The dermatophytes, classified in a single family Arthrodermataceae (Onygenales). This family has received more attention due to their keratin-degrading properties and the ability of some taxa to invade the skin and cause dermatophytes in humans and/or mammals. The phylogeny of Arthrodermataceae is remarkably stable, with Arthroderma representing the ancestral geophilic lineage and Trichophyton constituting a derived clade of anthropophiles and some zoophiles. The other genera appear to represent intermediate forms along this ecological spectrum. During a survey of Arthrodermataceae in China, a geophilic species was isolated. A multi-locus phylogenetic analysis of three markers (ITS, β-tubulin, and tef1-α) reveals that this taxon is a sister species to Arthroderma cuniculi. It can be differentiated from other species in Arthroderma by two types of microconidia: (i) smooth-walled, cylindrical to clavate, (ii) smooth-walled, obovate to pyriform. Phylogenetic analyses, and morphology provide evidence that the new isolate is a distinct species. This study enriches the Arthroderma species inventory and expands our understanding of dermatophyte biodiversity.

Pneumocystis jirovecii pneumonia (PjP) is a life-threatening infection in immunocompromised individuals. Its diagnosis remains challenging, especially in microscopy-negative cases. This study aimed to standardize and validate a qPCR assay targeting the mtLSU rRNA gene for detecting P. jirovecii DNA in respiratory samples from patients in Argentina.

Paracoccidioidomycosis (PCM) is a severe systemic mycosis classified as a neglected disease, predominantly found in South America, with Brazil reporting the highest number of cases. In children and adolescents, PCM primarily manifests as an acute/subacute (juvenile) form. This systematic review focused on PCM cases in individuals under 15 years of age, analyzing 163 reports published between 1970 and 2023. The literature search was conducted across LILACS, SciELO, and PubMed databases using DeCS and MeSH descriptors in Portuguese, English, and Spanish.Most cases (70%) occurred in Brazil, followed by Argentina, Peru, Venezuela, and Colombia. The mean age was 8.4 years, with a male predominance (63%) and a median diagnostic delay of six months, reflecting underreporting and late disease recognition. The predominant clinical presentation was the disseminated form (90%), with generalized lymphadenopathy as the most frequent manifestation. Common symptoms included fever (66%), weight loss (54%), hepatomegaly (30%), and splenomegaly (25%). Severe complications such as lymph node fistulization (27%) and bone involvement (16%) were associated with poorer prognosis.Among the cases, 53% were classified as severe, frequently exhibiting marked eosinophilia (> 25,000 cells/mm), ascites, and visceral involvement. Seven fatalities (5%) were recorded, strongly associated with hepatosplenomegaly (86% of fatalities vs. 22% of survivors), significant eosinophilia (71% vs. 15%), and rapid diagnosis (< 3 months). A predictive model combining these factors achieved 85.7% sensitivity and 92.3% specificity for mortality. Regarding therapy, combined antifungal regimens (e.g., amphotericin B plus itraconazole) achieved a 25% cure rate, while monotherapy with trimethoprim-sulfamethoxazole (TMP-SMX) was associated with 49% of fatalities.Pediatric PCM remains a neglected and highly lethal disease in severe forms. Early diagnosis, appropriate therapeutic combinations, and monitoring of clinical-laboratory markers with accurate classification are crucial for improved outcomes. The absence of detailed data in 34% of cases highlights gaps in clinical records, underscoring the need for prospective studies and standardization of severity criteria.

Invasive candidiasis is a major contributor to morbidity and mortality in hospitalized children, particularly in those with comorbidities or prolonged hospitalizations. This study evaluated the epidemiology, antifungal susceptibility, and outcomes of invasive Candida infections over an 11-year period.

Sporotrichosis, caused by the thermodimorphic fungus Sporothrix brasiliensis, is an emerging zoonotic infection in Brazil and other Latin American countries. Typically, the parasitic form in host tissue is yeast; however, we report three cases in immunocompromised patients exhibiting simultaneous yeast and mycelial structures in biopsies. Identification of S. brasiliensis was confirmed through calmodulin gene sequencing, with phylogenetic analysis supporting species-level classification. Direct examination and histopathology revealed both budding yeast cells (3-8 μm) and hyphae, a rare morphological phenomenon previously unreported for this species in humans. This atypical dimorphism may be influenced by local tissue conditions, such as oxygen exposure and lower temperatures, and has significant diagnostic implications. Recognition of polymorphic forms is essential for pathologists and mycologists, highlighting the evolving histopathological and diagnostic challenges in sporotrichosis.

Mycological diagnostics play a crucial role in patient management and treatment of invasive fungal infections. Despite the significant global burden of fungal diseases, awareness and diagnostic capabilities in mycology laboratories lag behind other microbiological disciplines. Mycological diagnostics often require microscopic analysis of clinical samples and culture. The interpretation of microscopy requires extensive expertise in clinical mycology. This study aimed to explore the feasibility of remote digital reading for preliminary identification of fungi. In this study, five mycology-trained participants were asked to analyze a total of 474 images divided into three main groups of yeasts (73 images), filamentous fungi (341 images), and direct fluorescent microscopy from clinical samples (60 images). The accuracy of the assessments varied, with an average correct decision rate between 78 and 93% across the three image groups. Individual participant's performance showed a mean accuracy rate ranging between 76 and 92%. A significant difference was observed in the assessment accuracy across specimen groups and among individual participants (p < 0.05). However, there was no significant interaction effect between participants and image group (p = 0.118). In conclusion, telemycology offers a promising alternative to standard microscopy diagnostics of fungal infections, especially in settings where skilled mycologists are lacking, including low- and middle-income countries.

Malassezia species are lipophilic yeasts that inhabit the skin of warm-blooded animals and that are associated with various skin disorders. Although Malassezia is frequently isolated from the external ear canal of cats, the influence of ectoparasites such as Otodectes cynotis (ear mites) on Malassezia species diversity has received limited attention. During an investigation of Malassezia diversity in cat ear canals infested with Otodectes cynotis, five Malassezia strains were isolated from the external ear canals. Phylogenetic analyses based on the internal transcribed spacer (ITS) region and the D1/D2 domains of the Large Subunit rDNA (LSU rDNA) revealed that those five isolates represent two known species, namely Malassezia globosa and Malassezia slooffiae, and a putative novel candidate species of Malassezia. The candidate species was found to be closely related to Malassezia gallinae and M. slooffiae, yet it differed from M. gallinae by 78 nucleotides (nt) in the ITS region and 9 nt in the D1/D2 domains, and from M. slooffiae by 70 nt in the ITS region and 5 nt in the D1/D2 domains. Based on phylogenetic analysis and phenotypic characteristics, we propose a novel species for which we suggest the name Malassezia cafarchiae sp. nov.

Invasive candidiasis (IC) is a life-threatening fungal infection caused by Candida species. Current diagnostic methods are based on blood culture of the fungus, a technique with limited sensitivity and slow turnaround times. To address these limitations, novel diagnostic strategies are under investigation. This study evaluates the diagnostic potential of the Candida albicans germ tube protein Hyr1 and a subterminal Hyr1 fragment (D22b), both produced in an eukaryotic expression system, for the diagnosis of IC; for that purpose, recombinant Hyr1 and D22b were expressed in Pichia pastoris and tested by ELISA using sera from 176 patients at risk of invasive fungal infections. The diagnostic performance of these antigens was determined and compared with other biomarkers (CAGTA and β-D-glucan). Interestingly, the recombinant proteins exhibited higher apparent molecular weights than predicted, suggesting the presence of post-translational modifications. Serological detection of antibodies against the recombinant Hyr1 and D22b fragment successfully distinguished patients with IC caused by the most commonly isolated Candida species, achieving sensitivities greater than 70% and specificities above 80%. These findings highlight the potential of the serological detection of antibodies to Hyr1 and D22b as a promising diagnostic approach that overcomes the drawbacks of CAGTA detection and could serve as a valuable complement to blood culture, supporting earlier diagnosis and guiding timely treatment decisions in IC. Furthermore, comparing results obtained with antigens produced in eukaryotic and prokaryotic systems, results suggest that accurate protein folding and post-translational processing influence the success of the diagnostic technique.

Cryptococcosis is a systemic mycosis prevalent in immunosuppressed individuals, particularly those with HIV/AIDS. Immune recovery achieved through antiretroviral therapy (ART) is crucial for controlling opportunistic infections in AIDS. Given clinical observations and evidence suggesting Cryptococcus spp. accelerates HIV replication in vitro, we hypothesized that cryptococcosis may hinder immune recovery in severely immunosuppressed AIDS patients.

We retrospectively analyzed 99 cases of zoonotic dermatophytosis diagnosed by culture over a 10-year period at a dermatological clinic. Microsporum canis was the most frequently isolated species (89 cases), followed by Trichophyton verrucosum (4 cases), T. mentagrophytes (4 cases), T. benhamiae (1 case), and T. erinacei (1 case). Patients < 15 years of age accounted for 31.3% of the cases. Tinea corporis was the predominant clinical form, with frequent facial and upper-extremity involvement. Topical corticosteroid misuse was noted in 37 patients, and multiple family members were affected in 20 cases. M. canis infections were mostly linked to cats, including stray cats and adopted shelter cats. Infections caused by T. benhamiae and T. erinacei were traced to guinea pigs and hedgehogs, respectively. These findings highlight diagnostic challenges and emerging animal reservoirs. The One Health approach requires active surveillance and education across human and animal health.

Candida tropicalis frequently causes invasive infections in immunocompromised hosts. Mortality rates are high compared to other yeasts, while antifungal resistance varies between countries. To date, multicenter studies regarding C. tropicalis infections in Türkiye are limited. The current study therefore characterized C. tropicalis infections in Türkiye. In this retrospective study, 120 invasive C. tropicalis isolates were collected from four hospitals in Türkiye, mostly from blood. In vitro antifungal susceptibility testing (AFST) was performed for eight common antifungals, and short tandem repeat (STR) genotyping was applied to investigate genetic relatedness within the current population and previously genotyped isolates. Patients with invasive C. tropicalis candidiasis were mostly elderly, with a central venous line (CVL) and cancer or diabetes as underlying disease, and an overall mortality rate of 37%. Except for a single isolate from blood being resistant to fluconazole and voriconazole, no resistance to common antifungals was found. Finally, nosocomial transmission within hospitals was limited as nearly all isolates displayed unique genotypes. When compared to 605 previously investigated isolates from 12 diverse countries, only few clusters were present, indicating an overall high genetic diversity for C. tropicalis. While isolates from the current study did not form a single monophyletic branch, there were 27 isolates that formed a distinct pan-susceptible clade together with isolates of other Middle Eastern countries. To conclude, we described a retrospective multicenter study on invasive C. tropicalis infections in Türkiye characterized by a high mortality rate for untreated patients, while isolates showed little antifungal resistance and high genetic diversity.

Lower respiratory tract fungal infections (LRTFIs) contribute significantly to global disease burden, yet systematic research is limited. This study analyzes their disability-adjusted life year (DALY) burden, exploring trends, geographic patterns, demographic differences, driving factors, and inequalities.

Aspergillus fumigatus, an opportunistic and allergenic pathogenic fungus, is responsible for a range of clinical disorders in humans, including invasive aspergillosis (IA), which can lead to severe infections in immunocompromised individuals. Unfortunately, the emergence of azole resistance has become a significant challenge in combating IA, necessitating further investigations into the underlying mechanisms of resistance. In this study, we conducted an integrated proteomic and phosphoproteomic analysis of biofilm proteins from both azole-resistant and wildtype strains of A. fumigatus under voriconazole pressure. Our proteomic analysis identified 148 upregulated and 146 downregulated proteins in the azole-resistant strains, while phosphoproteomic analysis revealed 316 upregulated phosphopeptides and 109 downregulated phosphopeptides, suggesting extensive phosphorylation modifications associated with azole resistance. Upon excluding the impact of protein changes, we identified 133 proteins with differential expression solely at the phosphorylation level, comprising 104 upregulated and 29 downregulated proteins. Functional annotation and analysis highlighted the significance of these differentially expressed phosphoproteins in cell wall integrity, filamentous growth, and high-osmolarity stress response, with 33 MAPK pathway-associated proteins displaying phosphopeptide level regulation. These findings provide valuable insights into the mechanisms behind azole resistance in A. fumigatus and offer potential new drug targets for combating this pathogenic fungus in humans.

This study evaluates and compares the diagnostic and prognostic capabilities of ChatGPT-4o and DeepSeek-R1 in 56 HIV-negative talaromycosis cases. Clinical case fragments were de-identified and submitted to both models, with diagnostic accuracy and prognostic prediction rates statistically analyzed using chi-square tests, Fisher's exact tests, and logistic regression. Results showed DeepSeek-R1 achieved significantly higher diagnostic accuracy (66.1%) than ChatGPT-4o (3.6%) (χ = 48.2, p < 0.001), attributable to its regional data training focusing on Southeast Asia and southern China. Conversely, ChatGPT-4o demonstrated superior prognostic prediction accuracy (78.6% vs. 50.0%, p < 0.001), with 90.2% specificity for improved (survival) outcomes, while DeepSeek-R1 showed 86.7% sensitivity for mortality. Key diagnostic predictors included hilar lymphadenectasis (odds ratio [OR] = 6.8, 95% confidence interval [CI]: 2.1-22.3, P = 0.002) and chest pain (OR = 5.9, 95% CI: 1.4-25.6, P = 0.016). The findings highlight DeepSeek-R1's regional diagnostic advantage and ChatGPT-4o's prognostic utility, advocating for their collaborative use to enhance early detection and management of this neglected fungal infection in immunocompromised, non-HIV populations.

The antifungal armamentarium is shrinking while resistance to licensed agents rises. Historically, actinomycetes and fungi delivered nystatin, amphotericin B, griseofulvin and the echinocandin scaffold, yet plant-derived compounds-despite potent in-vitro activity-have rarely reached the clinic.

Invasive fungal infections constitute a major cause of morbidity and mortality in children, affecting mainly those with malignancies and immunodeficiencies (primary or secondary), who receive solid or hematopoietic stem cell transplantation, and those in neonatal or pediatric intensive care units. Overuse and inappropriate prescription of antifungal (AF) agents have been reported in pediatrics, leading not only to an increase in adverse events and toxicities but also to the development of AF resistance. AF stewardship practices as part of broader antimicrobial stewardship programs are crucial for improving outcomes and reducing AF overuse and associated costs. This review has two main objectives: to summarize the published data on prescription patterns of AF agents in pediatrics and to describe the current state of pediatric AF stewardship programs worldwide, providing suggestions for their implementation. Given the significant burden of invasive fungal infections in vulnerable pediatric populations, identification of actions to improve AF stewardship practices in real-life clinical settings is essential.

Eumycetoma is a neglected tropical disease caused primarily by a Madurella mycetomatis infection, besides other related species. In this study, we designed a novel loop-mediated isothermal amplification (LAMP) primer set capable of simultaneously detecting four Madurella species (M. mycetomatis, M. pseudomycetomatis, M. tropicana, and M. fahalii). Genomic sequencing of M. pseudomycetomatis strain and comparative genome analysis revealed the candidate genes that were common among and specific to Madurella species. The 3 LAMP primer sets targeting these genes detected up to 1 pg of the genomic DNA of all 4 Madurella species, exhibiting no cross-reactivity toward other pathogenic fungi. Among these, one primer set showing better reactivity was selected as a candidate used for diagnosis. Therefore, we developed novel primer sets which enabled the simultaneous detection of four Madurella species. Our present findings will lead to a faster and simpler diagnostic tool for eumycetoma detection, especially in rural clinical settings.

Pneumocystis jirovecii pneumonia (PJP) is one of the leading causes of mortality in kidney transplant recipients. Identifying risk factors for mortality in high-risk patients is essential for developing timely and proactive treatment strategies.