Fungal Infections (Mycosis)

What are fungal infections?

Fungal infections, or mycosis, are diseases caused by a fungus (yeast or mold). Fungal infections are most common on your skin or nails, but fungi (plural of fungus) can also cause infections in your mouth, throat, lungs, urinary tract and many other parts of your body.

What are fungi?

Fungi are living things that are classified separately from plants or animals. They move around by spreading out or sending spores (reproductive parts) into the air or environment. Many fungi live naturally in our body (mouth, GI tract, skin) but can overgrow under certain circumstances.

Scientists estimate that there are millions of fungi in the world, but only a small number of them are known to cause disease in people. This includes certain yeasts and molds.

What does a fungal infection look like?

Fungal infections on or in your skin can look red, swollen or bumpy. They can look like a rash or you might be able to see a lump under your skin. Fungal infections in your nails can make them discolored (yellow, brown or white), thick or cracked. Fungal infections in your mouth or throat can cause a white coating or patches.

Who is most at risk for fungal infections?

Anyone can get a fungal infection, especially ones that affect your skin or nails. Fungal infections are more common in places on your body that trap moisture or have a lot of friction. You’re at higher risk for infection, especially severe ones, if you have poor circulation or diabetes, or if you have a weakened immune system from:

• HIV/AIDS.
• Cancer or cancer treatments.
• Immunosuppressant medications (for autoimmune conditions or organ, stem cell or bone marrow transplants).

Is a fungal infection serious?

The most common fungal infections, like those on your skin or nails, aren’t usually serious. If you have a weakened immune system, you’re at higher risk of serious illness from certain fungal infections.

What are the types of fungal infections?

Fungal infections can be on the surface of your skin, nails or mucous membranes (superficial or mucocutaneous), underneath your skin (subcutaneous) or inside other organs of your body — like your lungs, brain or heart (deep infection).

Superficial fungal Infections

Superficial fungal infections affect your nails, skin and mucous membranes (like your mouth, throat or vagina). Examples of superficial fungal infections include:

• Ringworm (dermatophytosis). A group of fungi that live off of skin, hair and nail cells (dermatophytes) cause ringworm. They can infect your feet (tinea pedis/athlete’s foot), your groin and inner thighs (tinea cruris/jock itch), your scalp (tinea capitis), your hands (tinea manuum), your facial hair and skin around it (tinea barbae) and other parts of your body (tinea corporis).
• Onychomycosis. Many types of fungi cause infections of your fingernails or toenails (onychomycosis). This can cause discolored and cracked nails.
• Candidiasis. Candida (usually Candida albicans) causes skin and mucous membrane (mucocutaneous) infections called candidiasis. These include oral thrush, some types of diaper rash, vaginal yeast infections (vulvovaginitis), esophageal candidiasis and candidal intertrigo.
• Tinea versicolor/pityriasis versicolor. The fungus Malassezia causes skin discoloration called tinea versicolor or pityriasis versicolor.

Subcutaneous fungal infections

You can get a fungal infection under the surface of your skin (subcutaneous) if fungus gets into a cut or wound, usually through injury while working with plants (like a scratch from a thorn). They cause rashes, ulcers and other symptoms on your skin.

Subcutaneous fungal infections are more common in tropical and subtropical areas of the world. Examples include:

• Sporotrichosis (rose gardener’s disease). Sporothrix fungus causes sporotrichosis. You can also get sporotrichosis in your lungs or other parts of your body.
• Chromoblastomycosis. Many different fungi can cause chromoblastomycosis. It can cause a long-lasting (chronic) skin infections. Rarely, it spreads to other parts of your body.
• Eumycetoma. Many different fungi can cause eumycetoma. It most commonly affects your feet.

Deep fungal infections

Deep fungal infections are found in places in your body other than your skin, like your lungs, blood, urinary tract or brain. Some are opportunistic infections, meaning that they usually only cause disease in people with weakened immune systems.

Deep or invasive fungal infections include:

• Histoplasmosis. Histoplasma, the fungus that causes histoplasmosis, can infect your lungs, brain or other parts of your body. It’s commonly found in the Ohio and Mississippi River valleys.
• Coccidioidomycosis (Valley fever). Caused by the fungus Coccidioides, coccidioidomycosis can infect your lungs and, rarely, move to other parts of your body. It’s most common in California and Arizona.
• Blastomycosis. Blastomyces, the fungus that causes blastomycosis, commonly infects your bones, skin and lungs. Rarely, it can also infect your brain and spinal cord.
• Aspergillosis. Aspergillus, the mold that causes aspergillosis, can cause several types of lung infections, including allergic bronchopulmonary aspergillosis (ABPA) and chronic pulmonary aspergillosis. It can also infect other parts of your body or form a fungus ball (aspergilloma).
• Candidal urinary tract infection. Bacteria cause most urinary tract infections (UTIs), but some are caused by yeast such as Candida.
• Invasive candidiasis. Various Candida species cause invasive candidiasis. It can infect your heart, blood (candidemia), brain, eyes (endophthalmitis), bones or other parts of your body.
• Pneumocystis pneumonia (PJP). The fungus Pneumocystis jirovecii can infect your lungs and cause Pneumocystis jirovecii pneumonia (PJP).
• Mucormycosis. A group of molds called mucormycetes cause mucormycosis. Mucormycetes can infect your sinuses and brain (rhinocerebral mucormycosis), lungs (pulmonary mucormycosis), intestines (gastrointestinal mucormycosis), skin (cutaneous mucormycosis) or many parts of your body at the same time (disseminated mucormycosis).
• Cryptococcosis. Cryptococcus neoformans and Cryptococcus gattii cause cryptococcosis. They usually infect your lungs, but sometimes can infect your brain and spinal cord (cryptococcal meningitis).

What are the symptoms of fungal infections?

Symptoms of fungal infections depend on what kind of fungal infection you have and where on your body it is. Symptoms are most common on your skin, nails or mucous membranes (like your mouth, throat or vagina). Sometimes you can have symptoms of an infection in your lungs, brain, eye, intestinal tract or sinuses.

Symptoms of superficial or subcutaneous infections

Symptoms of superficial or subcutaneous infections can include:

• Itching, soreness, redness or rash in the affected area.
• Discolored, thick or cracked nails.
• Pain while eating, loss of taste or white patches in mouth or throat.
• A painless lump under your skin.

Symptoms of fungal infections in your lungs

Symptoms of fungal infections in your lungs include:

• Cough, sometimes coughing up blood.
• Fatigue (tiredness).
• Fever.
• Shortness of breath.
• Muscle aches.
• Joint pain.
• Headache.
• Night sweats.

Other symptoms of fungal infections

Symptoms of fungal infections in other parts of your body include:

• Fungal infection in or around your brain: Headache, fever, neck pain, nausea/vomiting, sensitivity to light, confusion.
• Fungal infection of your eye: Pain, redness, discharge, blurred vision, tearing, sensitivity to light.
• Fungal infection of your intestinal tract: Abdominal pain, nausea, vomiting.
• Fungal infection of your sinuses: Fever, nasal congestion, headache, one-sided facial swelling, face pain.

What causes fungal infections?

Yeast, molds and other types of fungus cause fungal infections. Most fungi don’t cause disease in people, but a few do. Some infections are opportunistic, meaning they usually don’t cause infections, but can take advantage of certain situations, like a weakened immune system.

Some common fungi you can get infections from include:

• Dermatophytes. Dermatophytes are a group of fungi that live off of keratin, a substance in your hair, your nails and the outer layer of your skin. They don’t infect living tissue.
• Candida. Candida albicans is a yeast that naturally lives on your body, usually without causing problems. Under certain conditions, it can grow too much and cause itching and redness. Rarely, it can cause serious infections.
• Environmental fungi that live in soil or water. Examples include Histoplasma, Coccidioides, Blastomyces and Aspergillus.

How do they spread?

Common ways to get fungal infections include:

• From damp public spaces, like showers and locker rooms.
• Through a break in your skin or an injury.
• From breathing fungus in from the environment (like soil or dust).
• From taking antibiotics, which can allow some fungi that are naturally found on your body to grow out of control.
• You can get some dermatophyte infections from direct contact with an infected person or animal.

Are fungal infections contagious?

Some superficial fungal diseases, like ringworm, can spread from person to person through direct contact. Studies suggest that Pneumocystis jirovecii infections can also spread from one person to another. Other deep infections, like fungus that you breathe into your lungs from the environment, aren’t usually contagious.

How is a fungal infection diagnosed?

How your healthcare provider diagnoses fungal disease depends on where it is on your body. They may look for signs of fungus in — or try to grow (culture) fungus from — samples of your:

• Skin or other affected tissue.
• Nails (nail clipping).
• Blood.
• Phlegm (sputum).
• Fluid around your brain and spinal cord (CNS fluid).
• Pee (urine).
• Fluid from your eye (secretions).
• Vaginal discharge.

If they think you have a fungal infection in your lungs, brain or other internal organ, they might get X-rays, MRI or CT imaging to look for signs of infection.

How do you cure fungal infections?

Many fungal infections can be cured with antifungal medication, which kills fungus in and on your body. What form of medication your healthcare provider prescribes depends on where the fungus is.

Some treatments may be available without a prescription (over-the-counter, or OTC), but it’s a good idea to check with your provider before treating a fungal infection.

What medications are used to treat them?

To treat a fungal disease, your provider may prescribe antifungal treatment in the form of:

• Oral medication (pills).
• IV medication, given to you at a doctor’s office or hospital directly into a vein.
• Lotion, cream or powder.
• Mouthwash or lozenges.
• Eye drops.
• Shampoo.

How can I reduce my risk of a fungal infection?

Ways to reduce your risk of various fungal infections include practicing good personal hygiene and protecting yourself from fungi that are found in the environment. Tips for avoiding fungal infections include:

• Shower after getting dirty or sweaty. Don’t let areas of your skin stay damp.
• Don’t walk barefoot in public bathrooms, showers or locker rooms.
• Wear clean, dry, cotton underwear.
• Take care of your teeth and mouth.
• Clean and use contact lenses as directed by your eye care provider.
• Keep your nails short and clean.
• Only take antibiotics as prescribed. If you take antibiotics for too long, yeast can overgrow in your body and cause an infection.
• Don’t share sporting equipment, towels or other personal items with other people.
• Wear protective clothing, like gloves, boots, long pants and long-sleeved shirts when working with soil. Wear an N95 mask to avoid breathing in harmful fungus if you live in an area where it’s commonly found.
• If you live in an area with harmful fungus in the soil, wear a mask or stay indoors with the windows closed during dust storms.

What can I expect if I have a fungal disease?

What to expect when you have a fungal infection depends on whether you have underlying conditions and where the infection is on your body. Fungal infections of your hair, skin and nails are usually not serious, but can take a while to completely go away with treatment. Deep fungal infections, like those in your lungs or other organs, can be life-threatening, especially if you’re living with a weakened immune system.

When should I see my healthcare provider?

If you have symptoms of a fungal infection, especially in your lungs or other internal organs, contact your healthcare provider. Make sure to follow up with them if you’ve been treating a fungal infection and it’s not getting better.

What questions should I ask my doctor?

• What caused this infection and how can I avoid it in the future?
• How do I prevent spreading the infection to other people?
• When should I follow up with you?
• How do I use this medication?
• How long will it take to feel better?

A note from Cleveland Clinic

Fungi is around us all the time — in fact, some types of fungus live naturally on our bodies without us even thinking about it. So it’s not surprising that most of us will get a fungal infection at some point in our lives. Most can be resolved with treatment. If you have a weakened immune system or are at risk for severe or long-lasting infections, talk to your healthcare provider about how you can protect yourself.