Candidiasis, Cryptococcosis, Chromomycosis, and Sporotrichosis

Candidiasis
Candidiasis, Cryptococcosis, Chromomycosis, and
Sporotrichosis
Name of Disease -- Candidiasis (Candidosis, Moniliasis,
Thrush (mucocutaneous candidiasis))
Causative agent -- Candida albicans and other species of Candida
Classification -- yeast-like fungi
The disease is more common in neonates, the elderly, and immunocompromised/
immunosuppressed/debilitated individuals
Mode of Transmission
Usually non-communicable since the organisms are normally present in low numbers on
the mucous membrane surfaces
May in some cases be acquired from contact with secretions from another individual
Neonates acquire the organisms from the mother during passage through the birth canal.
Thrush (Mucocutaneous form)
A mycosis confined to the superficial layers of the skin and/or mucous membranes.
Lesions -- red macules or ulcers on the skin with gray curdy patches on the mucous
membrane surface.
Ulcers or pseudomembranes may form on the esophagus, stomach, or intestine.
Disseminated form
Organisms may spread through the blood to internal organs such as the heart, liver,
spleen, kidney, lungs, meninges, brain, etc.
Tissues are invaded by the pseudohyphae of the organism producing tissue inflammation.

Immunization and Treatment
Immunization -- none
Treatment --
mucocutaneous infections - oral or topical Nystatin
systemic infections - oral Ketoconazole or I.V. Amphotericin B
Cryptococcosis
Name of the Disease -- Cryptococcosis
Causative Agent -- Cryptococcus neoformans
Classification of Causative Agent -- Fungus
Description -- Encapsulated, yeast-like fungus
Mode of Transmission
Inhalation of spores
Spores are associated with droppings of pigeons and bats.
Disease Progression
Mild self-limiting pulmonary infection is the most common
Debilitated individuals are susceptible to dissemination
Dissemination through the blood may result in a chronic type of meningitis
Immunization and Treatment
Immunization -- none
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Treatment -- Amphotericin B (Fungizone®) administered IV sometimes in combination
with 5-fluorocytosine
-- Fluconazone may be used as a follow up to an initial course of Amphotericin B

Chromomycosis
Name of Disease -- Chromomycosis
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Causative agent -- members of the genera: Phialophora, Fonsecaea, Cladosporium, or
Rhinocladiella
Classification -- filamentous fungi which are normally associated with decaying
vegetation primarily in tropical regions.
The disease is more common in tropical rural, barefooted agricultural workers.
Mode of transmission
Puncture wounds while going barefoot
The organism is associated with decaying vegetation.
Disease progression
Chronic, spreading infection of the skin and subcutaneous tissues of the feet and ankles
Slow progression (years) yielding ulcers and large cauliflower-like masses.
Swelling of the lower extremities is due to lymph stasis.
Immunization and Treatment
Immunization -- none
Treatment -- oral 5-fluorocytosine or Itraconazole
Sporotrichosis
Name of Disease -- Sporotrichosis
Causative agent -- Sporothrix schenckii
Classification -- diphasic fungus associated with decaying vegetation and especially
with sphagnum moss
Mode of transmission
By a puncture wound which implants some of the spores

The organism is associated with the soil and decaying vegetation.
Disease progression
The infection is acquired by a puncture wound which implants some of the spores into
the subcutaneous tissues
Begins as a primary nodule at the site of entry which may eventually ulcerate
Lymphatics draining the involved limb become firm and a series of nodules develop
along these lymphatic vessels
Involves only the subcutaneous tissues and lymphatics.
Immunization and Treatment
Immunization -- none
Treatment -- oral Lugol’s iodine solution (preferred) or Itraconazole
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