FUNGAL DISEASES

Types of Fungal Diseases

Fungi are everywhere. There are millions of different fungal species on Earth, but
only about 300 of those are known to make people sick. 1-3 Fungal diseases are
often caused by fungi that are common in the environment. Fungi live outdoors
in soil and on plants and trees as well as on many indoor surfaces and on human
skin. Most fungi are not dangerous, but some types can be harmful to health.

Aspergillosis
Caused by the fungus Aspergillus and usually occurs in people with lung diseases
or weakened immune systems.

Candidiasis
Caused by the yeast Candida. Candidiasis can occur in the mouth and throat,
vagina, or the bloodstream.

Coccidioidomycosis (Valley Fever)

Caused by Coccidioides, a fungus that lives in the southwestern United States and
parts of Mexico and Central and South America.

C. gattii Infection
Caused by Cryptococcus gattii, which lives in tropical and sub-tropical areas of the
world, the United States Pacific Northwest, and British Columbia.

Fungal Nail Infections

Common infections of the fingernails or toenails.

Mucormycosis
A rare infection that mainly affects people with weakened immune systems.

Pneumocystis pneumonia (PCP)

Caused by the fungus Pneumocystis jiroveciiand mainly affects people with
weakened immune systems.

Sporotrichosis
Caused by the fungus Sporothrix, which lives throughout the world in soil and on
plants.
Blastomycosis
Caused by the fungus Blastomyces, which lives in moist soil in parts of the United
States and Canada

Candida auris
Emerging, often multidrug-resistant fungus found in healthcare settings that
presents a serious global health threat.

C. neoformans Infection
Caused by Cryptococcus neoformans, which can infect the brain, causing
meningitis in people with weakened immune systems, particularly those who
have HIV/AIDS.

Fungal Eye Infections

Rare infections that can develop after an eye injury or eye surgery.

Histoplasmosis
Caused by the fungus Histoplasma, which lives in the environment, often in
association with large amounts of bird or bat droppings.

Mycetoma
Caused by certain types of bacteria and fungi found in soil and water, typically in
rural regions of Africa, Latin America, and Asia.

Ringworm
A common fungal skin infection that often looks like a circular rash.

Talaromycosis
Caused by Talaromyces, a fungus found in Southeast Asia, southern China, or
eastern India and affects people who have weakened immune systems.

Blastomycosis
Caused by the fungus Blastomyces, which lives in moist soil in parts of the United States and Canada
symptoms
Fever
Cough
Night sweats
Muscle aches or joint pain
Weight loss
Chest pain
Fatigue (extreme tiredness)
Causes
Anyone can get blastomycosis if they’ve been in an  area where Blastomyces lives in the
environment. People who participate in outdoor activities that expose them to wooded areas (such
as forestry work, hunting, and camping) in these areas may be at higher risk for getting
blastomycosis.1 People who have weakened immune systems may be more likely to develop severe
blastomycosis than people who are otherwise healthy.
diagnosed
Healthcare providers use your medical and travel history, symptoms, physical examinations, and
laboratory tests to diagnose blastomycosis. A doctor will likely test for blastomycosis by taking a blood
sample or a urine sample and sending it to a laboratory.
Healthcare providers may do imaging tests such as chest x-rays or CT scans of your lungs. They may also
collect a sample of fluid from your respiratory tract or perform a tissue biopsy, in which a small sample
of affected tissue is taken from the body and examined under a microscope. Laboratories may also see
if Blastomyces will grow from body fluids or tissues (this is called a culture).
treatment
antifungal medication. Itraconazole is a type of antifungal medication that is typically used to treat mild
to moderate blastomycosis. Amphotericin B is usually recommended for severe blastomycosis in the
lungs or infections that have spread to other parts of the body. Depending on the severity of the
infection and the person’s immune status, the course of treatment can range from six months to one
year

Candidiasis
Candidiasis is a fungal infection caused by yeasts that belong to the
genusCandida. There are over 20 species of Candida yeasts that can cause
infection in humans, the most common of which is Candida albicans.

types

 Candida infections of the mouth, throat, and esophagus

 Vaginal Candidiasis
 Invasive Candidiasis

Symptoms

 White patches on the inner cheeks, tongue, roof of the mouth, and throat
(photo showing candidiasis in the mouth)
 Redness or soreness
 Cottony feeling in the mouth
 Loss of taste
 Pain while eating or swallowing
  Cracking and redness at the corners of the mouth

Risk & Prevention

Who gets candidiasis in the mouth, throat, or esophagus?
Candidiasis in the mouth, throat, or esophagus is uncommon in healthy adults.
People who are at higher risk for getting candidiasis in the mouth and throat
include babies, especially those younger than one month old, and people who: 3-7

 Wear dentures
 Have diabetes
 Have cancer
 Have HIV/AIDS
 Take antibiotics or corticosteroids, including inhaled corticosteroids for
conditions like asthma
 Take medications that cause dry mouth or have medical conditions that
cause dry mouth
 Smoke

Diagnosis & Testing

Healthcare providers can usually diagnose candidiasis in the mouth or throat
simply by looking inside.8Sometimes a healthcare provider will take a small
sample from the mouth or throat. The sample is sent to a laboratory for testing,
usually to be examined under a microscope.

Healthcare providers usually diagnose candidiasis in the esophagus by doing an

endoscopy. An endoscopy is a procedure to examine the digestive tract using a
tube with a light and a camera. A healthcare provider might prescribe antifungal
medication without doing an endoscopy to see if the patient’s symptoms get
better. 

Treatment
Candidiasis in the mouth, throat, or esophagus is usually treated with antifungal
medicine.6 The treatment for mild to moderate infections in the mouth or throat
is usually an antifungal medicine applied to the inside of the mouth for 7 to 14
days. These medications include clotrimazole, miconazole, or nystatin. For severe
infections, the treatment is usually fluconazole or another type of antifungal
medicine given by mouth or through a vein for people who don’t get better after
taking fluconazole. The treatment for candidiasis in the esophagus is usually
fluconazole. Other types of prescription antifungal medicines can also be used for
people who can’t take fluconazole or who don’t get better after taking
fluconazole.

Vaginal Candidiasis
Definition
Candidiasis is an infection caused by a yeast (a type of fungus)
called Candida. Candida normally lives inside the body (in places such as the
mouth, throat, gut, and vagina) and on skin without causing any problems.
Sometimes Candida can multiply and cause an infection if the environment inside
the vagina changes in a way that encourages its growth. Candidiasis in the vagina
is commonly called a “vaginal yeast infection.” Other names for this infection are
“vaginal candidiasis,” “vulvovaginal candidiasis,” or “candidal vaginitis.”

 Symptoms
The symptoms of vaginal candidiasis include:1,2

 Vaginal itching or soreness

 Pain during sexual intercourse
 Pain or discomfort when urinating
 Abnormal vaginal discharge

Although most vaginal candidiasis is mild, some women can develop severe
infections involving redness, swelling, and cracks in the wall of the vagina.

Contact your healthcare provider if you have any of these symptoms. These
symptoms are similar to those of other types of vaginal infections, which are
treated with different types of medicines. A healthcare provider can tell you if you
have vaginal candidiasis and how to treat it.
Risk & Prevention
Who gets vaginal candidiasis?
Vaginal candidiasis is common, though more research is needed to understand
how many women are affected. Women who are more likely to get vaginal
candidiasis include those who:

 Are pregnant
 Use hormonal contraceptives (for example, birth control pills)
 Have diabetes
 Have a weakened immune system (for example, due to HIV infection or
medicines that weaken the immune system, such as steroids and
chemotherapy)
 Are taking or have recently taken antibiotics

 How can I prevent vaginal candidiasis?

Wearing cotton underwear might help reduce the chances of getting a yeast
infection.2 Because taking antibiotics can lead to vaginal candidiasis, take these
medicines only when prescribed and exactly as your healthcare provider tells you.
Learn more about when antibiotics work and when they should be avoided.

 Sources
Candida normally lives inside the body (in places such as the mouth, throat, gut,
and vagina) and on skin without causing any problems. Scientists estimate that
about 20% of women normally have Candida in the vagina without having any
symptoms.2 Sometimes, Candida can multiply and cause an infection if the
environment inside the vagina changes in a way that encourages its growth. This
can happen because of hormones, medicines, or changes in the immune system.

Diagnosis & Testing

A laboratory test is usually needed to diagnose vaginal candidiasis because the
symptoms are similar to those of other types of vaginal infections. A healthcare
provider will usually diagnose vaginal candidiasis by taking a small sample of
vaginal discharge to be examined under a microscope or sent to a laboratory for
a fungal culture. However, a positive fungal culture does not always mean
that Candida is causing the symptoms because some women can have Candida in
the vagina without having any symptoms.

 Treatment
Vaginal candidiasis is usually treated with antifungal medicine. 3 For most
infections, the treatment is an antifungal medicine applied inside the vagina or a
single dose of fluconazole taken by mouth. For more severe infections, infections
that don’t get better, or keep coming back after getting better, other treatments
might be needed. These treatments include more doses of fluconazole taken by
mouth or other medicines applied inside the vagina such as boric acid, nystatin,
or flucytosine.

INVASIVE CANDIDIASIS

Photomicrograph of the fungus Candida albicans

Invasive candidiasis is an infection caused by a yeast (a type of fungus)
called Candida.  Unlike Candida infections in the mouth and throat (also called
“thrush”) or vaginal “yeast infections,” which are localized to one part of the body,
invasive candidiasis is a serious infection that can affect the blood, heart, brain,
eyes, bones, or other parts of the body

People who develop invasive candidiasis are often already sick from other
medical conditions, so it can be difficult to know which symptoms are related to
a  Candida  infection. However, the most common symptoms of invasive
candidiasis are fever and chills that don’t improve after antibiotic treatment for
suspected bacterial infections. Other symptoms can develop if the infection
spreads to other parts of the body, such as the heart, brain, eyes, bones, or joints.

Who gets invasive candidiasis?

Most cases of invasive candidiasis occur in people who have recently been
admitted to a hospital or been in contact with other healthcare settings such as
nursing homes. People who are at high risk for developing invasive candidiasis
include:1

 Patients who have a central venous catheter

 Patients in the intensive care unit (ICU)
 People who have weakened immune systems (for example, people who
have had an organ transplant,  have HIV/AIDS, or are on cancer
chemotherapy)
 People who have taken broad-spectrum antibiotics
 People who have a very low neutrophil (a type of white blood cell) count
(neutropenia)
 People who have kidney failure or are on hemodialysis
 Patients who have had surgery, especially gastrointestinal surgery
 Patients who have diabetes
 Diagnosis
 The most common way that healthcare providers test for invasive
candidiasis is by taking a blood sample and sending it to a laboratory to
see if it will grow Candida in a culture.
 Treatment
 The specific type and dose of antifungal medication used to treat invasive
candidiasis usually depends on the patient’s age, immune status, and
location and severity of the infection. For most adults, the initial
recommended antifungal treatment is an echinocandin (caspofungin,
micafungin, or anidulafungin) given through the vein (intravenous or IV).
Fluconazole, amphotericin B, and other antifungal medications may also be
appropriate in certain situations.

Athlete's foot
Tinea pedis or athlete's foot is a common fungal infection that affects the foot.
Athlete's foot is commonly associated with sports and athletes because the fungus
grows perfectly in warm, moist environments, such as socks and shoes, sports
equipment, and locker rooms.
In reality, anyone may be affected by athlete's foot. It is most common in warmer
climates and summer months, where it can quickly multiply.
Symptoms
The symptoms of athlete's foot may vary slightly from person to person. Classic
symptoms include:
redness or blisters on the affected area
the infected skin may be soft, or layers may start to break down
peeling or cracking skin
the skin may scale and peel away
itching, stinging, or burning sensations in the infected area
Diagnosis, treatment, and prevention
Not all itchy feet are the result athlete's foot. Doctors usually diagnose the infection
by scraping scaling skin off of a person and inspecting it under a microscope for
evidence of any fungus.
There are a few different fungi that can cause athlete's foot. The infection may
behave differently depending on the specific fungus that is infecting the skin.
Athlete's foot is often treated with topical antifungal ointments, which are available
to purchase over-the-counter or online. Severe infections can require additional oral
medications as well. The feet will also need to be cared for and kept dry to help kill
the fungus.
Prevention methods include allowing the feet plenty of air to breathe and keeping
them clean and dry. It is a good idea to wear sandals in public showers or locker
rooms.
Yeast infection
Vaginal yeast infections are a common form of Candida overgrowth in women,
usually caused byCandida albicans.
An overgrowth of Candida disrupts the normal balance of the bacteria and yeast in
the vagina. This imbalance of bacteria may be due to antibiotics, stress, and hormone
imbalances, or poor eating habits, among other things.
Candida infections can also commonly cause fungal toenail infections and diaper
rash.
Symptoms
Symptoms of a yeast infection include:
itching and swelling around the vagina
burning sensations or pain during urination or intercourse
redness and soreness on and surrounding the vagina
unusual vaginal discharge, such as gray clumps that resemble cottage cheese or a
very watery discharge
A rash may develop over time in some cases. Yeast infections should be treated
quickly, as the symptoms may become severe if left untreated.
Diagnosis, treatment, and prevention
The classic symptoms of a yeast infection make them easy to diagnose. Doctors may
ask about the person's medical history, such as any previous yeast infections
or sexually transmitted infections(STIs). They may also ask whether the person was
recently taking antibiotics.
Doctors will then examine the vaginal walls and cervix for signs of infection, taking
cells from the vagina if necessary for proper diagnosis.
Treatment of yeast infections depends on their severity. Standard treatments include
creams, tablets, or suppositories, which are available via prescription, or over-the-
counter or online. Complicated infections may require complex treatments.
Avoiding yeast infections begins with a balanced diet and proper hygiene. Wearing
loose-fitting clothing made from natural fibers may also help prevent infection.
Washing underwear in very hot water and changing feminine products often can also
help prevent fungal growth.
Jock itch
Tinea cruris, commonly known as jock itch, is another common fungal skin infection.
These fungi love warm and damp environments and thrive in moist areas of the
body, such as the groin, buttocks, and inner thighs. Jock itch may be more common
in summer or in warm, humid areas of the world.
Jock itch is mildly contagious and is often spread through direct contact with an
infected person or an object that is carrying the fungus.
Symptoms
Jock itch appears on the body as an itchy, red rash that often has a circular shape to
it. Symptoms include:
redness in the groin, buttocks, or thighs
chafing, irritation, itching, or burning in the infected area
a red rash with a circular shape and raised edges
cracking, flaking, or dry peeling of the skin in the infected area

Diagnosis, treatment, and prevention

Jock itch has a very particular look and can usually be identified based on its
appearance. If doctors are uncertain, they may take a skin sample to inspect and
confirm their diagnosis.
Treating jock itch usually involves topical antifungal ointments and proper hygiene.
Many cases of jock itch are improved by over-the-counter medications, though some
require prescription medications. Cleaning the affected area and keeping it dry can
also help kill the fungus.
Jock itch can be prevented by wearing loose-fitting natural fibers, such as cotton
underwear which is available to buy online. Avoiding contact with others who have
the infection is also important. Avoiding shared items, such as towels and sporting
equipment may also help.
Ringworm
Tinea corporis or ringworm is a skin infection caused by a fungus that lives on dead
tissues, such as the skin, hair, and nails. Ringworm is the fungus that causes both jock
itch and athlete's foot. When it appears anywhere else on the body, the infection is
just called ringworm.
Symptoms
Ringworm is usually easy to notice because of its shape. A red patch that may itch or
be scaly will often turn into a raised, ring-shaped patch of skin over time. It may even
spread out into several rings.
The outside of this ring is red and may appear raised or bumpy, while the inside of
the ring will remain clear or become scaly.
Ringworm is highly contagious, and it can be transmitted by skin-to-skin contact, or
from contact with pets, such as dogs. The fungus may also survive on objects, such as
towels, clothes, and brushes.
The ringworm fungus also infects soil and mud, so people who play or work in
infected dirt may catch ringworm as well.
Diagnosis, treatment, and prevention
Other skin conditions may look like ringworm, so doctors will usually want to take a
skin sample to inspect for the fungus.
After confirming a diagnosis, doctors will recommend a treatment, depending on
how severe the symptoms are.
Creams and medicated ointments are often sufficient to treat many cases of
ringworm, and may be purchased over-the-counter or online. Ringworm of the scalp
or severe ringworm may require a prescription.
Basic hygiene can help treat and prevent ringworm as well. Keeping the skin clean
and dry can help avoid infection.
Safety in public includes wearing sandals into public showers or locker rooms and
avoiding shared items and towels.

Fungal Nail Infections

Definition
Fungal nail infections are common infections of the fingernails or toenails that
can cause the nail to become discolored, thick, and more likely to crack and
break. Infections are more common in toenails than fingernails. 1 The technical
name for a fungal nail infection is “onychomycosis.”
Symptoms
Nails with a fungal infection are often:
Discolored (yellow, brown, or white)
Thick
Fragile or cracked
A fungal nail infection usually isn’t painful unless it becomes severe.
Some people who have fungal toenail infections also have a fungal skin infection
on the foot, especially between the toes (commonly called “athlete’s foot”).
How does someone get a fungal nail infection?
Fungal nail infections can be caused by many different types of fungi (yeasts or
molds) that live in the environment. Small cracks in your nail or the surrounding
skin can allow these germs to enter your nail and cause an infection.
Who gets fungal nail infections?
Anyone can get a fungal nail infection. Some people may be more likely than
others to get a fungal nail infection, including older adults and people who have
the following conditions:2,3
A nail injury or nail surgery
Diabetes
A weakened immune system
Blood circulation problems
Athlete’s foot (ringworm on the foot)
Prevention
Keep your hands and feet clean and dry.
Clip your fingernails and toenails short and keep them clean.
Don’t walk barefoot in areas like locker rooms or public showers.
Don’t share nail clippers with other people.
When visiting a nail salon, choose a salon that is clean and licensed by your
state’s cosmetology board. Make sure the salon sterilizes its instruments (nail
clippers, scissors, etc.) after each use, or, you can bring your own
Diagnosis
Your healthcare provider may diagnose a fungal nail infection by looking at the
affected nail and asking questions about your symptoms. He or she may also take
a nail clipping to look at under a microscope or send to a laboratory for a fungal
culture. 
Treatment
Fungal nail infections can be difficult to cure, and they typically don’t go away
without antifungal treatment. The best treatment for a fungal nail infection is
usually prescription antifungal pills taken by mouth. In severe cases, a doctor
might remove the nail completely. It can take several months to a year for the
infection to go away.