Fungi represent a significant group of pathogens capable of causing a range of diseases in humans under the right set of conditions. Although the majority of fungi appear to be harmless to humans it is worth bearing in mind that a normally non-pathogenic fungus can cause a clinically relevant problem if the immune system is suppressed as a result of therapy (e.g. for receipt of organ transplant) or disease (e.g. cancer).
MEDICAL SIGNIFICANCE OF FUNGI
Fungi represent a
significant group of pathogens capable of causing a range of diseases in humans
under the right set of conditions. Although the majority of fungi appear to be
harmless to humans it is worth bearing in mind that a normally non-pathogenic
fungus can cause a clinically relevant problem if the immune system is
suppressed as a result of therapy (e.g. for receipt of organ transplant) or
disease (e.g. cancer). In a case of profound immune-compromise a wide range of
fungi can present as capable of inducing disease.
The most common fungal
pathogens of humans can be divided into three broad classes: yeasts, moulds and
dermatophytes. The yeast C. albicans
is the most frequently encountered human fungal pathogen, being responsible for
a wide range of superficial and systemic infections. The superficial infections
include oropharyngeal and genital conditions, the former occurs predominantly
in HIV-positive individuals, geriatric patients and premature infants and may
arise when a weakened or immature immune system is present. Genital candidosis
is very common and approximately 75% of women are affected by vulvovaginal
candidosis (VVC) during their life with a further 5–12% suffering from
recurring bouts of infection over a prolonged period of time.
The mould Aspergillus fumigatus is the dominant
fungal pulmonary pathogen of humans and generally presents as a problem in
those with pre-existing lung disease or damage. In addition to pulmonary infection
other sites may be affected including the brain, kidneys and sinuses depending
upon the level of immunocompromise of the individual. Groups particularly
susceptible to colonization by Aspergillus
species include those with cavities due to tuberculosis, patients affected with
asthma or cystic fibrosis and those with profound immunosuppression due to
leukaemia (neutropenia). Aspergillosis presents as a serious problem in
patients immunosuppressed in advance of organ transplantation.
Dermatophyte is the term
applied to a range of fungi capable of colonizing the skin, nails or hair. The
principal dermatophytic fungi are Trichophyton,
Microsporum and Epidermophyton species. The most commonly encountered dermatophytic
infections are athlete’s foot (infection of the foot) and ringworm (fungal
infection of the scalp or skin).
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