, sexual forms or teleomorphs were formerly classified in the genus ''Filobasidiella'', while ''Cryptococcus' ...
,
coccidioidomycosis Coccidioidomycosis (, ) is a mammalian mycosis, fungal disease caused by ''Coccidioides immitis'' or ''Coccidioides posadasii''. It is commonly known as cocci, Valley fever, California fever, desert rheumatism, or San Joaquin Valley fever. Cocci ...
and
histoplasmosis Histoplasmosis is a fungal infection caused by ''Histoplasma capsulatum''. Symptoms of this infection vary greatly, but the disease affects primarily the lungs. Occasionally, other organs are affected; called disseminated histoplasmosis, it can ...
, affect people who live in or visit certain parts of the world. Others such as
aspergillosis Aspergillosis is a fungal infection of usually the lungs, caused by the genus ''Aspergillus'', a common mold that is breathed in frequently from the air, but does not usually affect most people. It generally occurs in people with lung diseases su ...
,
pneumocystis pneumonia ''Pneumocystis'' pneumonia (PCP), also known as ''Pneumocystis jirovecii'' pneumonia (PJP), is a form of pneumonia that is caused by the yeast-like fungus '' Pneumocystis jirovecii''. ''Pneumocystis'' specimens are commonly found in the lungs o ...
,
candidiasis Candidiasis is a fungal infection due to any species of the genus '' Candida'' (a yeast). When it affects the mouth, in some countries it is commonly called thrush. Signs and symptoms include white patches on the tongue or other areas of the ...
,
mucormycosis Mucormycosis, also known as black fungus, is a severe fungal infection that comes under fulminant fungal sinusitis, usually in people who are immunocompromised. It is curable only when diagnosed early. Symptoms depend on where in the body the ...
and talaromycosis, tend to affect people who are unable to fight infection themselves. Mycoses might not always conform strictly to the three divisions of superficial, subcutaneous and systemic. Some superficial fungal infections can cause systemic infections in people who are immunocompromised. Some subcutaneous fungal infections can invade into deeper structures, resulting in systemic disease. ''
Candida albicans ''Candida albicans'' is an opportunistic pathogenic yeast that is a common member of the human gut flora. It can also survive outside the human body. It is detected in the gastrointestinal tract and mouth in 40–60% of healthy adults. It is usu ...
'' can live in people without producing symptoms, and is able to cause both mild candidiasis in healthy people and severe
invasive candidiasis Invasive candidiasis is an infection ( candidiasis) that can be caused by various species of ''Candida'' yeast. Unlike ''Candida'' infections of the mouth and throat ( oral candidiasis) or vagina ( ''Candidal'' vulvovaginitis), invasive candidi ...
in those who cannot fight infection themselves.


ICD-11 codes

ICD-11 The ICD-11 is the eleventh revision of the International Classification of Diseases (ICD). It replaces the ICD-10 as the global standard for recording health information and causes of death. The ICD is developed and annually updated by the World H ...
codes include: * 1F20
Aspergillosis Aspergillosis is a fungal infection of usually the lungs, caused by the genus ''Aspergillus'', a common mold that is breathed in frequently from the air, but does not usually affect most people. It generally occurs in people with lung diseases su ...
* 1F21 Basidiobolomycosis * 1F22
Blastomycosis Blastomycosis, also known as Gilchrist's disease, is a fungal infection, typically of the lungs, which can spread to brain, stomach, intestine and skin, where it appears as crusting purplish warty plaques with a roundish bumpy edge and central ...
* 1F23 Candidosis * 1F24
Chromoblastomycosis Chromoblastomycosis is a long-term mycosis, fungal infection of the skin and subcutaneous tissue (a chronic (medicine), chronic subcutaneous mycosis). It can be caused by many different types of fungi which become implanted under the skin, ofte ...
* 1F25
Coccidioidomycosis Coccidioidomycosis (, ) is a mammalian mycosis, fungal disease caused by ''Coccidioides immitis'' or ''Coccidioides posadasii''. It is commonly known as cocci, Valley fever, California fever, desert rheumatism, or San Joaquin Valley fever. Cocci ...
* 1F26 Conidiobolomycosis * 1F27
Cryptococcosis Cryptococcosis is a potentially fatal fungal infection of mainly the lungs, presenting as a pneumonia, and in the brain, where it appears as a meningitis. Coughing, difficulty breathing, chest pain and fever are seen when the lungs are infect ...
* 1F28
Dermatophytosis Dermatophytosis, also known as tinea and ringworm, is a fungal infection of the skin (a dermatomycosis), that may affect skin, hair, and nails. Typically it results in a red, itchy, scaly, circular rash. Hair loss may occur in the area aff ...
* 1F29
Eumycetoma Eumycetoma, also known as Madura foot, is a persistent Mycoses, fungal infection of the skin and the tissues subcutaneous tissue, just under the skin, affecting most commonly the feet, although it can occur in hands and other body parts. It s ...
* 1F2A
Histoplasmosis Histoplasmosis is a fungal infection caused by ''Histoplasma capsulatum''. Symptoms of this infection vary greatly, but the disease affects primarily the lungs. Occasionally, other organs are affected; called disseminated histoplasmosis, it can ...
* 1F2B Lobomycosis * 1F2C
Mucormycosis Mucormycosis, also known as black fungus, is a severe fungal infection that comes under fulminant fungal sinusitis, usually in people who are immunocompromised. It is curable only when diagnosed early. Symptoms depend on where in the body the ...
* 1F2D Non-dermatophyte superficial dermatomycoses * 1F2E Paracoccidioidomycosis * 1F2F
Phaeohyphomycosis Phaeohyphomycosis is a diverse group of fungal infections, caused by dematiaceous fungi whose morphologic characteristics in tissue include hyphae, yeast-like cells, or a combination of these. It can be associated with an array of melanistic fil ...
* 1F2G Pneumocystosis * 1F2H Scedosporiosis * 1F2J Sporotrichosis * 1F2K Talaromycosis * 1F2L Emmonsiosis


Superficial mycoses

Superficial mycoses include
candidiasis Candidiasis is a fungal infection due to any species of the genus '' Candida'' (a yeast). When it affects the mouth, in some countries it is commonly called thrush. Signs and symptoms include white patches on the tongue or other areas of the ...
in healthy people, common tinea of the skin, such as tinea of the
body Body may refer to: In science * Physical body, an object in physics that represents a large amount, has mass or takes up space * Body (biology), the physical material of an organism * Body plan, the physical features shared by a group of anim ...
,
groin In human anatomy, the groin, also known as the inguinal region or iliac region, is the junctional area between the torso and the thigh. The groin is at the front of the body on either side of the pubic tubercle, where the lower part of the abdom ...
,
hands A hand is a prehensile, multi-fingered appendage located at the end of the forearm or forelimb of primates such as humans, chimpanzees, monkeys, and lemurs. A few other vertebrates such as the koala (which has two opposable thumbs on each "han ...
,
feet The foot (: feet) is an anatomical structure found in many vertebrates. It is the terminal portion of a limb which bears weight and allows locomotion. In many animals with feet, the foot is an organ at the terminal part of the leg made up of ...
and
beard A beard is the hair that grows on the jaw, chin, upper lip, lower lip, cheeks, and neck of humans and some non-human animals. In humans, beards are most commonly seen on pubescent or adult males, though women have been observed with beards ...
, and ''
malassezia ''Malassezia'' is a genus of fungi (specifically, a yeast belonging to the division Basidiomycota). Some species of ''Malassezia'' are found on the skin of animals, including humans. Because malassezia requires fat to grow, it is most common in ...
'' infections such as
pityriasis versicolor Pityriasis commonly refers to flaking (or scaling) of the skin. The word comes from the Greek πίτυρον 'bran'. Classification Types include: * Pityriasis alba, dry, fine-scaled, pale patches on the face * Pityriasis lichenoides chronica, c ...
. File:Human tongue infected with oral candidiasis.jpg, Oral candidiasis File:Dermatophytosis 20190815-02ASD.jpg, Tinea corporis File:Pityriasis versicolor frontal retouche.jpg, Pityriasis versicolor File:Toefungus.jpg,
Onychomycosis Onychomycosis, also known as tinea unguium, is a fungal infection of the nail. Symptoms may include white or yellow nail discoloration, thickening of the nail, and separation of the nail from the nail bed. Fingernails may be affected, but it is ...


Subcutaneous

Subcutaneous fungal infections include sporotrichosis,
chromoblastomycosis Chromoblastomycosis is a long-term mycosis, fungal infection of the skin and subcutaneous tissue (a chronic (medicine), chronic subcutaneous mycosis). It can be caused by many different types of fungi which become implanted under the skin, ofte ...
, and
eumycetoma Eumycetoma, also known as Madura foot, is a persistent Mycoses, fungal infection of the skin and the tissues subcutaneous tissue, just under the skin, affecting most commonly the feet, although it can occur in hands and other body parts. It s ...
.


Systemic

Systemic fungal infections include
histoplasmosis Histoplasmosis is a fungal infection caused by ''Histoplasma capsulatum''. Symptoms of this infection vary greatly, but the disease affects primarily the lungs. Occasionally, other organs are affected; called disseminated histoplasmosis, it can ...
,
cryptococcosis Cryptococcosis is a potentially fatal fungal infection of mainly the lungs, presenting as a pneumonia, and in the brain, where it appears as a meningitis. Coughing, difficulty breathing, chest pain and fever are seen when the lungs are infect ...
,
coccidioidomycosis Coccidioidomycosis (, ) is a mammalian mycosis, fungal disease caused by ''Coccidioides immitis'' or ''Coccidioides posadasii''. It is commonly known as cocci, Valley fever, California fever, desert rheumatism, or San Joaquin Valley fever. Cocci ...
,
blastomycosis Blastomycosis, also known as Gilchrist's disease, is a fungal infection, typically of the lungs, which can spread to brain, stomach, intestine and skin, where it appears as crusting purplish warty plaques with a roundish bumpy edge and central ...
,
mucormycosis Mucormycosis, also known as black fungus, is a severe fungal infection that comes under fulminant fungal sinusitis, usually in people who are immunocompromised. It is curable only when diagnosed early. Symptoms depend on where in the body the ...
,
aspergillosis Aspergillosis is a fungal infection of usually the lungs, caused by the genus ''Aspergillus'', a common mold that is breathed in frequently from the air, but does not usually affect most people. It generally occurs in people with lung diseases su ...
,
pneumocystis pneumonia ''Pneumocystis'' pneumonia (PCP), also known as ''Pneumocystis jirovecii'' pneumonia (PJP), is a form of pneumonia that is caused by the yeast-like fungus '' Pneumocystis jirovecii''. ''Pneumocystis'' specimens are commonly found in the lungs o ...
and systemic candidiasis. Systemic mycoses due to primary pathogens originate normally in the
lung The lungs are the primary Organ (biology), organs of the respiratory system in many animals, including humans. In mammals and most other tetrapods, two lungs are located near the Vertebral column, backbone on either side of the heart. Their ...
s and may spread to other organ systems. Organisms that cause systemic mycoses are inherently
virulent Virulence is a pathogen's or microorganism's ability to cause damage to a host. In most cases, especially in animal systems, virulence refers to the degree of damage caused by a microbe to its host. The pathogenicity of an organism—its abilit ...
.. Systemic mycoses due to opportunistic pathogens are infections of people with immune deficiencies who would otherwise not be infected. Examples of immunocompromised conditions include
AIDS The HIV, human immunodeficiency virus (HIV) is a retrovirus that attacks the immune system. Without treatment, it can lead to a spectrum of conditions including acquired immunodeficiency syndrome (AIDS). It is a Preventive healthcare, pr ...
, alteration of normal flora by antibiotics, immunosuppressive therapy, and metastatic cancer. Examples of opportunistic mycoses include
Candidiasis Candidiasis is a fungal infection due to any species of the genus '' Candida'' (a yeast). When it affects the mouth, in some countries it is commonly called thrush. Signs and symptoms include white patches on the tongue or other areas of the ...
,
Cryptococcosis Cryptococcosis is a potentially fatal fungal infection of mainly the lungs, presenting as a pneumonia, and in the brain, where it appears as a meningitis. Coughing, difficulty breathing, chest pain and fever are seen when the lungs are infect ...
and
Aspergillosis Aspergillosis is a fungal infection of usually the lungs, caused by the genus ''Aspergillus'', a common mold that is breathed in frequently from the air, but does not usually affect most people. It generally occurs in people with lung diseases su ...
.


Signs and symptoms

Most common mild mycoses often present with a rash. Infections within the skin or under the skin may present with a lump and skin changes. Less common deeper fungal infections may present with pneumonia-like symptoms or
meningitis Meningitis is acute or chronic inflammation of the protective membranes covering the brain and spinal cord, collectively called the meninges. The most common symptoms are fever, intense headache, vomiting and neck stiffness and occasion ...
.


Causes

Mycoses are caused by certain
fungi A fungus (: fungi , , , or ; or funguses) is any member of the group of eukaryotic organisms that includes microorganisms such as yeasts and mold (fungus), molds, as well as the more familiar mushrooms. These organisms are classified as one ...
;
yeast Yeasts are eukaryotic, single-celled microorganisms classified as members of the fungus kingdom (biology), kingdom. The first yeast originated hundreds of millions of years ago, and at least 1,500 species are currently recognized. They are est ...
s,
mold A mold () or mould () is one of the structures that certain fungus, fungi can form. The dust-like, colored appearance of molds is due to the formation of Spore#Fungi, spores containing Secondary metabolite#Fungal secondary metabolites, fungal ...
s and some fungi that can exist as both a mold and yeast. They are everywhere and infection occurs after spores are either breathed in, come into contact with skin or enter the body through the skin such as via a cut, wound or injection. ''Candida albicans'' is the most common cause of fungal infection in people, particularly as oral or vaginal thrush, often following taking antibiotics.


Risk factors

Fungal infections are more likely in people with weak immune systems. This includes people with illnesses such as HIV/AIDS, and people taking medicines such as
steroids A steroid is an organic compound with four fused rings (designated A, B, C, and D) arranged in a specific molecular configuration. Steroids have two principal biological functions: as important components of cell membranes that alter mem ...
or
cancer treatments Cancer treatments are a wide range of treatments available for the many different types of cancer, with each cancer type needing its own specific treatment. Treatments can include surgery, chemotherapy, radiation therapy, hormonal therapy, targe ...
. People with
diabetes Diabetes mellitus, commonly known as diabetes, is a group of common endocrine diseases characterized by sustained high blood sugar levels. Diabetes is due to either the pancreas not producing enough of the hormone insulin, or the cells of th ...
also tend to develop fungal infections. Very young and very old people, also, are groups at risk. Individuals being treated with
antibiotic An antibiotic is a type of antimicrobial substance active against bacteria. It is the most important type of antibacterial agent for fighting pathogenic bacteria, bacterial infections, and antibiotic medications are widely used in the therapy ...
s are at higher risk of fungal infections. Children whose
immune systems The immune system is a network of biological systems that protects an organism from diseases. It detects and responds to a wide variety of pathogens, from viruses to bacteria, as well as cancer cells, parasitic worms, and also objects such as ...
are not functioning properly (such as children with cancer) are at risk of invasive fungal infections.


COVID-19

During the
COVID-19 pandemic The COVID-19 pandemic (also known as the coronavirus pandemic and COVID pandemic), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), began with an disease outbreak, outbreak of COVID-19 in Wuhan, China, in December ...
some fungal infections have been associated with
COVID-19 Coronavirus disease 2019 (COVID-19) is a contagious disease caused by the coronavirus SARS-CoV-2. In January 2020, the disease spread worldwide, resulting in the COVID-19 pandemic. The symptoms of COVID‑19 can vary but often include fever ...
. Fungal infections can mimic COVID-19 and occur at the same time as COVID-19, and more serious fungal infections can complicate COVID-19. A fungal infection may occur after
antibiotics An antibiotic is a type of antimicrobial substance active against bacteria. It is the most important type of antibacterial agent for fighting pathogenic bacteria, bacterial infections, and antibiotic medications are widely used in the therapy ...
for a bacterial infection which has occurred following COVID-19. The most common serious fungal infections in people with COVID-19 include
aspergillosis Aspergillosis is a fungal infection of usually the lungs, caused by the genus ''Aspergillus'', a common mold that is breathed in frequently from the air, but does not usually affect most people. It generally occurs in people with lung diseases su ...
and invasive
candidiasis Candidiasis is a fungal infection due to any species of the genus '' Candida'' (a yeast). When it affects the mouth, in some countries it is commonly called thrush. Signs and symptoms include white patches on the tongue or other areas of the ...
. COVID-19–associated
mucormycosis Mucormycosis, also known as black fungus, is a severe fungal infection that comes under fulminant fungal sinusitis, usually in people who are immunocompromised. It is curable only when diagnosed early. Symptoms depend on where in the body the ...
is generally less common, but in 2021 was noted to be significantly more prevalent in India.


Mechanism

Fungal infections occur after spores are breathed in, come into contact with skin or enter the body through a wound.


Diagnosis

Diagnosis is generally by signs and symptoms,
microscopy Microscopy is the technical field of using microscopes to view subjects too small to be seen with the naked eye (objects that are not within the resolution range of the normal eye). There are three well-known branches of microscopy: optical mic ...
,
biopsy A biopsy is a medical test commonly performed by a surgeon, interventional radiologist, an interventional radiologist, or an interventional cardiology, interventional cardiologist. The process involves the extraction of sampling (medicine), sample ...
, culture and sometimes with the aid of
medical imaging Medical imaging is the technique and process of imaging the interior of a body for clinical analysis and medical intervention, as well as visual representation of the function of some organs or tissues (physiology). Medical imaging seeks to revea ...
.


Differential diagnosis

Some tinea and candidiasis infections of the skin can appear similar to
eczema Dermatitis is a term used for different types of skin inflammation, typically characterized by itchiness, redness and a rash. In cases of short duration, there may be small blisters, while in long-term cases the skin may become thickened ...
and
lichen planus Lichen planus (LP) is a chronic inflammatory and autoimmune disease that affects the skin, nails, hair, and mucous membranes. It is not an actual lichen, but is named for its appearance. It is characterized by polygonal, flat-topped, violaceous p ...
. Pityriasis versicolor can look like seborrheic dermatitis,
pityriasis rosea Pityriasis rosea is a type of skin rash. Classically, it begins with a single red and slightly scaly area known as a "herald patch". This is then followed, days to weeks later, by an eruption of many smaller scaly spots; pinkish with a red edge ...
,
pityriasis alba Pityriasis alba is a skin condition, a type of dermatitis, commonly seen in children and young adults as dry, fine-scaled, pale patches on the face. It is self-limiting and usually only requires use of moisturizer creams. The condition is so name ...
and
vitiligo Vitiligo (, ) is a chronic autoimmune disorder that causes patches of skin to lose pigment or color. The cause of vitiligo is unknown, but it may be related to immune system changes, genetic factors, stress, or sun exposure, and susceptibili ...
. Some fungal infections such as
coccidioidomycosis Coccidioidomycosis (, ) is a mammalian mycosis, fungal disease caused by ''Coccidioides immitis'' or ''Coccidioides posadasii''. It is commonly known as cocci, Valley fever, California fever, desert rheumatism, or San Joaquin Valley fever. Cocci ...
,
histoplasmosis Histoplasmosis is a fungal infection caused by ''Histoplasma capsulatum''. Symptoms of this infection vary greatly, but the disease affects primarily the lungs. Occasionally, other organs are affected; called disseminated histoplasmosis, it can ...
, and
blastomycosis Blastomycosis, also known as Gilchrist's disease, is a fungal infection, typically of the lungs, which can spread to brain, stomach, intestine and skin, where it appears as crusting purplish warty plaques with a roundish bumpy edge and central ...
can present with
fever Fever or pyrexia in humans is a symptom of an anti-infection defense mechanism that appears with Human body temperature, body temperature exceeding the normal range caused by an increase in the body's temperature Human body temperature#Fever, s ...
,
cough A cough is a sudden expulsion of air through the large breathing passages which can help clear them of fluids, irritants, foreign particles and Microorganism, microbes. As a protective reflex, coughing can be repetitive with the cough reflex fol ...
, and
shortness of breath Shortness of breath (SOB), known as dyspnea (in AmE) or dyspnoea (in BrE), is an uncomfortable feeling of not being able to breathe well enough. The American Thoracic Society defines it as "a subjective experience of breathing discomfort that con ...
, thereby resembling
COVID-19 Coronavirus disease 2019 (COVID-19) is a contagious disease caused by the coronavirus SARS-CoV-2. In January 2020, the disease spread worldwide, resulting in the COVID-19 pandemic. The symptoms of COVID‑19 can vary but often include fever ...
.


Prevention

Keeping the skin clean and dry, as well as maintaining good
hygiene Hygiene is a set of practices performed to preserve health. According to the World Health Organization (WHO), "Hygiene refers to conditions and practices that help to maintain health and prevent the spread of diseases." Personal hygiene refer ...
, will help larger topical mycoses. Because some fungal infections are contagious, it is important to wash hands after touching other people or animals. Sports clothing should also be washed after use.


Treatment

Treatment depends on the type of fungal infection, and usually requires
topical A topical medication is a medication that is applied to a particular place on or in the body. Most often topical medication means application to body surfaces such as the skin or mucous membranes to treat ailments via a large range of classes ...
or systemic antifungal medicines. Pneumocystosis that does not respond to anti-fungals is treated with
co-trimoxazole Trimethoprim/sulfamethoxazole, sold under the trade names Bactrim, Cotrim (a short form of the British Approved Name, Co-trimoxazole) and Septra, among others, is a fixed-dose combination antibiotic medication used to treat a variety of bac ...
. Sometimes, infected tissue needs to be surgically cut away.


Epidemiology

Worldwide, every year fungal infections affect more than one billion people. An estimated 1.6 million deaths from fungal disease were reported in 2017. The figure has been rising, with an estimated 1.7 million deaths from fungal disease reported in 2020. Fungal infections also constitute a significant cause of
illness A disease is a particular abnormal condition that adversely affects the structure or function (biology), function of all or part of an organism and is not immediately due to any external injury. Diseases are often known to be medical condi ...
and mortality in children. According to the Global Action Fund for Fungal Infections, every year there are over 10 million cases of fungal asthma, around 3 million cases of long-term aspergillosis of lungs, 1 million cases of blindness due to fungal keratitis, more than 200,000 cases of meningitis due to cryptococcus, 700,000 cases of invasive candidiasis, 500,000 cases of pneumocystosis of lungs, 250,000 cases of invasive aspergillosis, and 100,000 cases of histoplasmosis.


History

In 500 BC, an account of ulcers in the mouth by
Hippocrates Hippocrates of Kos (; ; ), also known as Hippocrates II, was a Greek physician and philosopher of the Classical Greece, classical period who is considered one of the most outstanding figures in the history of medicine. He is traditionally referr ...
may have described thrush. Paris-based Hungarian microscopist
David Gruby David Gruby (20 August 1810 – 14 November 1898) was a Hungarian physician born in the village of Kis-Kér (now Bačko Dobro Polje, Serbia) to a Jewish farmer.Geoffrey Clough Ainsworth, ''Introduction to the History of Medical and Veterinary Myc ...
first reported that human disease could be caused by fungi in the early 1840s.


SARS 2003

During the 2003 SARS outbreak, fungal infections were reported in 14.8–33% of people affected by SARS, and it was the cause of death in 25–73.7% of people with SARS.


Other animals

A wide range of fungal infections occur in other animals, and some can be transmitted from animals to people, such as ''
Microsporum canis ''Microsporum canis'' is a pathogenic, asexual fungus in the phylum Ascomycota that infects the upper, dead layers of skin on domesticated cats, and occasionally dogs and humans. The species has a worldwide distribution. Taxonomy and evolution ...
'' from cats.


See also

* *
Actinomycosis Actinomycosis is a rare infectious disease, infectious bacterial disease caused by the gram-positive ''Actinomyces'' species. The name refers to ray-like appearance of the organisms in the granules. About 70% of infections are due to either ''Acti ...
* Climate change and infectious diseases


References

{{Authority control Tropical diseases Animal fungal diseases Fungal diseases