Coelomycete Fungi in the Clinical Lab

Most human mycoses are incited by fungi that replicate by the production of asexual propagules (usually called conidia), which are readily dispersed throughout nature and also in vitro. Fungi that are acquired in this manner include a diversity of yeasts and dermatophytes, as well as those whose acquisition is primarily pulmonary, such as the thermally dimorphic primary pathogens, and several opportunistic genera such as Aspergillus, Fusarium and others. Recent reports, however, indicate an increasing number of infections, ranging from superficial to systemic, that are due to coelomycetous fungi. In these fungi, the asexual spores are produced within fruiting bodies referred to as a conidiomata. As these conidia are less frequently airborne, the method of acquisition is commonly by traumatic implantation of plant material or by a diversity of contaminated fomites, rather than by inhalation. These infections are also more commonly seen in immunocompromised individuals. In this work, we have attempted to provide a historial overview as well as the current taxonomy for this group of fungi, an up-to-date assessment of the scope of infections caused by various coelomycetous genera, their clinical entities, useful tools for isolation and identification, and general guidelines for the appropriate management and treatment of these mycoses.