What fungus infection causes ulcers?

From the Guidelines

Candida species are the most common fungal infections that cause ulcers, particularly in immunocompromised patients. Several fungal infections can cause ulcers, with Candida species being the most common culprits, as seen in a study by 1. Candidiasis (thrush) frequently causes painful ulcers in the mouth, throat, and genital areas. Other significant fungal pathogens that can lead to ulcerative lesions include Histoplasma capsulatum, Cryptococcus neoformans, and Aspergillus species.

Key Points

• Treatment typically involves antifungal medications such as fluconazole (200-400mg daily for 1-2 weeks for oral candidiasis), nystatin (oral suspension 4-6mL four times daily), or clotrimazole troches (10mg dissolved in mouth five times daily) as mentioned in 1.
• For severe or systemic infections, stronger antifungals like amphotericin B may be necessary, as indicated in 1 and 1.
• These medications work by disrupting the fungal cell membrane or inhibiting essential fungal processes.
• Proper diagnosis is crucial as fungal ulcers can mimic bacterial or viral lesions.
• Patients with compromised immune systems are particularly susceptible to these infections and may require longer treatment courses or prophylactic therapy to prevent recurrence, as seen in 1. Some of the key fungal infections that cause ulcers include:
• Candida species: The most common cause of fungal ulcers, particularly in immunocompromised patients, as mentioned in 1.
• Aspergillus species: Can cause cutaneous infections, including ulcers, particularly in immunocompromised patients, as seen in 1.
• Histoplasma capsulatum: Can cause ulcers in the mouth, throat, and genital areas, particularly in immunocompromised patients.
• Cryptococcus neoformans: Can cause ulcers in the mouth, throat, and genital areas, particularly in immunocompromised patients.

From the Research

Fungus Infections Causing Ulcers

• Histoplasmosis is a fungal infection that can cause ulcers, particularly in immunocompromised patients 2, 3, 4.
• The infection is caused by the dimorphic fungus Histoplasma capsulatum and can be acquired through inhalation of conidial forms present in the environment 2.
• Clinical features of histoplasmosis may vary from asymptomatic infections to disseminated severe forms that affect patients with acquired immunodeficiency syndrome or hematological malignancies and allograft recipients 2, 3.
• Orofacial lesions caused by systemic mycoses, including histoplasmosis, have been reported to cause chronic oral ulceration, particularly in immunocompromised individuals 5.
• Diagnosis and management of histoplasmosis should be undertaken in consultation with a physician with appropriate expertise, as pulmonary and other systemic infection may be present 5.
• Treatment of histoplasmosis can be performed with oral azolic (itraconazol) and in disseminated forms, amphotericin B (preferentially the lipidic formulations) consists of the elected drug to initiate therapy 2, 3.