[Current role of deep mycoses in infectious pathology]

Deep mycoses present new aspects characterized by deep, visceral mycotic localisations and septicemia, particularly in immunocompromised conditions. In immunodepressed patients (leukaemia, transplantation), the granulopenia descending to 500 elements/ml leads not only to invasive aspergillosis and candidosis but also to infections due to opportunistic fungi exceptionally or never seen formerly. AIDS favours opportunistic fungi related to defective cellular immunity as Cryptococcus neoformans, responsible of severe meningoencephalitis and septicemia, as Candida albicans responsible of thrush and oesophagitis, but also true pathogenic fungi (Histoplasma capsulatum) becoming opportunistic in such conditions. C. albicans provokes in heroin addicts a new septicemic syndrome with cutaneous, ocular and osteoarticular lesions and in leukaemic patients hepatic micro-abscesses soon after the neutropenic phase induced by chemotherapy. New methods for immunologic diagnosis (research of circulating fungal antigen), for clinical diagnosis (scanning, magnetic resonance). New strategy of antifungal chemotherapy (itraconazole, fluconazole) allow to a better knowledge and control of this new infectious pathology.