Mycological Tests Research Articles

爪白癬診療における真菌検査の実態調査

爪白癬診療における真菌検査の実態調査

Fungal and mycotoxin contamination of maize hybrids in different maturity groups

In the present study, the frequency of toxigenic fungi and occurrence of aflatoxin B1 (AFB1), deoxynivalenol (DON) and total fumonisins (FBs) in the kernels of six maize hybrids from different FAO maturity groups (ZP 341, ZP 427, ZP 434, ZP 560, ZP 606, ZP 666) in three localities (Belosavci, Ladjevci and Divci) in Serbia, during the harvest in 2013, was investigated. Using standard mycological tests of maize kernels, the presence of potentially toxigenic fungi species from the genera Aspergillus, Fusarium and Penicillium was found. In the studied localities, species Fusarium verticillioides was the most frequently isolated from the most hybrids, with a maximum frequency of 30%, while the presence of Aspergillus spp. ranged from 0 to 16%, and Penicillium spp. from 0 to 20%. By applying Immunoadsorbent enzymatic assay (ELISA) the concentrations of AFB1, DON and FBs were determined in maize. The differences between tested hybrids in the level of mycotoxins in kernels were statistically significant (P?0.01) for DON and FBs, but not for the content of AFB1. Also, the interaction between the hybrid and location was significant (P?0.01) for the level of DON and FBs, while there was no statistical significance for the level of AFB1. Maximum values of AFB1, DON and FBs level were 1.02 ?g kg-1 (ZP 427), 12 ?g kg-1 (ZP 341) and 1528.56 ?g kg-1 (ZP 427). The concentrations of the tested mycotoxins in kernels did not exceed the maximum allowed limits stipulated by Serbian regulations (Sluzbeni glasnik RS, 2014). Given that agro-ecological conditions in Serbia are favourable for the occurrence of toxigenic fungi and their mycotoxins, it is necessary to exert the control of maize kernels annually, in harvest and postharvest periods.

Evaluación de la Patogenicidad Inhalatoria del Micoinsecticida Beauveria bassiana LF14 en Ratones

<p>Se realizaron pruebas de bioseguridad para evaluar los posibles efectos patogénicos del aislamiento autóctono LF14 de <em>Beauveria bassiana</em> en ratones albinos NMRI; el cual posee una elevada virulencia hacia <em>Rhodnius prolixus</em> y <em>Triatoma maculata</em> (Triatominae), vectores de enfermedad de Chagas en Venezuela. Se administró 1x10<sup>9</sup> conidias/ml del hongo mediante gotas nasales. Se realizaron observaciones clínicas y de comportamiento, así como de peso corporal en forma diaria y por 14 días. Asimismo, se estimó el aclaramiento fúngico mediante examen directo y cultivo de muestras intranasales, y de infectividad con la toma de muestras de tejidos de varios órganos, incluyendo un estudio histopatológico a los 3, 7 y 14 días después de la inoculación. No ocurrieron muertes ni alteraciones clínico-patológicas discernibles, siendo el tipo de comportamiento activo-normal en el 100% de los casos. El peso promedio corporal se incrementó, tanto en los animales expuestos a LF14 <em>B. bassiana</em> como los controles, habiendo diferencias entre sexos (p<0.0000). No se detectaron anormalidades en la inspección anatomopatológica ni hubo reacciones tisulares de consideración. Solo se obtuvieron conidias viables sin germinar al día tres de la necropsia en pulmón y tráquea, sugiriendo que no existe evidencia de multiplicación fúngica. Los resultados obtenidos permiten sugerir que el aislamiento <em>B. bassiana</em> LF14 no es patogénico por vía inhalatoria en <em>Mus musculus</em> (NMRI).</p>

Epidemiology of onychomycosis in Italy: prevalence data and risk factor identification.

The prevalence of onychomycosis differs according to geographic area and over time and is influenced by several factors. The epidemiology of onychomycosis in Italy is still unclear. To evaluate the prevalence of onychomycosis in a representative sample of the Italian population a group of Dermatologists and General Practitioners carried out an observational survey on the patients coming to their office during a 1-month period. Any patient with skin or systemic disease giving their consent was enrolled. Demographic characteristics, comorbidities, lifestyles, history of previous mycosis, clinical aspects of onychomycosis and mycological evaluation were studied. A total of 8331 patients (56.7% female and 43.3% male) were evaluated. More than half of them were aged ≥46 years. Onychomycosis was diagnosed in 14.2% of patients. Big toe and thumb were the most frequently affected nails. Onychomycosis was moderate-severe in 74.1% of the cases. Mycological tests were positive in 81.3% of the cases. Dermatophytes were found in 76.6% of the cases, yeasts in 17.2% and moulds in 6.3%. Risk factors and/or comorbidities were present in 68.2% of the cases. This survey showed a 14% prevalence of onychomycosis in the evaluated population. The main risk factors were previous onychomycosis, diabetes, hallux valgus and use of occlusive footwear.

Cost analysis of inappropriate treatments for suspected dermatomycoses

Superficial mycoses are estimated to affect more than 20-25% of the world’s population with a consistent increase over the years. Most patients referred to our clinic for suspected dermatomycoses have already been treated with pharmacotherapy, without a previous mycological examination and many show changes in the clinical manifestations. Indeed, some medications, such as steroids, antiviral, antibiotics and antihistamines are not able to erase a fungal infection, but also they can cause atypical clinical manifestations. The consequences of inappropriate treatment include delayed diagnosis, prolonged healing time, and additional costs. The aims of this study were (1) to evaluate the incidence of increased costs attributable to inappropriate therapy sustained by the National Health Service and patients and (2) to highlight the importance of mycological evaluation before starting treatment, in order to improve diagnostic accuracy. An observational retrospective and prospective study was performed from September 2013 to February 2014, in 765 patients referred to our center (University Hospital “ Federico II”) in Naples, Italy, for suspected mycological infection. The following treatments (alone or in combination) were defined as inappropriate: (1) cortisone in a patient with at least one positive site; (2) antifungals in (a) patients with all negative sites or (b) ineffective antifungal treatment (in terms of drug chosen, dose or duration) in those with all positive sites; or (3) antibiotics; (4) antivirals or (5) antihistamines, in patients with ≥ 1 positive site. Five hundred and fifty patients were using medications before the assessment visit. The total amount of avoidable costs related to inappropriate previous treatments was € 121,417, representing 74% of the total treatment costs. 253/550 patients received drugs also after the visit. For these patients, the cost of treatment prescribed after mycological testing was € 42,952, with a decrease with respect to the total consumption of drugs at the time of access to the Mycology Laboratory of € 34,781. Thus, our cost analysis shows that it is important to obtain a reduction of costs for pathologies that need to be confirmed by examinations before starting treatment.

Implementation of a Training Course Increased the Diagnosis of Histoplasmosis in Colombia.

Histoplasmosis causes a significant mortality, especially persons living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) from developing countries where access to both appropriate diagnostic methods and antiretroviral therapy are limited. A total of 81 physicians assigned to 17 Colombian departments (states) received training in the clinical, epidemiological, and diagnostic aspects of histoplasmosis. Once this training was received and during the period of October 2009-November 2012, these physicians sent biological samples for immunodiagnostic, mycological, and molecular tests from their patients with suspicion of histoplasmosis. A total of 1,536 samples from 768 patients were evaluated. Of the 768 patients studied, 463 (60%) were HIV positive, 214 (28%) HIV negative, and in 91 (12%) this diagnosis was unknown, and 538 (70%) were males. The 1,536 specimens studied comprised 722 sera, 439 blood samples, and 241 urines, which were tested by immunodiffusion (ID), culture, and antigenuria, respectively; in addition, 134 specimens were tested by performing a molecular assay. Histoplasmosis was diagnosed in 133 patients (17%). After the training, we observed more diagnoses from 27 to 44 cases per year. In this study, a significantly increased number of histoplasmosis cases reported by year were observed after implementing an educational training program.

Canine bone sporotrichosis: a case report

A esporotricose é uma micose subcutânea e zoonótica, causada pelo fungo dimórfico Sporothrix schenckii. A infecção ocorre através de uma lesão traumática na pele associada ao meio ambiente ou animais. É uma doença incomum em cães, e está mais frequentemente associada aos felinos. Este artigo relata o caso de um canino atendido na Unidade Hospitalar de Animais de Companhia (UHAC) da Pontifícia Universidade Católica do Paraná (PUCPR) com diagnóstico de esporotricose óssea. O animal apresentava como sinal clínico claudicação em membros torácicos há quatro meses. Para confirmação do diagnóstico foram realizados exames hematológico, radiológico, micológico e histopatológico. O animal foi tratado durante dois meses com itraconazol na dose de 10 mg kg-1 SID, por via oral com melhora parcial, foi associado ao protocolo uma solução hipersaturada de iodeto de potássio a 20%, na dose de 40 mg kg-1, a cada 24 horas, obtendo-se regressão e cura das lesões.

Efficacy and safety of 1064-nm Nd:YAG laser in treatment of onychomycosis

Background: Onychomycosis is a common nail disease, especially in older patients. Various treatment options are currently available for onychomycosis; however, their limitations include high failure rates, time-consuming nature, high cost and high risk of drug interactions. Previous studies on the treatment of dermatophyte onychomycosis with a long-pulsed 1064-nm Nd:YAG laser demonstrated excellent outcomes without severe side effects. Objective: To evaluate the efficacy and side effects of onychomycosis treatment with a long-pulsed 1064-nm Nd:YAG laser. Methods: Sixty-four onychomycotic nails (35 patients) were evaluated. The first treatment cycle involved treatment with a long-pulsed 1064-nm Nd:YAG laser in four sessions at 1-week intervals. A potassium hydroxide examination and fungal culture were performed every week during this treatment course and then at a 1-month follow-up visit. If either test was positive for a pathogenic organism, a second treatment cycle was performed. If the two tests produced negative results, each affected nail was followed up at 3- and 6-month visits after completion of the second treatment protocol. In cases of resistance (positive for a pathogenic organism after completion of the second treatment cycle), the onychomycotic nails were excluded from the study and treated by standard methods. Results: Of all 64 nails evaluated, 59 completed the first cycle of treatment and 24 (40.7%) demonstrated mycological clearance at the 1-month follow up. Thirty-five of the 59 nails (59.3%) were positive for a pathogenic organism and underwent a second treatment cycle. Upon completion of the second treatment cycle, 28 nails remained enrolled in the study, and the mycological test results were negative in nine of these (31.2%). For all nails that completed the first or second treatment cycle, the overall cure rates at the 1-, 3- and 6-month follow-up visits were 63.5, 57.7 and 51.9%, respectively. Side effects were mild and limited to erythema and swelling after the laser procedure. Conclusions: Long-pulsed 1064-nm Nd:YAG laser therapy is safe and effective for the treatment of onychomycosis. However, a larger sample and longer follow-up period are needed to confirm our findings.

21-year retrospective study of the prevalence of Scopulariopsis brevicaulis in patients suspected of superficial mycoses.

IntroductionIn the genus Scopulariopsis, Scopulariopsis brevicaulis is the most common aetiological agent of infections in humans. It usually affects nails and is one of the commonest moulds associated with onychomycoses. Other forms of infections (skin, subcutaneous, deep tissues, and disseminated infections) have also been described.AimTo examine the prevalence of S. brevicaulis in clinical materials obtained from patients suspected of keratinized tissues mycoses.Material and methodsThe analysis of the prevalence of S. brevicaulis in clinical specimens was based on mycological test's results carried out for patients who were referred with a suspicion of superficial mycoses to the Department of Mycology, Chair of Microbiology, Jagiellonian University Medical College from 1992 till 2012.ResultsIn the years 1992–2012 16,815 clinical samples (nail scrapings, nail swabs, skin scrapings, skin swabs, hair) were collected. Pathogenic fungi were detected in 7193 samples and S. brevicaulis was present in 255 (3.5%). The prevalence of S. brevicaulis in males and females was comparable. The species was most often isolated from toenails (80%), both from males and females. In the analysed period we observed a decrease in the prevalence of S. brevicaulis. In most cases (60%) S. brevicaulis occurred alone in 40% of S. brevicaulis positive cultures, other fungi were also isolated. The fungi most frequently isolated with S. brevicaulis were Trichophyton rubrum, T. mentagrophytes, Penicillium sp., Candida sp., and Aspergillus sp.ConclusionsScopulariopsis brevicaulis is not a common cause of superficial fungal infections of keratinized tissues, but is a typical mould associated with toenail onychomycosis. A proper identification of this species in onychomycoses is essential for the implementation of effective antifungal therapy.

Seborrhoeic dermatitis and a herpes zoster infection developed during treatment with adalimumab due to Crohn's disease.

Seborrhoeic dermatitis and a herpes zoster infection developed during treatment with adalimumab due to Crohn's disease.

Mycological Evaluation of Imported Frozen Fish

A total number of 100 samples of four types of frozen fish (Barbone, Sardine, Baca and Mackerel) were collected from different Alexandria markets. The samples were subjected to mycological tests to evaluate the fungal load of these frozen fish. The result showed that the predominant genera of the isolated mould from the 4 types of fish were Asperigellus spp. and Penicillium spp. In addition to other mould isolates these were Cladosporium spp., Fusarium spp., Alternaria spp., Nigrosporium spp., Paecilomyces spp., Mucor spp. and Rhizopus spp. It showed also that the predominant genus of isolated yeast, from the 4 types of fish, was Candida spp. and the other isolated yeast were Torulopsis spp., Rhodotorulla spp. and Geotrichium spp. This study showed how these types of frozen fish were being contaminated from different sources by yeast and mould. Also, the hazardous and public health importance of such contaminants were fully discussed and suggested recommendations to improve its quality and safety were explained to be implemented.

Potential respiratory pathogens colonisation of the denture plaque of patients with chronic obstructive pulmonary disease.

The role of bacterial infections in acute exacerbations of chronic obstructive pulmonary disease (COPD) is widely examined. Denture plaque in patients with COPD is an example of bacterial and fungal biofilm, which is a reservoir of potentially pathogenic respiratory tract microorganisms. Poor denture hygiene might cause acute exacerbations of COPD. Assessment of prevalence of respiratory tract pathogens in denture plaque in stable patients with COPD and it influence on oral ontocenoses depending upon the therapy. The study was based on the clinical assessment of oral mucosa and denture hygiene in 53 patients with COPD with mean age of 70±18years and 14 generally healthy participants with mean age of 65±14years. Microbiological and mycological tests were performed by culturing direct denture swabs. The study showcased the presence of potential pathogenic micro-organisms in denture plaque of 48 patients with COPD (90%) and nine healthy subjects (64.3%). Yeast-like fungi prevailed in denture surface swabs of 40 (75%) in patients with COPD and 8 (57%) in cases of control group. In 66% of patients, various degree of oral mucosa inflammation prevailed. Denture plaque could be a potential source of bacterial and fungal infections in patients with COPD.

Mycological Evaluation of Water soluble Fixed Type Preservatives for Timbers

Three water soluble fixed type preservatives viz., copper-chrome-arsenic composition, acid-cupric-chromate composition and copper-chrome-boric composition applied on thirteen types of timbers, were evaluated for their permanence-cum-toxicity by mycological tests. The data have been statistically analysed. The results have shown that, in general, copper-chrome-arsenic preservative is superior in performance amongst these preservatives. All the preservatives have, however, been found satisfactory in respect of specific types of timbers under leached and unleached conditions.

Mucormycosis in children: a study of 22 cases in a Mexican hospital.

We present a single-centre, retrospective study (1985-2012) of 22 cases of mucormycosis in children. A total of 158 mucormycosis cases were identified, of which 22 (13.96%) were children. The mean age of the children was 10.3 years (range: 6 months-18 years), and 59% of the infections occurred in males. The rhinocerebral form was the main clinical presentation (77.27%), followed by the primary cutaneous and pulmonary patterns. The major underlying predisposing factors were diabetes mellitus in 68.18% of the patients and haematologic diseases in 27.7% of the patients. The cases were diagnosed by mycological tests, with positive cultures in 95.4% of the patients. Rhizopus arrhizus was the foremost aetiologic agent in 13/22 cases (59.1%). In 21 cultures, the aetiologic agents were identified morphologically and by molecular identification. In 10 cultures, the internal transcribed spacer region of the ribosomal DNA was sequenced. Clinical cure and mycological cure were achieved in 27.3% cases, which were managed with amphotericin B deoxycholate and by treatment of the underlying conditions.

Ten Essential Oils for Beech Wood Protection - Efficacy Against Wood-destroying Fungi and Moulds, and Effect on Wood Discoloration

This work analyses the anti-fungal efficacy and stability of 10 essential oils, as well as their colour stability, in wood. The efficacy of oils against the decay fungi Coniophora puteana and Trametes versicolor as well as the moulds Aspergillus niger and Penicillium brevicompactum was evaluated first on filter papers treated with 1, 3.5, 10%, or 100% concentrate, and then on beech wood treated with 10% solutions. Accelerated ageing of treated beech samples was done before mycological tests and consisted of heating, leaching followed by heating, and Xenotest followed by heating. The highest growth inhibition of moulds and C. puteana was caused by thyme, oregano, sweet flag, and clove oils, while the savory and birch oils were less effective. These oils are potentially useful for wood protection against brown-rot fungi and moulds, mostly in interior conditions. The essential oils had only a negligible effect against the white-rot fungus T. versicolor, which was more apparent after previous ageing of wood. Some essential oils with a yellow tone (birch, oregano, sweet flag, savory, and tea tree oils) significantly changed (p<0.05) the natural colour of beech wood, but the new colours were relatively stable and underwent only mild changes after accelerated ageing in Xenotest.

Diagnosis and treatment monitoring of toenail onychomycosis by reflectance confocal microscopy: Prospective cohort study in 58 patients

The clinical presentation of onychomycosis is often nonspecific and can lead to inappropriate antifungal therapy. Available mycologic tests share many drawbacks. We sought to evaluate the accuracy of reflectance confocal microscopy (RCM) for the diagnosis of onychomycosis compared with standard mycologic tests. In all, 58 patients with suspected onychomycosis were enrolled prospectively. RCM, potassium hydroxide preparation, and fungal culture were performed at baseline and after treatment in patients with confirmed onychomycosis. RCM diagnosis of onychomycosis was based on the presence of filamentous and/or roundish structures in the nail plate, corresponding respectively to septate hyphae and/or arthroconidia. Of patients, 46 of 58 were correctly classified by RCM, with a diagnosis yield of 79.3%, sensitivity of 52.9%, specificity of 90.2%, positive predictive value of 69.2%, and negative predictive value of 82.2%. The use of a handheld RCM imager permitted a faster examination with the same accuracy. RCM performed after treatment in 9 patients showed a normal nail plate, and healing was confirmed by mycologic tests or by follow-up. Existing RCM scanner heads are not intended for nail examination. RCM has excellent specificity and can be used as a rapid, office-based test to strengthen theprescription of antifungal therapy and for follow-up. Technical improvement could aid sensitivity.

A dermatological approach to the feet of soccer players

Background: Soccer is a sport in which the feet are very susceptible to injuries and dermatological diseases. Present literature does not have much data about the possible dermatologic conditions occurring in soccer players and the associated factors. Therefore, the aim of this study was to evaluate the dermatologic foot problems and associated factors in soccer players. Findings: We evaluated forty young soccer players and recorded dermatologic conditions localized to their feet. The skin and nail lesions were recorded by the site of occurrence, symmetry and diagnosis. Further mycological, bacteriological or other screening tests were done to clarify the diagnosis. Diagnoses were classified into 4 groups: bacterial infections, fungal infections, dermatoses and traumatic lesions. Associated factors were also evaluated in detail. The results of our study revealed that there were at least two dermatological problem in the feet of soccer players and the commonest problems were foot odor, fungal infections and traumatic lesions, respectively. Conclusion: As dermatological foot lesions are common in soccer players, regular evaluation of soccer players’ feet should be essential so as to identify skin problem, to treat them early and effectively in order to avoid deficits in performance.

Biological Composition of Sewage Sludge in the Aspect of Threats to the Natural Environment

One of the prerequisites for sustainable development is integrated waste management, including sewage sludge. Besides its good fertilization properties, sewage sludge, which is an inevitable by-product of sewage treatment, accumulates toxic chemical substances and dangerous pathogenic and toxicogenic organisms. Uncontrolled introduction of sewage sludge into soil might pose a serious threat to food chain and natural soil microfl ora. This in effect might disturb the ecological balance in a particular ecosystem. This study presents author's own investigations of the sanitary conditions of sewage sludge and the conditions after the processes of aerobic and anaerobic stabilization. The investigated sewage sludge originated from a municipal wastewater treatment plant. The sewage sludge samples were transferred onto proliferation and diagnostic media. The results of the analysis obtained in this study confi rmed that sewage sludge is a material which is rich in microorganisms, including pathogenic bacterial species such as: Escherichia coli and Salmonella typhimurium. Mycological tests demonstrated that sewage sludge is a material which is conducive to proliferation of yeast- -like and mould-like fungi, among which both pathogenic and toxinogenic species can be present. Quantitative analysis of the investigated sewage sludge demonstrated that the processes of stabilization reduce the content of microorganisms but they do not guarantee product safety in sanitary terms. A huge variability and variety of biological composition points to the need for further research in the fi eld of sanitary characteristics of sewage sludge and survival rate in microorganisms from different types of sewage sludge.

Krostki (wielkości łebka szpilki) zlokalizowane na bocznych powierzchniach twarzy

L isty do redakcji Small pustules (pin-sized) distributed on the lateral aspects of the face Krostki (wielkości lebka szpilki) zlokalizowane na bocznych powierzchniach twarzy Przegl Dermatol 2014, 101, 225–226 DOI: 10.5114/dr.2014.43815 We would like to present two cases of sterile pu- stules on the face, observed in young patients. CASE REPORTS Case 1 A 23-year-old female patient was seen in the Derma- tology Department for small pustules (pin-sized), witho- ut a rash, distributed on the lateral aspects of the face, observed 2 days prior to admission (Fig. 1). She was in a good state of health, with no history of dermatological diseases, and no history of drug intake. She was a stu- dent, not working with irritants or oily substances. Usual laboratory investigations revealed no ab- normal values. Direct mycological examination and culture for fungi were negative and culture from a pustule failed repeatedly to isolate any bacteria. Swabs taken from the nose and oral cavity were ste- rile. Endocrinological examination was normal. fever or other signs of infectious disease before the eruption. At clinical examination pin-sized pustules distributed in clusters, non-flaccid, non-tender, with no signs of inflammation were seen at the margins of the lips and on the menton. A few similar pustules were present on the lips too. No adenopathy, no fever, and no other dermatological lesions were observed. Results of complete blood count with differential leucocyte count were unremarkable. Gram stain of blister fluid was negative. Analysis of blister fluid with 10% potassium hydroxide preparation showed no fungal elements. The Tzanck test was negative. HIV and VDRL tests were negative. Full blood co- unt, coagulation screen, serum chemistry and liver function tests were all within normal limits. DISCUSSION A 17-year-old man, a pupil, came to the Dermato- logy Unit due to sudden onset of a peculiar eruption around the mouth: small pustules with no erythema- tous base, non-follicular and non-pruritic (Fig. 2). He was otherwise a healthy person, with no chronic dise- ases and no previous treatments. The patient denied All pustules in patients were parafollicular. Pre- viously, they did not use cosmetics with heavy oil as make-up. There are many similarities between the cases: young persons during educational period (a student and a pupil); healthy people, no history of drug intake; pin-sized pustules arranged in a pe- culiar form on the face, which disappeared sponta- neously within one week precisely; bacteriological, mycological and virological tests were negative. Figure 1. Patient 1. Small pustules (pin-sized) distributed on the lateral aspects of the face Figure 2. Patient 2. Small pustules (pin-sized), non-follicular, aro- und the mouth Case 2 Przegląd Dermatologiczny 2014/3

Candidal carriage, isolation and species variation in patients undergoing radiotherapy and chemotherapy for head and neck tumours

Background: Opportunistic fungal infections, mainly candidiasis, is common in immunocompromised patients such as those undergoing chemo or radiatiotherapy and pose a great threat. Hence this study was done, attempting to find out the candidal carrier state and species variation, in such patients. Aims and Objectives: To determine the prevalence and speciation of Candida colonizing in the oral cavity of individuals attending to the cancer clinics in south India. Materials and Methods: Study groups comprised of 50 healthy, asymptomatic individuals as controls (Group I); 50 patients on : chemotherapy (Group - II) and 50 patients undergoing radiotherapy for head and neck cancers (Group - III). Mycological tests for the candidal isolation and speciation were done. Results: A total of 49 cases showed candidal culture positivity (32.67%). Candidal carriage was highest in Group II and Group III (38%). C. albicans was the most prevalent species (30%). The culture positivity and the colony forming unit/ml from the subjects of control group and the study group were highly significant, in pair-wise comparisons. Conclusion: Patients undergoing chemotherapy and radiotherapy for head and neck cancers are at a risk of developing oral candidiasis due to immunosuppression. C. albicans is the predominant isolate, but non-albicans species are also emerging as opportunistic pathogens. All may cause a similar spectrum of disease but differences in disease severity and antifungal susceptibility are noted. Hence, speciation can help to target the treatment of the disease in a much better way.