Journal of Fungi

1069 KiB

Open AccessArticle

Activity of Amphotericin B and Anidulafungin Combined with Rifampicin, Clarithromycin, Ethylenediaminetetraacetic Acid, N-Acetylcysteine, and Farnesol against Candida tropicalis Biofilms

by Marcelo Ernesto Fernández-Rivero, José L. Del Pozo, Amparo Valentín, Araceli Molina De Diego, Javier Pemán and Emilia Cantón

J. Fungi 2017, 3(1), 16; https://doi.org/10.3390/jof3010016 - 22 Mar 2017

Cited by 19 | Viewed by 4898

Abstract

We evaluated the activity of (1) amphotericin-B (AMB), combined with rifampicin (RIF), clarithromycin (CLA), N-acetylcysteine (NAC), ethylenediaminetetraacetic acid (EDTA), and farnesol (FAR) (1000, 1000, 1000, 4000, and 30,000 mg/L, and 300 µM, respectively), against Candida tropicalis biofilms formed on polytetrafluoroethylene (PTFE) and [...] Read more.

We evaluated the activity of (1) amphotericin-B (AMB), combined with rifampicin (RIF), clarithromycin (CLA), N-acetylcysteine (NAC), ethylenediaminetetraacetic acid (EDTA), and farnesol (FAR) (1000, 1000, 1000, 4000, and 30,000 mg/L, and 300 µM, respectively), against Candida tropicalis biofilms formed on polytetrafluoroethylene (PTFE) and (2) anidulafungin (ANF) combined with the same compounds at 8, 10, 5, 40, and 30 mg/L, and 30 µM, respectively, against biofilms formed on titanium. Biofilm growth kinetics were performed in a CDC Biofilm Reactor (CBR). PTFE or titanium disks were removed from the CBR at 24, 48, 72, and 96 h to determine the Log₁₀CFU/cm². Killing kinetics were performed by adding the drugs to 24-h-mature biofilms (time 0). Disks were removed after 24, 48, and 72 h of drug exposure to determine Log₁₀CFU/cm². Viable cells in biofilms were 4.73 and 4.29 Log₁₀CFU/cm² on PTFE and titanium, respectively. Maximum Log₁₀ decreases in CFU/cm² depend on the combination and were: 3.53 (AMB + EDTA), 2.65 (AMB + RIF), 3.07 (AMB + NAC), 2.52 (AMB + CLA), 1.49 (AMB + FAR), 2.26 (ANF + EDTA), 2.45 (ANF + RIF), 2.47 (ANF + NAC), 1.52 (ANF + CLA), and 0.44 (ANF + FAR). In conclusion, EDTA, NAC, RIF, and CLA improve the activity of AMB and ANF against biofilms developed on both surfaces, which could be an effective strategy against C. tropicalis biofilm-related infections. Full article

(This article belongs to the Special Issue Fungal Biofilms)

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Open AccessArticle

Microscopic Analysis of Pigments Extracted from Spalting Fungi

by Sarath M. Vega Gutierrez and Sara C. Robinson

J. Fungi 2017, 3(1), 15; https://doi.org/10.3390/jof3010015 - 14 Mar 2017

Cited by 16 | Viewed by 8348

Abstract

Pigments that are currently available in the market usually come from synthetic sources, or, if natural, often need mordants to bind to the target substrate. Recent research on the fungal pigment extracts from Scytalidium cuboideum, Scytalidium ganodermophthorum, Chlorociboria aeruginosa, and [...] Read more.

Pigments that are currently available in the market usually come from synthetic sources, or, if natural, often need mordants to bind to the target substrate. Recent research on the fungal pigment extracts from Scytalidium cuboideum, Scytalidium ganodermophthorum, Chlorociboria aeruginosa, and Chlorociboria aeruginascens have been shown to successfully dye materials, like wood, bamboo, and textiles, however, there is no information about their binding mechanisms. Due to this, a microscopic study was performed to provide information to future manufacturers interested in these pigments. The results of this study show that S. ganodermophthorum and C. aeruginosa form an amorphous layer on substrates, while S. cuboideum forms crystal-like structures. The attachment and morphology indicate that there might be different chemical and physical interactions between the extracted pigments and the materials. This possibility can explain the high resistance of the pigments to UV light and color fastness that makes them competitive against synthetic pigments. These properties make these pigments a viable option for an industry that demands natural pigments with the properties of the synthetic ones. Full article

(This article belongs to the Special Issue Fungal Pigments)

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901 KiB

Open AccessReview

The Candida albicans Biofilm Matrix: Composition, Structure and Function

by Christopher G. Pierce, Taissa Vila, Jesus A. Romo, Daniel Montelongo-Jauregui, Gina Wall, Anand Ramasubramanian and Jose L. Lopez-Ribot

J. Fungi 2017, 3(1), 14; https://doi.org/10.3390/jof3010014 - 8 Mar 2017

Cited by 108 | Viewed by 11160

Abstract

A majority of infections caused by Candida albicans—the most frequent fungal pathogen—are associated with biofilm formation. A salient feature of C. albicans biofilms is the presence of the biofilm matrix. This matrix is composed of exopolymeric materials secreted by sessile cells within [...] Read more.

A majority of infections caused by Candida albicans—the most frequent fungal pathogen—are associated with biofilm formation. A salient feature of C. albicans biofilms is the presence of the biofilm matrix. This matrix is composed of exopolymeric materials secreted by sessile cells within the biofilm, in which all classes of macromolecules are represented, and provides protection against environmental challenges. In this review, we summarize the knowledge accumulated during the last two decades on the composition, structure, and function of the C. albicans biofilm matrix. Knowledge of the matrix components, its structure, and function will help pave the way to novel strategies to combat C. albicans biofilm infections. Full article

(This article belongs to the Special Issue Fungal Biofilms)

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Open AccessArticle

Real-Time Approach to Flow Cell Imaging of Candida albicans Biofilm Development

by Andrew McCall and Mira Edgerton

J. Fungi 2017, 3(1), 13; https://doi.org/10.3390/jof3010013 - 6 Mar 2017

Cited by 14 | Viewed by 5587

Abstract

The ability of Candida albicans to form biofilms is a virulence factor that allows tissue attachment and subsequent infection of host tissues. Fungal biofilms have been particularly well studied, however the vast majority of these studies have been conducted under static conditions. Oral [...] Read more.

The ability of Candida albicans to form biofilms is a virulence factor that allows tissue attachment and subsequent infection of host tissues. Fungal biofilms have been particularly well studied, however the vast majority of these studies have been conducted under static conditions. Oral biofilms form in the presence of salivary flow, therefore we developed a novel flow system used for real-time imaging of fungal biofilm development. C. albicans wild-type (WT) cells readily attached to the substrate surface during the 2 h attachment phase, then formed heterogeneous biofilms after 18 h flow. Quantitative values for biomass, rates of attachment and detachment, and cell–cell adhesion events were obtained for C. albicans WT cells and for a hyperfilamentous mutant Δhog1. Attachment rates of C. albicans WT cells were nearly 2-fold higher than C. albicans Δhog1 cells, although Δhog1 cells formed 4-fold higher biomass. The reduced normalized detachment rate was the primary factor responsible for the increased biomass of Δhog1 biofilm, showing that cell detachment rates are an important predictor for ultimate biofilm mass under flow. Unlike static biofilms, C. albicans cells under constant laminar flow undergo continuous detachment and seeding that may be more representative of the development of in vivo biofilms. Full article

(This article belongs to the Special Issue Fungal Biofilms)

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418 KiB

Open AccessArticle

Characterization of Blue Mold Penicillium Species Isolated from Stored Fruits Using Multiple Highly Conserved Loci

by Guohua Yin, Yuliang Zhang, Kayla K. Pennerman, Guangxi Wu, Sui Sheng T. Hua, Jiujiang Yu, Wayne M. Jurick II, Anping Guo and Joan W. Bennett

J. Fungi 2017, 3(1), 12; https://doi.org/10.3390/jof3010012 - 1 Mar 2017

Cited by 45 | Viewed by 6727

Abstract

Penicillium is a large genus of common molds with over 400 described species; however, identification of individual species is difficult, including for those species that cause postharvest rots. In this study, blue rot fungi from stored apples and pears were isolated from a [...] Read more.

Penicillium is a large genus of common molds with over 400 described species; however, identification of individual species is difficult, including for those species that cause postharvest rots. In this study, blue rot fungi from stored apples and pears were isolated from a variety of hosts, locations, and years. Based on morphological and cultural characteristics and partial amplification of the β-tubulin locus, the isolates were provisionally identified as several different species of Penicillium. These isolates were investigated further using a suite of molecular DNA markers and compared to sequences of the ex-type for cognate species in GenBank, and were identified as P. expansum (3 isolates), P. solitum (3 isolates), P. carneum (1 isolate), and P. paneum (1 isolate). Three of the markers we used (ITS, internal transcribed spacer rDNA sequence; benA, β-tubulin; CaM, calmodulin) were suitable for distinguishing most of our isolates from one another at the species level. In contrast, we were unable to amplify RPB2 sequences from four of the isolates. Comparison of our sequences with cognate sequences in GenBank from isolates with the same species names did not always give coherent data, reinforcing earlier studies that have shown large intraspecific variability in many Penicillium species, as well as possible errors in some sequence data deposited in GenBank. Full article

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3220 KiB

Open AccessReview

Candida glabrata Biofilms: How Far Have We Come?

by Célia F. Rodrigues, Maria Elisa Rodrigues, Sónia Silva and Mariana Henriques

J. Fungi 2017, 3(1), 11; https://doi.org/10.3390/jof3010011 - 1 Mar 2017

Cited by 82 | Viewed by 12648

Abstract

Infections caused by Candida species have been increasing in the last decades and can result in local or systemic infections, with high morbidity and mortality. After Candida albicans, Candida glabrata is one of the most prevalent pathogenic fungi in humans. In addition [...] Read more.

Infections caused by Candida species have been increasing in the last decades and can result in local or systemic infections, with high morbidity and mortality. After Candida albicans, Candida glabrata is one of the most prevalent pathogenic fungi in humans. In addition to the high antifungal drugs resistance and inability to form hyphae or secret hydrolases, C. glabrata retain many virulence factors that contribute to its extreme aggressiveness and result in a low therapeutic response and serious recurrent candidiasis, particularly biofilm formation ability. For their extraordinary organization, especially regarding the complex structure of the matrix, biofilms are very resistant to antifungal treatments. Thus, new approaches to the treatment of C. glabrata’s biofilms are emerging. In this article, the knowledge available on C. glabrata’s resistance will be highlighted, with a special focus on biofilms, as well as new therapeutic alternatives to control them. Full article

(This article belongs to the Special Issue Fungal Biofilms)

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1341 KiB

Open AccessReview

The Crucial Role of Biofilms in Cryptococcus neoformans Survival within Macrophages and Colonization of the Central Nervous System

by Lilit Aslanyan, David A. Sanchez, Silvana Valdebenito, Eliseo A. Eugenin, Raddy L. Ramos and Luis R. Martinez

J. Fungi 2017, 3(1), 10; https://doi.org/10.3390/jof3010010 - 24 Feb 2017

Cited by 32 | Viewed by 7734

Abstract

Cryptococcus neoformans is an encapsulated yeast-like fungus capable of causing life threatening meningoencephalitis in patients with impaired immunity. This microbe primarily infects the host via inhalation but has the ability to disseminate to the central nervous system (CNS) either as a single cell [...] Read more.

Cryptococcus neoformans is an encapsulated yeast-like fungus capable of causing life threatening meningoencephalitis in patients with impaired immunity. This microbe primarily infects the host via inhalation but has the ability to disseminate to the central nervous system (CNS) either as a single cell or inside of macrophages. Upon traversing the blood brain barrier, C. neoformans has the capacity to form biofilm-like structures known as cryptococcomas. Hence, we will discuss the C. neoformans elements contributing to biofilm formation including the fungus’ ability to survive in the acidic environment of a macrophage phagosome and inside of the CNS. The purpose of this mini-review is to instill fresh interest in understanding the importance of biofilms on fungal pathogenesis. Full article

(This article belongs to the Special Issue Fungal Biofilms)

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2966 KiB

Open AccessArticle

Combinatorial Biosynthesis of Novel Multi-Hydroxy Carotenoids in the Red Yeast Xanthophyllomyces dendrorhous

by Hendrik Pollmann, Jürgen Breitenbach, Hendrik Wolff, Helge B. Bode and Gerhard Sandmann

J. Fungi 2017, 3(1), 9; https://doi.org/10.3390/jof3010009 - 22 Feb 2017

Cited by 10 | Viewed by 5606

Abstract

The red yeast Xanthophyllomyces dendrorhous is an established platform for the synthesis of carotenoids. It was used for the generation of novel multi oxygenated carotenoid structures. This was achieved by a combinatorial approach starting with the selection of a β-carotene accumulating mutant, stepwise [...] Read more.

The red yeast Xanthophyllomyces dendrorhous is an established platform for the synthesis of carotenoids. It was used for the generation of novel multi oxygenated carotenoid structures. This was achieved by a combinatorial approach starting with the selection of a β-carotene accumulating mutant, stepwise pathway engineering by integration of three microbial genes into the genome and finally the chemical reduction of the resulting 4,4’-diketo-nostoxanthin (2,3,2’,3’-tetrahydroxy-4,4’-diketo-β-carotene) and 4-keto-nostoxanthin (2,3,2’,3’-tetrahydroxy-4-monoketo-β-carotene). Both keto carotenoids and the resulting 4,4’-dihydroxy-nostoxanthin (2,3,4,2’,3’,4’-hexahydroxy-β-carotene) and 4-hydroxy-nostoxanthin (2,3,4,2’3’-pentahydroxy-β-carotene) were separated by high-performance liquid chromatography (HPLC) and analyzed by mass spectrometry. Their molecular masses and fragmentation patterns allowed the unequivocal identification of all four carotenoids. Full article

(This article belongs to the Special Issue Fungal Pigments)

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583 KiB

Open AccessReview

Candida Species Biofilms’ Antifungal Resistance

by Sónia Silva, Célia F. Rodrigues, Daniela Araújo, Maria Elisa Rodrigues and Mariana Henriques

J. Fungi 2017, 3(1), 8; https://doi.org/10.3390/jof3010008 - 21 Feb 2017

Cited by 187 | Viewed by 13108

Abstract

Candida infections (candidiasis) are the most prevalent opportunistic fungal infection on humans and, as such, a major public health problem. In recent decades, candidiasis has been associated to Candida species other than Candida albicans. Moreover, biofilms have been considered the most prevalent [...] Read more.

Candida infections (candidiasis) are the most prevalent opportunistic fungal infection on humans and, as such, a major public health problem. In recent decades, candidiasis has been associated to Candida species other than Candida albicans. Moreover, biofilms have been considered the most prevalent growth form of Candida cells and a strong causative agent of the intensification of antifungal resistance. As yet, no specific resistance factor has been identified as the sole responsible for the increased recalcitrance to antifungal agents exhibited by biofilms. Instead, biofilm antifungal resistance is a complex multifactorial phenomenon, which still remains to be fully elucidated and understood. The different mechanisms, which may be responsible for the intrinsic resistance of Candida species biofilms, include the high density of cells within the biofilm, the growth and nutrient limitation, the effects of the biofilm matrix, the presence of persister cells, the antifungal resistance gene expression and the increase of sterols on the membrane of biofilm cells. Thus, this review intends to provide information on the recent advances about Candida species biofilm antifungal resistance and its implication on intensification of the candidiasis. Full article

(This article belongs to the Special Issue Fungal Biofilms)

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Open AccessArticle

Comparative Efficacies of Antimicrobial Catheter Lock Solutions for Fungal Biofilm Eradication in an in Vitro Model of Catheter-Related Fungemia

by Joel Rosenblatt, Ruth A. Reitzel, Nylev Vargas-Cruz, Anne-Marie Chaftari, Ray Hachem and Issam I. Raad

J. Fungi 2017, 3(1), 7; https://doi.org/10.3390/jof3010007 - 10 Feb 2017

Cited by 10 | Viewed by 4910

Abstract

Fungal catheter-related bloodstream infections (CRBSIs)—primarily due to Candida species—account for over 12% of all CRBSIs, and have been progressively increasing in prevalence. They present significant health and economic burdens, and high mortality rates. Antimicrobial catheter lock solutions are an important prophylactic option for [...] Read more.

Fungal catheter-related bloodstream infections (CRBSIs)—primarily due to Candida species—account for over 12% of all CRBSIs, and have been progressively increasing in prevalence. They present significant health and economic burdens, and high mortality rates. Antimicrobial catheter lock solutions are an important prophylactic option for preventing fungal CRBSIs. In this study, we compared the effectiveness of two FDA-approved catheter lock solutions (heparin and saline) and three experimental antimicrobial catheter lock solutions—30% citrate, taurolidine-citrate-heparin (TCH), and nitroglycerin-citrate-ethanol (NiCE)—in an in vitro model of catheters colonized by fungi. The fungi tested were five different strains of Candida clinical isolates from cancer patients who contracted CRBSIs. Time-to-biofilm-eradication was assessed in the model with 15, 30, and 60 min exposures to the lock solutions. Only the NiCE lock solution was able to fully eradicate all fungal biofilms within 60 min. Neither 30% citrate nor TCH was able to fully eradicate any of the Candida biofilms in this time frame. The NiCE lock solution was significantly superior to TCH in eradicating biofilms of five different Candida species (p = 0.002 for all). Full article

(This article belongs to the Special Issue Fungal Biofilms)

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Open AccessReview

Cutaneous Disseminated and Extracutaneous Sporotrichosis: Current Status of a Complex Disease

by Alexandro Bonifaz and Andrés Tirado-Sánchez

J. Fungi 2017, 3(1), 6; https://doi.org/10.3390/jof3010006 - 10 Feb 2017

Cited by 79 | Viewed by 24035

Abstract

Sporotrichosis is an implantation or inoculation mycosis caused by species of Sporothrix schenckii complex; its main manifestations are limited to skin; however, cutaneous-disseminated, disseminated (visceral) and extracutaneous variants of sporotrichosis can be associated with immunosuppression, including HIV-AIDS, chronic alcoholism or more virulent strains. [...] Read more.

Sporotrichosis is an implantation or inoculation mycosis caused by species of Sporothrix schenckii complex; its main manifestations are limited to skin; however, cutaneous-disseminated, disseminated (visceral) and extracutaneous variants of sporotrichosis can be associated with immunosuppression, including HIV-AIDS, chronic alcoholism or more virulent strains. The most common extracutaneous form of sporotrichosis includes pulmonary, osteoarticular and meningeal. The laboratory diagnosis requires observing yeast forms and isolating the fungus; the two main causative agents are Sporothrix schenckii (ss) and Sporothrix brasiliensis. Antibody levels and species recognition by Polimerase Chain Reaction using biological samples or cultures are also useful. The treatment of choice for most cases is amphotericin B and subsequent itraconazole for maintenance therapy. Full article

(This article belongs to the Special Issue Fungal Infections in the Developing World)

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Open AccessReview

Global Aspects of Triazole Resistance in Aspergillus fumigatus with Focus on Latin American Countries

by Sarah Santos Gonçalves

J. Fungi 2017, 3(1), 5; https://doi.org/10.3390/jof3010005 - 10 Feb 2017

Cited by 15 | Viewed by 4569

Abstract

Azole resistance in Aspergillus has emerged as an escalating problem in health care, and it has been detected in patients exposed, or not, to these drugs. It is known that azole antifungals are widely applied not only in clinical treatments for fungal infections, [...] Read more.

Azole resistance in Aspergillus has emerged as an escalating problem in health care, and it has been detected in patients exposed, or not, to these drugs. It is known that azole antifungals are widely applied not only in clinical treatments for fungal infections, but also as agricultural fungicides, resulting in a significant threat for human health. Although the number of cases of azole-resistant aspergillosis is still limited, various resistance mechanisms are described from clinical and environmental isolates. These mechanisms consist mainly of alterations in the target of azole action (CYP51A gene)—specifically on TR₃₄/L98H and TR₄₆/Y121F/T289A, which are responsible for over 90% of resistance cases. This review summarizes the epidemiology, management, and extension of azole resistance in A. fumigatus worldwide and its potential impact in Latin American countries, emphasizing its relevance to clinical practice. Full article

(This article belongs to the Special Issue Fungal Infections in the Developing World)

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1461 KiB

Open AccessReview

Entomopathogenicity and Biological Attributes of Himalayan Treasured Fungus Ophiocordyceps sinensis (Yarsagumba)

by Bikash Baral

J. Fungi 2017, 3(1), 4; https://doi.org/10.3390/jof3010004 - 5 Feb 2017

Cited by 25 | Viewed by 15652

Abstract

Members of the entomophagous fungi are considered very crucial in the fungal domain relative to their natural phenomenon and economic perspectives; however, inadequate knowledge of their mechanisms of interaction keeps them lagging behind in parallel studies of fungi associated with agro-ecology, forest pathology [...] Read more.

Members of the entomophagous fungi are considered very crucial in the fungal domain relative to their natural phenomenon and economic perspectives; however, inadequate knowledge of their mechanisms of interaction keeps them lagging behind in parallel studies of fungi associated with agro-ecology, forest pathology and medical biology. Ophiocordyceps sinensis (syn. Cordyceps sinensis), an intricate fungus-caterpillar complex after it parasitizes the larva of the moth, is a highly prized medicinal fungus known widely for ages due to its peculiar biochemical assets. Recent technological innovations have significantly contributed a great deal to profiling the variable clinical importance of this fungus and other related fungi with similar medicinal potential. However, a detailed mechanism behind fungal pathogenicity and fungal-insect interactions seems rather ambiguous and is poorly justified, demanding special attention. The goal of the present review is to divulge an update on the published data and provides promising insights on different biological events that have remained underemphasized in previous reviews on fungal biology with relation to life-history trade-offs, host specialization and selection pressures. The infection of larvae by a fungus is not a unique event in Cordyceps; hence, other fungal species are also reviewed for effective comparison. Conceivably, the rationale and approaches behind the inheritance of pharmacological abilities acquired and stored within the insect framework at a time when they are completely hijacked and consumed by fungal parasites, and the molecular mechanisms involved therein, are clearly documented. Full article

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Open AccessEditorial

Acknowledgement to Reviewers of Journal of Fungi in 2016

by Journal of Fungi Editorial Office

J. Fungi 2017, 3(1), 3; https://doi.org/10.3390/jof3010003 - 11 Jan 2017

Cited by 1 | Viewed by 3222

Abstract

The editors of Journal of Fungi would like to express their sincere gratitude to the following reviewers for assessing manuscripts in 2016.[...] Full article

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Open AccessReview

Biocontrol Properties of Basidiomycetes: An Overview

by Subramaniyan Sivanandhan, Ameer Khusro, Michael Gabriel Paulraj, Savarimuthu Ignacimuthu and Naif Abdullah AL-Dhabi

J. Fungi 2017, 3(1), 2; https://doi.org/10.3390/jof3010002 - 10 Jan 2017

Cited by 34 | Viewed by 10063

Abstract

In agriculture, there is an urgent need for alternate ecofriendly products to control plant diseases. These alternate products must possess preferable characteristics such as new modes of action, cost effectiveness, biodegradability, and target specificity. In the current scenario, studies on macrofungi have been [...] Read more.

In agriculture, there is an urgent need for alternate ecofriendly products to control plant diseases. These alternate products must possess preferable characteristics such as new modes of action, cost effectiveness, biodegradability, and target specificity. In the current scenario, studies on macrofungi have been an area of importance for scientists. Macrofungi grow prolifically and are found in many parts of the world. Basidiomycetes (mushrooms) flourish ubiquitously under warm and humid climates. Basidiomycetes are rich sources of natural antibiotics. The secondary metabolites produced by them possess antimicrobial, antitumor, and antioxidant properties. The present review discusses the potential role of Basidiomycetes as anti-phytofungal, anti-phytobacterial, anti-phytoviral, mosquito larvicidal, and nematicidal agents. Full article

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Open AccessReview

New Trends in Paracoccidioidomycosis Epidemiology

by Roberto Martinez

J. Fungi 2017, 3(1), 1; https://doi.org/10.3390/jof3010001 - 3 Jan 2017

Cited by 192 | Viewed by 11553

Abstract

Paracoccidioidomycosis is a systemic fungal disease occurring in Latin America and more prevalent in South America. The disease is caused by the dimorphic fungus Paracoccidioides spp. whose major hosts are humans and armadillos. The fungus grows in soil and its infection is associated [...] Read more.

Paracoccidioidomycosis is a systemic fungal disease occurring in Latin America and more prevalent in South America. The disease is caused by the dimorphic fungus Paracoccidioides spp. whose major hosts are humans and armadillos. The fungus grows in soil and its infection is associated with exposure to the rural environment and to agricultural activities, with a higher risk in coffee and tobacco plantations. Population studies assessing the reactivity to Paracoccidioides spp. antigens by intradermal reaction or serological tests have detected previous subclinical infections in a significant proportion of healthy individuals living in various endemic countries. Paracoccidioidomycosis-disease is manifested by a small minority of infected individuals. The risk of developing the disease and its type of clinical form are related to the personal and life style characteristics of infected individuals, including genetic background, age, sex, ethnicity, smoking habit, alcohol drinking, and eventual cellular immunosuppression. Brazil, Colombia, Venezuela, Argentina, and Ecuador have endemic areas that had already been defined in the 20th century. The incidence of paracoccidioidomycosis can be altered by climate phenomena and mainly by human migration and occupation of poorly explored territories. In Brazil, the endemy tends to expand towards the North and Center-West around the Amazon Region. Full article

(This article belongs to the Special Issue Fungal Infections in the Developing World)

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