Medical mycology最新文献

{"title":"A notable azole-nonsusceptible Candida orthopsilosis in the Candida parapsilosis complex isolated from onychomycosis in Hue City, Central Vietnam.","authors":"Thi Minh Chau Ngo, Dong Duong Ton That, Phuong Anh Ton Nu, Le Chi Cao, Giang Tran Thi, Thi Bich Thao Do, Thi Ngoc Thuy Ha, Minh Tiep Vo, Phuoc Vinh Nguyen, Ba Hoang Anh Mai, My Tra Nguyen Thi, Đac Hanh Nguyen, Thanh Huy Nguyen","doi":"10.1093/mmy/myaf064","DOIUrl":"10.1093/mmy/myaf064","url":null,"abstract":"<p><p>The Candida parapsilosis complex, consisting of C. parapsilosis sensu stricto, C. orthopsilosis, and C. metapsilosis, is a major cause of Candida onychomycosis. Increasing reports of high levels of resistance to antifungal drugs, particularly fluconazole and echinocandin, have raised concerns about C. parapsilosis complex. This study investigates antifungal resistance and hydrolytic enzyme activity in these species. Species were identified using polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP) and internal transcribed spacer (ITS) 1-4 sequencing. Antifungal susceptibility was assessed using Sensititre™ YeastOne™. Hydrolytic enzyme production was assessed by agar plate culture. Among 43 isolates, C. parapsilosis sensu stricto was most prevalent (48.8%, n = 21/43), followed by C. orthopsilosis (39.6%, n = 17/43) and C. metapsilosis (11.6%, n = 5/43). All C. parapsilosis sensu stricto isolates were susceptible to antifungal agents, except 4.8% (n = 1/21) showing dose-dependent susceptibility to fluconazole and 4.8% (n = 1/21) resistance to amphotericin B. Candida orthopsilosis showed significant resistance to fluconazole and voriconazole (52.9% each, n = 9/17), posaconazole (23.5%, n = 4/17), and low resistance to amphotericin B (5.9%, n = 1/17). One C. metapsilosis isolate (20%) showed cross-resistance to fluconazole and voriconazole, and another (20%) was resistant to 5-flucytosine. Enzymatic assays showed higher protease and lipase activity in C. parapsilosis sensu stricto and C. orthopsilosis compared to C. metapsilosis, with C. parapsilosis sensu stricto showing the highest protease activity. Comprehensive research into antifungal susceptibility and virulence factors of the C. parapsilosis species complex is essential to monitor the growing threat of antifungal resistance and to better understand its role in onychomycosis pathogenesis.</p>","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fungal infections in burn patients: The rise of Fusarium as the most prevalent in a burn center in Mexico City.","authors":"Maura Cecilia González Guerrero, Jaime Arturo Mondragón Eguiluz, María de Lourdes García Hernández, Guillermo Cerón González, Claudia Adriana Colín Castro, Esteban Cruz Arenas, María de Lourdes Guerrero Almeida, Edgar Samuel Vanegas Rodríguez, Rafael Franco Cendejas, Luis Esaú López Jácome","doi":"10.1093/mmy/myaf059","DOIUrl":"10.1093/mmy/myaf059","url":null,"abstract":"<p><p>Burns are among the most devastating traumatic injuries. The primary risk of infection stems from disruption of the primary barrier, the skin. For patients with deep burns, loss of the dermis is the main risk factor for systemic bacterial and fungal infections, which occur in 70% and 20%-25% of cases, respectively. Meanwhile, viral infections occur in 5%-10% of cases. Fungal infections are associated with mortality rates ranging from 33% to 60%. This study is a retrospective, cross-sectional analysis conducted at the Centro Nacional de Investigación y Atención de Quemados at the Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra in Mexico City. The study examined all fungi recovered from biopsies of burn patients from July 2011 to July 2023. A total of 63 cases were included, predominantly flame burns (77.78%), with Fusarium spp. (53.97%) as the predominant fungal genus associated with infection, followed by Aspergillus spp. (19.04%). Most patients had third-degree burns, and the mean total body surface area burned was 46.2%. This study aims to describe the epidemiology and distribution of mold infections in a tertiary care center for burn patients in Mexico City from July 2011 to July 2023.</p>","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12284474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of ATM1 gene involved in antifungal resistance based on CRISPR/Cas9 technology in Cryptococcus gattii.","authors":"Jiahui Huang, Xuan Zhao, Xuelei Zang, Ziyi Jin, Xueqing Zhang, Yemei Huang, Liye Zhang, Xinying Xue, Ping Zhang","doi":"10.1093/mmy/myaf061","DOIUrl":"10.1093/mmy/myaf061","url":null,"abstract":"<p><p>Cryptococcus gattii is a fungal pathogen that poses significant threats to human health, affecting both immunocompromised and immunocompetent individuals. Treatment of C. gattii infections typically involves the use of antifungal agents, such as azoles. However, the increasing emergence of antifungal resistance in C. gattii is a growing concern, highlighting the critical need for novel therapeutic strategies. In our previous study, we identified a mitochondrial ATP-binding cassette (ABC) transporter, Atm1, as potentially involved in antifungal resistance in C. gattii through transcriptome sequencing, but its function remains unclear and requires additional confirmation and investigation. In this study, we developed a \"suicide\" clustered regularlyinterspaced short palindromic repeats-CRISPR-associated protein 9 system in C. gattii, based on the system used in C. neoformans, and successfully validated its functionality by targeting the ADE2 gene. We subsequently generated C. gattii mutants lacking ATM1 and assessed their growth under various stress conditions. Our data suggest that Atm1 is involved in the iron-sulfur cluster biosynthesis process. Besides, disruption of ATM1 resulted in various growth impairments, including reduced stress tolerance, impaired capsule formation, and diminished virulence. Importantly, we observed compromised antifungal drug resistance in the atm1∆ mutant and performed RNA sequencing-based transcriptome analysis and gene ontology analysis with and without antifungal treatment for further investigation. In conclusion, our findings indicate that ATM1 plays a role in iron homeostasis and is critical for antifungal resistance in C. gattii, offering new insights into potential drug development strategies for the clinical treatment of cryptococcosis.</p>","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Statistical Analysis of Pulmonary Mycosis in a Tertiary Hospital in Eastern China before and after the Pandemic of COVID-19.","authors":"Gege Cao, Ran Wang, Qingtian Hu, Yong Zhang, Desheng Wu","doi":"10.1093/mmy/myaf058","DOIUrl":"10.1093/mmy/myaf058","url":null,"abstract":"<p><p>Following the complete relaxation of Corona Virus Disease 2019 (COVID-19) epidemic control measures in China by the end of 2022, the number of patients with pulmonary mycosis admitted to hospitals across the country has exhibited a more pronounced upward trend. However, statistical data is lacking to determine whether there is a significant correlation between COVID-19 and pulmonary mycosis. This study collected baseline information, the first laboratory indicators after admission, the types of pathogens, and the prognosis data of patients with pulmonary fungal infections from a tertiary hospital in northern Anhui Province from January 1, 2017, to December 31, 2023, to reveal any association between COVID-19 infection and pulmonary fungal infections. The research results indicated that the G and GM test levels of patients who recovered from COVID-19 and those currently experiencing active infection with COVID-19 were significantly higher than those of patients with pulmonary fungal infections who had never been infected with COVID-19. Infection with COVID-19 and other viruses (excluding COVID-19), mechanical ventilation, and concurrent solid tumors were identified as independent risk factors for poor prognosis in patients with pulmonary fungal diseases. Among patients with viral infections, COVID-19 infection was the most common, with 25 cases (41.67%), followed by herpes simplex virus infection, with 15 cases (25.00%).</p>","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular identification of Fonsecaea pedrosoi in chromoblastomycosis: Insights from paraffin-embedded human skin biopsies and clinicopathology.","authors":"Rigoberto Hernandez-Castro, Roberto Arenas, Israel Esquivel-Pinto, Teerapong Rattananukrom","doi":"10.1093/mmy/myaf055","DOIUrl":"10.1093/mmy/myaf055","url":null,"abstract":"<p><p>Chromoblastomycosis (CBM) is a chronic fungal infection caused by dematiaceous fungi. In some cases, culture methods fail to identify the fungal species, and fresh tissue for molecular identification is unavailable. The use of molecular techniques on formalin-fixed, paraffin-embedded (FFPE) samples can aid in identifying the causative agent. This study aimed to identify fungal species in histopathologically confirmed cases of CBM using PCR and sequencing of 18S-ITS1-5.8S-ITS2-28S rDNA region of FFPE skin biopsies and to describe their clinicopathological features. This retrospective study used FFPE samples from nine CBM patients from remote regions of Mexico. The samples were submitted to the Mycology Section at the Hospital General \"Dr. Manuel Gea González\" (2000-2016) for molecular identification of the causative agent and characterization of clinicopathological features. Lesions were most commonly located on the forearm (four cases), with one case each on the buttock, back, foot, and leg. One patient presented with cutaneous dissemination. Verrucous plaques were observed in 88.9% of cases. Histology and direct examination confirmed CBM, showing muriform cells and varying degrees of dermal fibrosis in all cases. DNA extracted from FFPE samples was amplified and sequenced in the 18S-ITS1-5.8S-ITS2-28S rDNA region, identifying Fonsecaea pedrosoi with 100% homology in all cases. This study identifies F. pedrosoi as the predominant pathogen of CBM in the evaluated samples of Mexican origin and demonstrates the reliability of molecular identification using FFPE samples.</p>","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genomic insights into the dermatophyte Trichophyton indotineae in Singapore: Resistance and transmission dynamics.","authors":"Jeanette W P Teo, Janet W S Cheng, Jamie S Wee, Douglas Chan, Ka Lip Chew","doi":"10.1093/mmy/myaf062","DOIUrl":"10.1093/mmy/myaf062","url":null,"abstract":"<p><p>During an 11-month study at two hospital sites, 33 isolates initially classified as the Trichophyton mentagrophytes complex were subjected to whole-genome sequencing. Of these, 24 (72.7%) were identified as T. indotineae and 9 (27.3%) as T. interdigitale, with no T. mentagrophytes detected. Among the 22 patients with available clinical data, 75% exhibited involvement of multiple anatomical sites; although only two patients reported recent travel, 63.6% were migrant workers. Symptom resolution was documented in only four patients, whereas five experienced recurrences. Nearly 80% of T. indotineae isolates displayed terbinafine resistance linked to squalene epoxidase mutations, while no phenotypic azole resistance was observed, consistent with the absence of cyp51 mutations. Single-nucleotide polymorphism (SNP) analysis of both T. indotineae (520-1531 SNPs) and T. interdigitale (1380-115 963 SNPs) revealed no phylogenetic clustering, suggesting independent introductions.</p>","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Zoonotic sporotrichosis: Systematic review and clinical aspects of feline and canine cases.","authors":"Ailén Dumont-Viollaz, Dos Amanda Ribeiro Santos, Pamela Thomson","doi":"10.1093/mmy/myaf060","DOIUrl":"10.1093/mmy/myaf060","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Sporotrichosis is a worldwide endemic mycosis caused by thermodimorphic fungi of the genus Sporothrix. Of the around 70 Sporothrix species, four are classified within the clinical or pathogenic clade (Sporothrix schenckii, S. brasiliensis, S. globosa, and S. luriei), which are usually isolated from animal and human infections. The disease shows various clinical presentations (fixed and disseminated cutaneous, lymphocutaneous, systemic, or extracutaneous forms), with itraconazole being the antifungal of choice in most cases. The cat is the key player in the zoonotic scenario of sporotrichosis, but despite the high number of felines with sporotrichosis, there are few studies that explore the clinical aspects of the disease in dogs and cats. The objective of this review was to establish associations between clinical aspects and treatment outcomes in feline and canine sporotrichosis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Through a systematic review using the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) method, scientific articles from Web of Science (WOS) and Scopus databases were collected. The presence of information about the treatment and clinical outcome of feline and canine sporotrichosis was used as inclusion criterion. We included articles in English, Portuguese, or Spanish, published from 1978 to August 5, 2024. The data collected included patient species, sex, country, lifestyle, predisposing factors, diagnosis, sporotrichosis clinical form, disease evolution time, therapy type, treatment, treatment duration, clinical outcomes, and side effects. To analyze the data, we used RStudio and the Python programming language in the Colaboratory (COLAB) environment. Using violin plots, we analyzed the distribution of the time of disease evolution and the duration of treatment according to (1) patient species, (2) sporotrichosis clinical form, (3) diagnosis, and (4) clinical outcome. Additionally, we analyzed the independence between qualitative variables and the strength of the association between nine different groups of variables.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of the total of 508 articles initially found, 54 met the inclusion criteria, of which 152 cases of animal sporotrichosis were reported (131 cat cases and 21 dog cases). Most of the reported cases came from Brazil, with S. brasiliensis being the species found in the highest proportion. A total of 19.73% of the cases were male cats, linked to outdoor behavior. Monotherapies were the most used type of therapy, and itraconazole was the most used antifungal, with high favorable responses and low adverse effects. Analysis of relationship of the treatment duration with the clinical outcomes showed significant association of longer treatment period and favorable clinical outcome, when compared with death or diseases relapse. Furthermore, we found statistically significant associations when the clinical outcomes were correlated with clinica","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A 40-year antifungal susceptibility surveillance of Talaromyces marneffei (1984-2024) at a tertiary hospital in Guangxi, China.","authors":"Xinyu Zhou, Yanqing Zheng, Dongyan Zheng, Zhiwen Jiang, Kaisu Pan, Guoqun Liu, Saroj Karki, Xiaojuan He, Cunwei Cao","doi":"10.1093/mmy/myaf047","DOIUrl":"10.1093/mmy/myaf047","url":null,"abstract":"<p><p>Long-term trends in the antifungal susceptibility of Talaromyces marneffei isolates have not been well characterized. We conducted a 40-year surveillance study analyzing the antifungal susceptibility of 131 T. marneffei isolates collected from the clinical laboratory of the First Affiliated Hospital of Guangxi Medical University between 1984 and 2024. In vitro susceptibilities to conventional antifungal agents, including itraconazole, voriconazole, fluconazole, and amphotericin B, were analyzed using the Clinical and Laboratory Standards Institute broth microdilution method. We also explored the potential influence of host Human Immunodeficiency Virus (HIV) status and fungal mating type (MAT) on susceptibility patterns. The minimum inhibitory concentrations (MICs) for itraconazole, voriconazole, fluconazole, and amphotericin B ranged from 0.015 to 0.06 μg/ml, 0.008 to 0.03 μg/ml, 1 to 8 μg/ml, and 0.25 to 1 μg/ml, respectively. Fluconazole showed a significant decline in susceptibility over time (P < .01), whereas the susceptibilities to the other antifungals remained stable (P > .05). The correlations observed between the MICs of different triazoles (P < .01) suggest potential cross-resistance among triazoles. MAT and HIV infection status did not significantly affect antifungal susceptibility patterns (P > .05). These findings underscore the importance of ongoing antifungal susceptibility surveillance in T. marneffei, considering the changes in fluconazole susceptibility and potential triazole cross-resistance, while other antifungals remain stable.</p>","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144192009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cat-transmitted sporotrichosis by Sporothrix brasiliensis: Focus on its potential transmission routes and epidemiological profile.","authors":"Fernanda de Andrade Galliano Daros Bastos, Marconi Rodrigues de Farias, Isabella Dib Ferreira Gremião, Francelise Bridi Cavassin, Fabiana Dos Santos Monti, Rogério Rodrigues Vilas Boas, Bruno Paulo Rodrigues Lustosa, Emanuel Razzolini, Vânia Aparecida Vicente, Flávio Queiroz-Telles","doi":"10.1093/mmy/myaf051","DOIUrl":"10.1093/mmy/myaf051","url":null,"abstract":"<p><p>Cat-transmitted sporotrichosis (CTS) by Sporothrix brasiliensis is an important epizoonosis with alarming numbers of cases involving felines, canines, and humans. Considering the increasing incidence of CTS this study sought to elucidate the epidemiological characteristics of cats with sporotrichosis and evaluate the potential transmission routes of S. brasiliensis in several biological samples from cats with sporotrichosis. Samples were collected from ulcerated skin lesions, front paws, nasal cavity, and droplets collected from sick cats during sneezing episodes in a veterinarian university hospital, in the city of Curitiba, southern Brazil, between June 2021 and April 2022. A total of 100 cats with sporotrichosis were enrolled in the study. The fungus was isolated in 60% of samples from the nasal cavity and 71% of respiratory droplets. The growth of S. brasiliensis on the right and left front paw was observed in 41% of the cats included, and in 38%, there was growth of the fungus even without an apparent lesion on the paw. Of the infected cats, 64% had multifocal lesions throughout the body. The identification of S. brasiliensis in samples of exudate, paws, nasal cavity, and sneeze droplets suggests that transmission can occur not only through classic routes, but also through the movement of the infected cat, as well as through respiratory droplets expelled by the cat sneezing or nasal drip. Furthermore, the presence of S. brasiliensis on the paws of sick cats indicates the possibility that the fungus is being disseminated in the environment in which the animal lives.</p>","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics and outcomes of ocular candidiasis among patients who use buprenorphine intravenously.","authors":"Yoo-Ri Chung, Delphine Lam, Yves Edel, Eric Caumes, Francesc March de Ribot, Arnaud Fekkar, Bahram Bodaghi, Sara Touhami","doi":"10.1093/mmy/myaf048","DOIUrl":"10.1093/mmy/myaf048","url":null,"abstract":"<p><p>We evaluated the characteristics and outcomes of ocular candidiasis in patients using buprenorphine intravenously. A retrospective analysis of 35 eyes of people who use drugs diagnosed with presumed ocular candidiasis between 2000 and 2017 was performed. Data on demographics, ocular findings, and microbiological results were extracted from medical records. Logistic regression was performed to identify factors of poor visual prognosis, then multivariate analysis used the variables that were statistically significant in univariate analysis. Most patients (83%) were male, with a mean duration of 7.1 ± 7.3 years from the onset of intravenous use of buprenorphine to diagnosis of ocular candidiasis. The mean best-corrected visual acuity (BCVA in logMAR) at diagnosis was 1.33 ± 0.73, improving significantly to 0.94 ± 0.91 at the last follow-up (P = .019). Diagnostic samples included aqueous humor from all patients and vitrectomy samples from 26 patients (74%), with positivity rates for Candida species culture of 23% and 27%, respectively. Extraocular sites tested positive for Candida in 54% of cases. Although representing 66% of identifications, Candida albicans was not the only identified organism. Treatment involved primarily fluconazole (91%) and intravitreal amphotericin B (69%). Poor visual outcomes correlated with low BCVA and presence of retinal detachment at baseline. Ocular candidiasis occurs in the context of chronic drug use. Diagnostic yield from ocular samples is relatively low, necessitating the investigation of extraocular infection sites or injection equipment. Poor baseline vision and retinal detachment were significant predictors of poor visual prognosis.</p>","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}