Candidiasis (Moniliasis)

Candidiasis is a fungal infection caused by a yeast (a type of fungus) called Candida. Some species of
Candida can cause infection in people; the most common is Candida albicans. Candida normally lives on
the skin and inside the body, in places such as the mouth, throat, gut, and vagina, without causing any
problems.

The picture with angles of the mouth are also the places where intertriginous conditions favor the
overgrowth of ubiquitous C. albicans.

In this picture, Oral thrush causes creamy white lesions, usually on tongue or inner cheeks. Sometimes
oral thrush may spread to the roof of mouth, gums or tonsils, or the back of the throat.
Nail Infection

In this picture, Nail infections caused by Candida can affect the nail plate (onychomycosis—seen at the
bottom of the nail), the edges of the nail (paronychia), or both.

Vaginal candidiasis

The picture shows a white or yellow cheeselike discharge from the vagina and burning, itching, and
redness along the walls and external area of the vagina.
Systemic candidiasis/ Candidemia

Picture shows the agar of systemic Candidiasis

Candida endophthalmitis

Picture presents the retinal lesions from Systemic candidiasis. It presents first as chorioretinitis with
minimal vitritis (vitreous inflammation) then later progresses to produce vitreous and sometimes aqueous
infection.
CRYTOCOCCOSIS (TORULOSIS OR EUROPEAN BLASTOMYCOSIS)

a chronic fungal infection of humans caused by Cryptococcocus neoformans and C. gattii.

Cryptococcal Meningitis

This picture, Cryptococcal meningitis is a fungal infection of the tissues covering the brain and spinal
cord. It is usually presents as a subacute meningoencephalitis. The patient commonly presents with
neurological symptoms such as a headache, altered mental status.

Pulmonary cryptococcosis

Pulmonary cryptococcosis is commonly seen in immunocompromised patients and it has become an

emerging disease in immunocompetent patients.

The findings of computed tomography scans vary: a) a single small nodule; b) a single large nodule; c)
multiple lung nodules; d) pneumonia, with a single focus of a dense pulmonary infiltrate; e) multiple
patches with lower density shadows; f) mixed, both nodule and pneumonic foci in bilateral lungs.
Biopsy results (c-d), Cryptococcus sp. yeasts (black arrows)

Cutaneous cryptococcosis

During the dermatological examination, well-defined papules and

nodules, erythematous, some with generalized centralis depression,
were noticed, being more exuberant, however, in the face, anterior and
posterior region of the trunk (Fig. 1,2).

A biopsy of the cutaneous injury was made, and the histopathological examination, by optical
microscopy with hematoxylin-eosin, revealed epidermis with acantholysis and dermis
with agglomerate presence of vacuolized cells. The PAS and Grocott staining (Fig. 4, 5) had been
positive for encapsulated yeast cells suggesting Cryptococcus neoformans.

Systemic cryptococcosis

Clinical photograph of the patient showing pruritic, umbilicated, papular skin lesions with
scarring over the left leg Photomicrographs showing (B) epithelioid cell granuloma with
numerous intracellular and extracellular round to oval capsulated organisms consistent with the
morphology of cryptococcal spores (arrow) on May Grunwald Giemsa stain 200× and (C)
numerous cryptococcal spores with capsule in the form of a halo around each yeast, phagocytied
by a multinucleated giant cell. Hematoxylin and Eosin stain 400×. Inset shows spherical yeast
form of Cryptococcus highlighted on Periodic Acid Schiff stain 1000×.

ASPERGILLOSIS

Aspergillosis is an infection caused by Aspergillus, a common mold (a type of fungus) that lives indoors
and outdoors.

Pulmonary Aspergillosis
a 38-year-old Ghanaian male on his 3rd week of treatment for smear-negative tuberculosis (TB) was
referred to our hospital for further management of massive hemoptysis. He had noticed a small amount of
hemoptysis about 1 month prior to his current visit along with weight loss, low-grade fevers, and night
sweats. After reviewing the patient’s history and obtaining chest radiographs (Fig. 1A), the infectious
disease physician at our hospital made a clinical diagnosis of aspergilloma. Chest radiograph showing
fungal ball in the left apical lung taken at initial diagnosis; (B) 5 months into treatment with 200 mg of
daily itraconazole showing the aspergilloma.

Fig. 2. Chest computed tomography scan showing bilateral apical post-tuberculosis lung fibrosis
and a left apical 5.5 × 5.4-cm2 thick-walled cavity with a solid intracavity mass with air crescent
sign. (A) Lung; (B) mediastinal window.

MUCORMYCOSIS

Mucormycosis (previously called zygomycosis) is a serious but rare fungal infection caused by a group of
molds called mucormycetes. These molds live throughout the environment.

Primary Breast Mucormycosis

A sample picture of a female patient that her left breast was swollen, red, tender and warm with a
necrotic lesion of 3x4 cm.

Cutaneous Mucormycosis

In this Picture, upon re-evaluation of the leg wounds, development of necrotic eschars
at the wound margins was observed (Fig. 2 a). Day 4: the patient was put on mechanical ventilation (GCS<8/15) and
underwent extensive tissue debridement (Fig. 2 b, c, d). Liposomal amphotericin B (10mg /kg /24h) was added to the
antibiotic scheme on suspicion of mucormycosis.
PNEUMOCYSTIS PNEUMONIA

Pneumocystis pneumonia (PCP) is a serious infection caused by the fungus Pneumocystis jirovecii.
Scientists have changed both the classification and the name of this organism since it first appeared in
patients with HIV in the 1980s.  Pneumocystis jirovecii used to be classified as a protozoan but is now
considered a fungus.

A 50-year-old man presented to the pulmonology clinic with complaints of fever, weight loss and
productive cough since the last 1 month. His fever was low grade and spiked in the evenings, reaching a
maximum of 38°C. He had previously taken several antibiotics without any relief and most recently had
finished a course of amoxicillin for 7 days.

His chest X-ray showed bilateral diffuse interstitial prominence with nodular infiltrates (figure 1).

CT scan showed patchy area of ground glass with relative sparing of the apices and intralobular septal
thickening with some nodular infiltrates in bilateral lung fields (figure 2).
Chest X-ray was repeated and it showed alveolar infiltrates on bilateral perihilar and lower zones (figure
3).

Microscopy of the specimen with the silver stain, the periodic acid-Schiff-diastase stain and
immunofluorescent staining did not reveal anything of significance; no evidence of granulomatous
inflammation or malignancy was seen. However, within the alveolar spaces, pink frothy proteinaceous
exudate was visualised (figure 4).

TALAROMYCOSIS (FORMERLY PENICILLIOSIS)

Talaromycosis is an infection caused by the fungus Talaromyces marneffei. The name of the fungus and
the name of the infection have changed. T. marneffei used to be called Penicillium marneffei, and
talaromycosis used to be called penicilliosis.  Talaromycosis only affects people who live in or visit
Southeast Asia, southern China, or eastern India.
A-28-year-old male military personnel presented with a four day history of right sided non-colicky
abdominal pain radiating to the back, and associated with fever and rigor for two weeks, at Regional
Institute of Medical Sciences (RIMS), Imphal, Manipur, India.

An abdominal radiograph was non-contributory and computed tomography of the abdomen multiple
enlarged mesentric lymph nodes [Table/Fig-1]. Patient was treated conservatively and started on
broad spectrum intravenous antibiotics (ceftriaxone and ofloxacin) but his condition did not improve.

Cultures of blood and lymph node aspirate showed growth on 3rd day itself which were consistent
with culture characteristics of Penicillium marneffei [Table/Fig-3]. Peri oral umbilicated lesions
[Table/Fig-4] appeared in the 4th day during the course of antifungal treatment which further
described the Penicillium dissemination.
REFERENCES

https://www.cdc.gov/fungal/diseases/candidiasis/index.html

https://www.mayoclinic.org/diseases-conditions/oral-thrush/symptoms-causes/syc-20353533

https://www.msdmanuals.com/home/skin-disorders/fungal-skin-infections/candidiasis-yeast-
infection

https://www.uptodate.com/contents/treatment-of-endogenous-endophthalmitis-due-to-candida-
species

https://www.msdmanuals.com/professional/infectious-diseases/fungi/cryptococcosis

https://www.ncbi.nlm.nih.gov/books/NBK525986/

https://academic.oup.com/mmy/article/57/2/133/5133472

https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-020-4818-1

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https://www.sciencedirect.com/science/article/pii/S1876034117302496

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