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Dematiaceous Molds.

Eunice H Wong1, Sanjay G Revankar1

  • 1Division of Infectious Diseases, Harper University Hospital, Wayne State University, 3990 John R., 5 Hudson, Detroit, MI 48201, USA.

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Dematiaceous fungi cause phaeohyphomycosis, ranging from local to disseminated infections. Melanin in fungal cell walls may contribute to virulence, and azoles show consistent in vitro activity against these challenging infections.

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Area of Science:

  • Medical Mycology
  • Infectious Diseases

Background:

  • Phaeohyphomycosis is a spectrum of clinical syndromes caused by dematiaceous fungi.
  • These fungi possess melanin in their cell walls, potentially acting as a virulence factor.
  • Infections range from localized traumatic implantation to disseminated disease in immunocompromised individuals.

Purpose of the Study:

  • To review the clinical syndromes, pathogenesis, and treatment of phaeohyphomycosis.
  • To highlight the role of melanin in the virulence of dematiaceous fungi.
  • To discuss the in vitro antifungal activity of azoles.

Main Methods:

  • Literature review of clinical cases and laboratory studies on dematiaceous fungi and phaeohyphomycosis.
  • Analysis of the role of fungal melanin in pathogenesis.
  • Evaluation of in vitro antifungal susceptibility data.

Main Results:

  • Phaeohyphomycosis presents with diverse clinical manifestations.
  • Melanin in fungal cell walls is a unique characteristic and potential virulence factor.
  • Systemic phaeohyphomycosis is often difficult to treat, while local infections may respond to surgical excision.
  • Azoles demonstrate the most reliable in vitro activity.

Conclusions:

  • Further research is essential to elucidate the pathogenesis of phaeohyphomycosis.
  • Improved therapeutic strategies are needed for systemic infections.
  • Understanding the role of melanin may lead to targeted treatments.