Reprinted from www.antimicrobe.org Table 1. Disease Entities Caused by Black Fungi

Entity Common Pathogens Clinical Histopathologic Prognosis Manifestations characteristics Chromoblastomycosis Chronic wart- or Sclerotic bodies Limited infections: Cladosporium carrionii caulfilower-like ("copper pennies") cure is possible; F. compacta lesions of and Extensive infections: Phialaphora verrucosa subcutaneous tissue cure is rare Rhinocladiella aquaspersa Mycetoma Madurella mycetomatis Chronic skin and Mycotic granules Worse than M. grisea subcutaneous lesions chromoblastomycosis; Pyrenochaeta romeroi with swelling and Limited infections: draining sinus tracts cure is possible; Extensive infections: cure is very rare Subcutaneous E. jeanselmei Heterogenous: well- Fungi within non- Cystic form: good Wangiella dermatitidis formed cysts; keratinized tissue Non-encapsulated Phialophora spp. subcutaneous tissue beneath the dermal form: fair, depends on Bipolaris spp. invasion; extensive layer; no granules or extent of tissue sinus tracts sclerotic bodies invasion; cures less likely in immunosuppressed patients Alternaria spp. Indistinguishable Fungi within is and onychomycosis Hendersonula toruloidea from infections by keratinized tissue difficult to eradicate; Phialophora spp. with extensive host dermatomycosis has Onychocola spp. response and tissue better prognosis damage Keratitis Curvularia spp. Nodule progressing Superficial or deep Fair: residual visual Alternaria spp. to ; feathery, fungal invasion of damage common; 25% Exserohilum spp. branching pattern in cornea; require penetrating Lasiodiplodia cornea endopthalmitis rare keratoplasty theobromae Sinusitis: Bipolaris spp., Chronic sinusitis Sparse fungi; Cure is uncommon; Allergic Sinusitis Curvularia spp., eosinophil-rich frequent relapses Exserohilum spp., mucoid material Alternaria spp. (allergic mucin); Charcot-Leyden crystals Sinusitis: Bipolaris spp., Nasal congestion; ball: Good Fungus ball Curvularia spp., rhinosinusitis abundant fungi Exserohilum spp., within inflammatory Alternaria spp. mass Allergic Bipolaris spp., Cough, wheezing Airway inflammation Good bronchopulmonary Curvularia spp. Pneumonia Bipolaris spp. Chronic pneumonia Granulomas Immunocompetent pts: Ochroconis gallopavum good Chaetomium spp. Immunocompromised pts: fair Central nervous system Cladophialophora Brain abscess (usually Acute and chronic Poor infection bantiana single) (granulomatous) Ramichloridium Meningitis inflammation mackenzei Encephalitis (rare) Ochroconis gallopavum Disseminated infection Scedosporium Fever, skin lesions, Depends on sites of Poor, despite prolificans septic shock infection aggressive therapy Bipolaris spp. Wangiella dermatitidis