ABSTRACT
Phaeohyphomycosis, meaning fungi with dark hyphae caused by melanization, also known as dematiaceous fungi are a large fungal group containing many genera and species, with over 100 molds known to cause infection in humans. With this wide variety of organisms, the manifestations of infection are also broad and range from fungal keratitis to invasive/disseminated disease. Human hosts with disease are usually HIV co-infected, solid organ transplant recipients, or cancer patients, as well as those who are iatrogenically inoculated with the fungi. There are many treatment challenges with these infections, with strategies usually requiring both a surgical and systemic antifungal component. Polyenes, flucytosine, echinocandins, terbinafine, and azoles have all been used for therapy with many instances requiring combination of multiple classes of antifungal agents. In this chapter, we discuss some of the manifestations of these infections and outline the surgical and antifungal strategies needed for treatment success and their limitations.
