Table 3.91.

Fungal infections with occasional implications in dentistry

Disease	Organism	Source	Main endemic areas	Main features	Prognosis and treatment*
Aspergillosis	Aspergillus fumigatus Aspergillus flavus Aspergillus niger Others	Ubiquitous	Worldwide	Allergic bronchopulmonary Pulmonary disseminated aspergilloma	Variable
Blastomycosis	Blastomyces dermatitidis	Soil	Mississippi and Ohio valleys in USA, Canada, North Africa and Venezuela	Cavitary pulmonary Disseminated Others	Often good, except in disseminated form
Candidosis	Candida albicans Candida tropicalis Candida glabrata Candida parapsilosis Candida krusei Candida lusitaniae Candida kefyr Candida guilliermondii Candida dubliniensis	Ubiquitous	Worldwide	Oral and mucocutaneous lesions	Often good, except in disseminated forms
Coccidioidomycosis	Coccidiodes immitis	Soil	Southwestern USA, Mexico, Latin America	Acute pulmonary Disseminated Chronic pulmonary Meningitis	Often good, except in disseminated or meningeal form
Cryptococcosis	Cryptococcus neoformans	Soil, pigeon droppings	Worldwide	Pneumonia Meningitis Disseminated Cryptococcoma	Poor in disseminated form
Histoplasmosis	Histoplasma capsulatum	Soil, bird and bat droppings	Mississippi and Ohio valleys in USA, Latin America, Africa, India, Far East, Australia	Benign pulmonary Disseminated Chronic pulmonary Cutaneous	Often good, except in disseminated form
Mucormycosis	Mucor, Rhizopus and Absidia	Ubiquitous	Worldwide	Rhinocerebral Pulmonary Gastrointestinal	Variable
Paracoccidioidomycosis (South American blastomycosis)	Paracoccidioides brasiliensis	Soil	South America, esp. Brazil	Pulmonary Disseminated	Good in young patients
Pneumocystosis	Pneumocystis carinii	Ubiquitous	Worldwide	Pulmonary Disseminated	Variable
Sporotrichosis	Sporothrix schenkii	Associated with thorny plants, wood, sphagnum moss	Worldwide	Lymphocutaneous Localised cutaneous Pulmonary Disseminated	Good

^*Apart from candidosis, the rest require systemic treatment with fluconazole or another azole (e.g. ketoconazole, miconazole, itraconazole, voriconazole), or amphotericin. Candidosis may respond to topical antifungals (nystatin, amphotericin or an azole).