Emergence of black moulds in fungal disease: epidemiology and therapy.

Black moulds are a heterogeneous group of darkly pigmented (dematiaceous) fungi, widely distributed in the environment, that occasionally cause infection in humans. The clinical spectrum of infection includes mycetomas, chromoblastomycosis, sinusitis, and superficial, cutaneous, subcutaneous and systemic phaeohyphomycosis. During the last 2 years, there have been reports of infection caused by black moulds in previously healthy individuals and in immunocompromised patients, including an outbreak of fungemia in hospitalized patients. Molecular analysis of strains obtained from patients and from the environment has suggested a common nosocomial source. In addition, data on antifungal susceptibility tests have become available. Surgical excision and antifungal therapy (usually itraconazole) remain the standard treatment for these infections.