DESCRIPTIONS OF MEDICAL FUNGI

DESCRIPTIONS OF MEDICAL FUNGI 

THIRD EDITION 

(revised November 2016) 

SARAH KIDD 1,3 , CATRIONA HALLIDAY 2 , 

HELEN ALEXIOU 1 and DAVID ELLIS 1,3 

1 National Mycology Reference Centre 

SA Pathology, Adelaide, SOUTH AUSTRALIA 

2 Clinical Mycology Reference Laboratory 

Centre for Infectious Diseases and Microbiology 

Laboratory Services, Pathology West, ICPMR, 

Westmead Hospital, Westmead, NEW SOUTH WALES 

3 

DEPARTMENT OF MOLECULAR & CELLULAR BIOLOGY 

SCHOOL OF BIOLOGICAL SCIENCES 

UNIVERSITY OF ADELAIDE, ADELAIDE 

AUSTRALIA 

2016 

We thank Pfizer Australia for an unrestricted educational grant to the Australian 

and New Zealand Mycology Interest Group to cover the cost of the printing.

Published by the Authors 

Contact: Dr. Sarah E. Kidd 

Head, National Mycology Reference Centre 

Microbiology & Infectious Diseases 

SA Pathology 

Frome Rd, Adelaide, SA 5000 

Email: sarah.kidd@sa.gov.au 

Phone: (08) 8222 3571 

Fax: (08) 8222 3543 

www.mycology.adelaide.edu.au 

© Copyright 2016 

The National Library of Australia Cataloguing-in-Publication entry: 

Creator: 

Title: 

Edition: 

ISBN: 

Notes: 

Kidd, Sarah, author. 

Descriptions of medical fungi / Sarah Kidd, Catriona Halliday, Helen Alexiou, 

David Ellis. 

Third edition. 

9780646951294 (paperback). 

Includes bibliographical references and index. 

Subjects: Fungi--Indexes. Mycology--Indexes. 

Other Creators/Contributors: 

Halliday, Catriona L., author. 

Alexiou, Helen, author. 

Ellis, David (David H.), author. 

Dewey Number: 579.5 

Printed in Adelaide by 

Newstyle Printing 

41 Manchester Street 

Mile End, South Australia 5031 

Front cover: Cryptococcus neoformans, and montages including Syncephalastrum, 

Scedosporium, Aspergillus, Rhizopus, Microsporum, Purpureocillium, Paecilomyces 

and Trichophyton. Back cover: the colours of Trichophyton spp.

Descriptions of Medical Fungi 

iii 

PREFACE 

The first edition of this book entitled Descriptions of Medical QAP Fungi was published 

in 1992 by David Ellis, Steve Davis, Helen Alexiou, Tania Pfeiffer and Zabeta 

Manatakis. The original concept was to provide all laboratories in the Royal College of 

Pathologists of Australasia (RCPA) Mycology Quality Assurance Program (QAP) with 

a set of description sheets covering medically important fungi. A second edition entitled 

Descriptions of Medical Fungi was released in 2007 by David Ellis, Steve Davis, Helen 

Alexiou, Rosemary Handke and Robyn Bartley. We now provide an updated third 

edition which includes new and revised descriptions. We have endeavoured to reconcile 

current morphological descriptions with more recent phylogenetic studies, however 

nomenclature changes in mycology are ongoing. To search for current accepted 

fungal names go to Index Fungorum (www.indexfungorum.org) and Mycobank (www. 

mycobank.org). 

Morphological Descriptions: These descriptions have by necessity been kept brief 

and many have been based on descriptions by other authors. For further information 

regarding any of the mycoses or pathogenic fungi mentioned, the reader is referred to 

the citations provided. For the precise definitions of the mycological terminology used, 

the reader is referred to Ainsworth and Bisby’s Dictionary of the Fungi (Kirk et al. 2008). 

Classification of the Fungi 

Kingdom Fungal Phyla Examples 

Protozoa Myxomycota Slime moulds 

Chromista Oomycota Pythium 

Eumycota 

Ascomycota 

Basidiomycota 

Chytridiomycota 

Glomeromycota 

Microsporidia 

Zygomycota 

Candida, Aspergillus, Scedosporium, 

Fusarium, Paecilomyces, Penicillium, 

Cladophialophora, Bipolaris, and other 

hyphomycetes, including the dimorphic 

fungi, dermatophytes, and Pneumocystis 

(Taphrinomycotina). 

Cryptococcus, Trichosporon, Malassezia. 

Chytrids 

Endomycorrhizal on plants 

170 genera, 1300 species 

Apophysomyces, Lichtheimia, Mucor, 

Saksenaea, Rhizomucor, Rhizopus. 

Fungi are now classified across three Kingdoms. Descriptions in this book are 

limited to the Eumycota and include medically important representatives from the 

Ascomycota, Basidiomycota and Zygomycota.

iv 


PREFACE 

Key Morphological Characters 

Culture Characteristics: 

• Surface texture [glabrous, suede-like, powdery, granular, fluffy, downy, cottony] 

• Surface topography [flat, raised, heaped, folded, domed, radial grooved] 

• Surface pigmentation [white, cream, yellow, brown, pink, grey, black etc] 

• Reverse pigmentation [none, yellow, brown, red, black, etc] 

• Growth rate [colony diameter 5 cm in 15 days] 

• Growth at 37 O C, 40 O C, 45 O C. 

Zygomycota. Sporangia characteristics: 

• Arrangement of sporangiospores [multispored, sporangiola, merosporangium] 

• Arrangement of sporangiophores [unbranched often in groups or frequently branched] 

• Sporangium shape [pyriform, spherical, flask-shaped etc] 

• Sporangium size [100 μm diam.] 

• Columella [Present or Absent] 

• Apophyses [Present or Absent] 

• Sporangiophore height [1 mm] 

• Rhizoids [Present or Absent] (look in the agar) 

• Sporangiospore size [6 μm] 

Hyphomycetes - Conidial Moulds 

1. Conidial characteristics: 

• Septation [one-celled, two-celled, multicelled with transverse septa only, or multicelled with 

both transverse and longitudinal septa] 

• Shape [spherical, sub-spherical, pyriform, clavate, ellipsoidal, etc] 

• Size [need a graduated eyepiece, length 10 μm] 

• Colour [hyaline or darkly pigmented] 

• Wall texture [smooth, rough, verrucose, echinulate] 

• How many conidial types present? [i.e. micro and macro] 

2. Arrangement of conidia as they are borne on the conidiogenous cells: 

• Solitary [single or in balls] 

• Catenulate (in chains) [acropetal (youngest conidium at the tip) or basipetal (youngest 

conidium at the base] 

3. Growth of the conidiogenous cell: 

• Determinant (no growth of the conidiophore after the formation of conidia) 

• Sympodial (a mode of conidiogenous cell growth which results in the development of 

conidia on a geniculate or zig-zag rachis) 

4. Type of conidiogenous cell present: 

• Non-specialised 

• Phialide (specialised conidiogenous cells that produces conidia in basipetal succession 

without increasing in length) 

• Annellide (specialised conidiogenous cell producing conidia in basipetal succession by a 

series of short percurrent proliferations (annellations). The tip of an annellide increases in 

length and becomes narrower as each subsequent conidium is formed) 

5. Any additional features present: 

• Hyphal structures [clamps, spirals, nodular organs, etc] 

• Synnemata, Sporodochia, Chlamydoconidia, Pycnidia 

• Confirmatory tests for dermatophytes


v 

PREFACE 

Molecular and/or MALDI-TOF MS Identification: The use of PCR-based assays, DNA 

sequencing, and other molecular methods, including those incorporating proteomic 

approaches such as matrix assisted laser desorption ionization time of flight mass 

spectroscopy (MALDI-TOF MS) have shown promising results to aid in accurate species 

identification of fungal cultures. These are used mainly to complement conventional 

methods since they require standardisation before widespread implementation can be 

recommended (Halliday et al. 2015). Molecular-based fungal identification is particularly 

helpful for fungi that lack distinguishing morphological features, e.g. Apophysomyces 

elegans, or to distinguish between species of the Aspergillus fumigatus complex. 

Comparative sequence analysis is now the ‘gold standard’ for identification of fungi. 

Methods are referenced where available and in many instances are recommended for 

more definitive identifications. 

Schematic diagram of the fungal rDNA gene cluster (adapted from CLSI MM18-A 

and Halliday et al. 2015). The 18S, 5.8S and 28S rDNA genes are separated by the 

two internal transcribed spacers. The 28S and 5S rDNA genes are separated by the 

intergenic spacer 1 (IGS1). The intergenic spacer 2 (IGS2) separates the rDNA repeat 

units from each other. 

Regardless of the genetic locus selected, accurate sequence-based identification is 

dependent upon database accuracy and adequate species representation. GenBank 

is well known to contain numerous errors in sequences and the species names 

attributed to the sequences, which are rarely corrected. Therefore caution must be 

used when interpreting sequencing comparisons against this database, and the use of 

multiple sequence databases is encouraged. Well-curated databases that are helpful 

for species identification include: 

1. International Society for Human and Animal Mycoses (ISHAM) ITS database (http:// 

its.mycologylab.org/). 

2. CBS-KNAW Fungal Biodiversity Centre database (http://www.cbs.knaw.nl).

vi 


PREFACE 

Frequently used molecular targets for species identification are outlined below: 

ITS 

D1/D2 

β-tubulin 

Molecular Target 

Internal transcribed spacer 

regions (ITS1-5.8S-ITS2) 

D1/D2 variable domains of 

the 28S rDNA gene 

Beta tubulin II 

Application 

Species level identification of wide 

range of fungi 

Species identification of many of the 

Mucorales 

Accurate species resolution of 

Aspergillus. 

Cal Calmodulin Species discrimination of Alternaria. 

EF-1α 

RPB1 

RPB2 

ACT 

GPDH 

Elongation factor alpha 

subunit 

RNA polymerase I subunit 

RNA polymerase II subunit 

Actin 

Glycerol-3-phosphate 

dehydrogenase 

Species complex identification of 

Fusarium. 

Species complex identification within 

genera of Fusarium, Penicillium and 

Talaromyces. 

Species discrimination of Aspergillus, 

Cladosporium, Coniochaeta, Verticillium, 

Verruconis. 

Species discrimination of Bipolaris, 

Curvularia, Verticillium. 

CHS Chitin synthase Species discrimination of Sporothrix 

Chi18-5 Chitinase 18-5 Species discrimination of Trichoderma 

Antifungal Susceptibility: For many species, antifungal susceptibility data has also 

been provided. This has been derived from both the literature and data from Australian 

clinical isolates generated by using the CLSI M27-A Standard for yeasts and the CLSI 

M38-A Standard for moulds. This composite data is provided as a guide only. In many 

cases the clinical relevance of in vitro antifungal susceptibility results remains difficult 

to interpret, and expert advice from a consulting microbiologist or infectious disease 

specialist may be required. 

CLSI M27-S4 clinical breakpoints are marked where available (green for susceptible, 

yellow for susceptible dose dependant or intermediate, red for resistant). 

Abbreviations: Amphotericin B (AmB), Fluconazole (FLU), Itraconazole (ITRA), 

Posaconazole (POSA), Voriconazole (VORI), Anidulafungin (ANID), Caspofungin 

(CAS), Micafungin (MICA), 5-Fluorocytosine (5FC), Terbinafine (TERB). 

Risk group (RG) recommendations are based on published data and on current 

definitions in accordance with the Australian/New Zealand Standard AS/NZS 

2243.3:2010. Safety in laboratories Part 3: Microbiological safety and containment. 

Note: International biosafety guidelines vary in their RG ratings of fungal species.


vii 

CONTENTS 

Acremonium 1 

Acrophialophora fusispora 2 

Alternaria 3 

Aphanoascus fulvescens 5 

Apophysomyces complex 6 

Arthroderma insingulare (formerly Trichophyton terrestre) 9 

Arthroderma uncinatum (formerly Trichophyton ajelloi) 10 

Arthrographis kalrae 11 

Aspergillus 12 

Aspergillus flavus complex 14 

Aspergillus fumigatus complex 16 

Aspergillus felis 16 

Aspergillus fumigatus 17 

Aspergillus lentulus 19 

Neosartorya fischeri 20 

Aspergillus nidulans complex 21 

Aspergillus niger complex 23 

Aspergillus terreus complex 25 

Aureobasidium pullulans 27 

Basidiobolus ranarum 28 

Beauveria 30 

Bipolaris 31 

Blastomyces dermatitidis 32 

Candida 34 

Candida albicans 37 

Candida catenulata 38 

Candida dubliniensis 39 

Candida glabrata complex 40 

Candida bracarensis 40 

Candida glabrata 41 

Candida nivariensis 42 

Candida haemulonii 43 

Candida inconspicua 44 

Candida parapsilosis complex 45 

Candida metapsilosis 45 

Candida orthopsilosis 46 

Candida parapsilosis 47 

Lodderomyces elongisporus 48 

Candida rugosa 49 

Candida tropicalis 50 

Chaetomium 51 

Chrysosporium tropicum 52 

Cladophialophora 53 

Cladophialophora bantiana 53 

Cladophialophora carrionii 55 

Cladosporium 57 

Clavispora lusitaniae (formerly Candida lusitaniae) 59 

Coccidioides immitis/posadasii complex 60

viii 


CONTENTS 

Colletotrichum coccodes 62 

Conidiobolus coronatus 63 

Coniochaeta hoffmannii (formerly Lecythophora hoffmannii) 64 

Cryptococcus 66 

Cryptococcus albidus 67 

Cryptococcus gattii 68 

Cryptococcus laurentii 70 

Cryptococcus neoformans 71 

Cunninghamella bertholletiae 73 

Curvularia 75 

Cyberlindnera fabianii (formerly Candida fabianii) 79 

Cylindrocarpon 80 

Debaryomyces hansenii (formerly Candida famata) 81 

Drechslera 82 

Epicoccum nigrum 83 

Epidermophyton floccosum 84 

Exophiala 85 

Exophiala dermatitidis 85 

Exophiala jeanselmei complex 86 

Exophiala spinifera complex 89 

Exserohilum rostratum 91 

Fonsecaea complex 93 

Fusarium 94 

Fusarium chlamydosporum complex 96 

Fusarium dimerum complex 97 

Fusarium fujikuroi complex 98 

Fusarium incarnatum-equiseti complex 98 

Fusarium oxysporum complex 99 

Fusarium solani complex 100 

Geotrichum candidum 102 

Gliocladium 104 

Graphium 105 

Histoplasma capsulatum 107 

Hortaea werneckii 108 

Kluyveromyces marxianus (formerly Candida kefyr) 109 

Lasiodiplodia theobromae 110 

Lichtheimia corymbifera (formerly Absidia corymbifera) 111 

Lomentospora prolificans (formerly Scedosporium prolificans) 113 

Lophophyton gallinae (formerly Microsporum gallinae) 115 

Madurella complex 116 

Madurella mycetomatis 116 

Trematosphaeria grisea (formerly Madurella grisea) 117 

Magnusiomyces capitatus (formerly Geotrichum capitatum) 118 

Malassezia 119 

Malbranchea pulchella 121 

Meyerozyma guilliermondii (formerly Candida guilliermondii) 122 

Microsphaeropsis arundinis 123


ix 

CONTENTS 

Microsporum 124 

Microsporum audouinii 125 

Microsporum canis 126 

Microsporum ferrugineum 129 

Mortierella wolfii 130 

Mucor 131 

Mucor amphibiorum 132 

Mucor circinelloides 133 

Mucor indicus 134 

Mucor irregularis 135 

Mucor ramosissimus 135 

Myrmecridium schulzeri (formerly Ramichloridium schulzeri) 136 

Nannizzia 137 

Nannizzia fulva (formerly Microsporum fulvum) 137 

Nannizzia gypsea (formerly Microsporum gypseum) 138 

Nannizzia nana (formerly Microsporum nanum) 139 

Nannizzia persicolor (formerly Microsporum persicolor) 140 

Neoscytalidium dimidiatum (formerly Hendersonula toruloidea) 141 

Ochroconis 143 

Onychocola canadensis 144 

Paecilomyces 145 

Paecilomyces marquandii 146 

Paecilomyces variotii 147 

Paracoccidioides brasiliensis 148 

Paraphyton cookei (formerly Microsporum cookei) 149 

Penicillium 150 

Phaeoacremonium parasiticum 152 

Phialophora verrucosa 154 

Phoma 155 

Pichia 156 

Pichia kudriavzevii (formerly Candida krusei) 156 

Pichia norvegensis (formerly Candida norvegensis) 157 

Pithomyces chartarum 158 

Pleurostomophora richardsiae (formerly Phialophora richardsiae) 159 

Prototheca 160 

Purpureocillium lilacinum (formerly Paecilomyces lilacinus) 161 

Quambalaria cyanescens 163 

Rhinocladiella 164 

Rhinocladiella atrovirens 164 

Rhinocladiella mackenziei (formerly Ramichloridium mackenziei) 165 

Rhizomucor 166 

Rhizomucor miehei 166 

Rhizomucor pusillus 167 

Rhizopus 168 

Rhizopus arrhizus (formerly Rhizopus oryzae) 169 

Rhizopus microsporus 170 

Rhodotorula 171 

Rhodotorula glutinis 172 

Rhodotorula mucilaginosa 173

x 


CONTENTS 

Saccharomyces cerevisiae 174 

Saksenaea vasiformis complex 175 

Saprochaete clavata (formerly Geotrichum clavatum) 177 

Sarocladium (formerly Acremonium) 178 

Scedosporium 179 

Scedosporium apiospermum 179 

Scedosporium aurantiacum 181 

Scedosporium boydii (formerly Pseudallescheria boydii) 182 

Schizophyllum commune 183 

Scopulariopsis 184 

Sepedonium 185 

Sporothrix schenckii complex 186 

Stemphylium 188 

Syncephalastrum racemosum 189 

Talaromyces marneffei (formerly Penicillium marneffei) 190 

Torulaspora delbrueckii (formerly Candida colliculosa) 192 

Trichoderma 193 

Trichophyton 194 

Trichophyton concentricum 195 

Trichophyton equinum 196 

Trichophyton eriotrephon (formerlyTrichophyton erinacei) 198 

Trichophyton interdigitale 200 

Trichophyton mentagrophytes 203 

Trichophyton quinckeanum 205 

Trichophyton rubrum 207 

Trichophyton schoenleinii 211 

Trichophyton soudanense 212 

Trichophyton tonsurans 213 

Trichophyton verrucosum 215 

Trichophyton violaceum 217 

Trichosporon 218 

Trichosporon asahii 219 

Trichosporon asteroides 221 

Trichosporon cutaneum 221 

Trichosporon inkin 222 

Trichosporon mucoides 222 

Trichosporon ovoides 222 

Trichothecium roseum 223 

Ulocladium 224 

Veronaea botryosa 225 

Verruconis gallopava (formerly Ochroconis gallopava) 226 

Verticillium 228 

Wickerhamomyces anomalus (formerly Candida pelliculosa) 229 

Yarrowia lipolytica (formerly Candida lipolytica) 230


xi 

CONTENTS 

Microscopy Stains & Techniques 231 

KOH with Calcofluor White 231 

KOH with Chlorazol Black 231 

India Ink mounts 231 

Lactophenol cotton blue (LPCB) 232 

Direct microscopic preparations 232 

Cellotape flag preparations 232 

Slide culture preparations 233 

Specialised Culture Media 234 

Bird seed agar 234 

Bromocresol purple milk solids agar 234 

Creatinine dextrose bromothymol blue thymine (CDBT) media 235 

Canavanine glucose bromothymol blue (CGB) media 235 

Cornmeal agar 236 

Cornmeal glucose sucrose agar 236 

Czapek Dox agar 236 

Modified Dixon’s agar 236 

Hair perforation test 237 

Lactritmel agar 237 

Littman oxgall agar 237 

Malt extract agar 238 

1% Peptone agar 238 

Potato dextrose agar 238 

Rice grain slopes 238 

Sabouraud’s dextrose agar (SDA) + cycloheximide and antibiotics 239 

Sabouraud’s dextrose agar (SDA) + antibiotics 239 

Sabouraud’s dextrose agar (SDA) 5% salt 239 

Tap water agar 240 

Urea agar with 0.5% glucose 240 

Vitamin free agar 240 

References 241

xii 


Schematic for the identification of medically important fungi. 

Acremonium Link ex Fries 

Key Features: Hyphomycete with solitary, erect, hyaline, awl-shaped phialides 

producing single-celled, globose to cylindrical conidia, mostly in slimy heads. 

Antifungal Susceptibility: Acremonium spp. data from about 60 isolates (Perdomo 

et al. 2011 and Australian National data); MIC µg/mL. 

Antifungal Range MIC 90 


AmB 0.25-16 16 VORI 0.06-8 8 

ITRA 0.25-16 16 POSA 0.125-8 16 

References: Gams (1971), Domsch et al. (2007), Samson et al. (1995), de Hoog et 

al. (2000, 2015), Glenn et al. (1996), Perdomo et al. (2011a), Summerbell et al. (2011).

Descriptions of Medical Fungi 1 

The genus Acremonium contains many species; most are saprophytic being isolated 

from dead plant material and soil. Several species including A. recifei and A. 

alabamense are recognised as opportunistic pathogens of man and animals, causing 

mycetoma, mycotic keratitis and onychomycosis. Recently, several Acremoniumlike 

species recognised as opportunistic pathogens have been transferred to other 

genera; Fusarium falciforme (formerly A. falciforme), Sarocladium kiliense (formerly 

A. kiliense), Gliomastic roseogriseum (formerly A. roseogriseum) and Sarocladium 

strictum (formerly A. strictum) (Glenn et al. 1996, Summerbell et al. 2011). 

RG-2 for species isolated from humans. 

Acremonium Link ex Fries 

Morphological Description: Colonies are usually slow growing, often compact and 

moist at first, becoming powdery, suede-like or floccose with age, and may be white, 

grey, pink, rose or orange in colour. Hyphae are fine and hyaline and produce mostly 

simple awl-shaped erect phialides with inconspicuous collarettes. Conidia are usually 

one-celled, hyaline or rarely pigmented, globose to cylindrical, and mostly aggregated 

in slimy heads at the apex of each phialide. Chlamydospores may be present. 

Comments: Microconidial Fusarium isolates may be confused with Acremonium, but 

they usually grow faster and have colonies with a characteristic fluffy appearance. 

Phialemonium species differ by having short, tapering phialides, mostly lacking a basal 

septum. Coniochaeta is characterised by having sessile phialidic collarettes that are 

formed directly on the hyphae. 

Molecular Identification: Summerbell et al. (2011) revised the genus on the basis of 

18S and D1/D2 sequence phylogeny. Sequence based identification may be performed 

using the D1/D2 or the ITS region. Caution must be exercised in the interpretation of 

database sequence comparisons due to the scarcity of database sequences from wellcharacterised 

strains, and some sequences may have been attributed to species that 

have been reclassified (Perdomo et al. 2011a). 

10 µm 

Acremonium spp. showing long awl-shaped phialides producing cylindrical, onecelled 

conidia mostly aggregated in slimy heads at the apex of each phialide.

2 


The genus Acrophialophora contains 16 species that are most commonly associated 

with soil, especially from India (Zhang et al. 2015a). Two species have been reported 

as human pathogens, A. fusispora and A. levis (Sandoval-Denis et al. 2015). ITS 

sequencing is recommended for species identification. 

RG-1 organism. 

Acrophialophora fusispora (S.B. Saksena) Samson 

Morphological Description: Colonies fast growing, greyish-brown with a black 

reverse. Conidiophores arising singly, terminally and laterally from the hyphae, erect, 

straight or slightly flexuose, tapering towards the apex, pale brown, rough-walled, up 

to 15 μm long, 2-5 μm wide, with whorls of phialides on the upper part. Phialides 

flask-shaped with a swollen base and a long, narrow neck, hyaline, smooth-walled or 

echinulate, 9-15 x 3-4.5 μm in the broadest part. Conidia in long chains, limoniform, 

one-celled, pale brown 5-12 x 3-6 μm, smooth to finely echinulate with indistinct spiral 

bands. Temperature: optimum 40 O C; maximum 50 O C. 

Key Features: Hyphomycete with flask-shaped phialides producing long chains of 

one-celled, limoniform, pale brown conidia, with indistinct spiral bands. Note: In A. 

levis the conidia lack spiral bands and the phialides have verruculose walls. 

Molecular Identification: D1/D2, ITS, 18S and β-tubulin sequences have been 

reported by Sandoval-Denis et al. (2015) and Zhang et al (2015a). 

References: Domsch et al. (2007), de Hoog et al. (2000, 2015), Al-Mohsen et al. 

(2000), Guarro et al. (2007), Sandoval-Denis et al. (2015), Zhang et al. (2015a). 

b 

10 μm 

a 

Acrophialophora fusispora (a) culture and (b) 

phialides and conidia with spiral striations (arrows). 

Antifungal Susceptibility: A. fusispora data from about 40 isolates (Sandoval- 

Denis et al. 2015 and Australian National data); MIC µg/mL. 



AmB 1-32 16 VORI 0.06-0.5 0.25 

ITRA 0.125-4 1 POSA 0.25-1 1


A ubiquitous genus containing common saprophytes in soil and air, and plant pathogens. 

A. infectoria is the most common clinical species (Pastor and Guarro, 2008). Although 

usually seen as saprophytic contaminants, Alternaria species in particular A. alternata 

and A. infectoria are recognised causative agents of subcutaneous phaeohyphomycosis 

and mycotic keratitis. They are a rare cause of onychomycosis, usually following trauma 

to the nail. 

RG-1 organisms. 

Alternaria Nees ex Fries 

Morphological Description: Colonies are fast growing, black to olivaceous-black or 

greyish, and are suede-like to floccose. Microscopically, branched acropetal chains 

(blastocatenate) of multicellular conidia (dictyoconidia) are produced sympodially from 

simple, sometimes branched, short or elongate conidiophores. Conidia are obclavate, 

obpyriform, sometimes ovoid or ellipsoidal, often with a short conical or cylindrical beak, 

pale brown, smooth-walled or verrucose. Temperature: optimum 25-28 O C; maximum 

31-32 O C. 

Molecular Identification: Multilocus genotype studies have shown the Alternaria 

complex currently comprises nine genera and eight Alternaria sections (Woudenbert et 

al. 2013). ITS sequencing is sufficient for genus and usually species level identification 

and can clearly differentiate A. alternata and A. infectoria (Pastor and Guarro, 2008). 

However, it is estimated that >14% of GenBank sequences of Alternaria species 

are misclassified, so unknown sequences should be compared to those of wellcharacterised 

reference strains (Woudenberg et al. 2013). 

Comments: Alternaria species soon lose their ability to sporulate in culture. Potato 

dextrose agar and cornmeal agar are the most suitable media to use, and incubation 

under ultra-violet light is recommended to maintain sporulation. 

Key Features: Dematiaceous hyphomycete producing chains of darkly pigmented, 

ovoid to obclavate dictyoconidia, often with short conical or cylindrical beaks. 

References: Simmons (1967, 2007), Ellis (1971), Domsch et al. (2007), Samson et al. 

(1995), de Hoog et al. (2000, 2015), Pryor and Gilbertson (2000), de Hoog and Horre 

(2002), Pastor and Guarro (2008), Woudenberg et al. (2013). 

Antifungal Susceptibility: Alternaria spp. (Australian National data); MIC µg/mL. 

No 8 

AmB 10 3 1 4 2 

VORI 10 1 3 5 1 

POSA 9 2 1 5 1 

ITRA 10 1 1 2 5 1

4 


Alternaria Nees ex Fries 

Alternaria alternata colonies are black to olivaceous-black or 

greyish, and are suede-like to floccose. 

20 μm 

Alternaria alternata showing branched acropetal chains and multicelled, 

obclavate to obpyriform conidia with short conical beaks.


Aphanoascus fulvescens is a soil-borne keratinolytic ascomycete that occasionally 

causes dermatomycosis in humans and animals. 


Aphanoascus fulvescens (Cooke) Apinis 

Morphological Description: Colonies are moderately fast growing, white to tan with 

the production of numerous spherical, pseudoparenchymatous, buff to light brown 

cleistothecia (non-ostiolate ascocarps). Asci are subspherical to ellipsoidal and eightspored. 

Ascospores light brown, yellowish to pale brown in mass, irregularly reticulate, 

lens-shaped, 3.5-4.7 x 2.5-3.5 µm. Aphanoascus fulvescens has a Chrysosporium 

anamorph showing typical pyriform to clavate-shaped conidia with truncated bases, 

15-17.5 x 3.7-6 µm, which are formed either intercalary, laterally or terminally. 

Molecular Identification: ITS sequencing will differentiate most species. The 

calmodulin gene may also be useful (Cano et al. 2002, Halliday et al. 2015). 

Key Features: Keratinolytic, cleistothecia, and a Chrysosporium anamorph. 

References: Domsch et al. (2007), McGinnis (1980), de Hoog et al. (2000, 2015), 

Cano and Guarro (1990), Cano et al. (2002). 

a 

b 

100 μm 

c 

10 μm 

Aphanoascus flavescens (a) culture, (b) cleistothecium and (c) conidia.

6 


Apophysomyces complex 

Historically the genus Apophysomyces was considered to be monotypic and A. elegans 

was reported to be an important human pathogen in immunocompetent patients 

following traumatic implantation. A phylogenetic revision of the genus has identified 

three additional species, A. ossiformis, A. trapeziformis and A. variabilis. Many isolates 

previously identified as A. elegans, now appear to be A. variabilis (Alvarez et al. 2010a). 

Molecular identification is required to accurately differentiate these species. 

Morphological characteristics overlap so identification and reporting of Apophysomyces 

complex is recommended for most diagnostic laboratories. 

Molecular Identification: The ITS region and D1/D2 domain may provide for accurate 

species identification (Halliday et al. 2015). ITS restriction fragment length polymorphism 

analysis has also been described (Chakrabarti et al. 2003). 


Apophysomyces elegans Misra, Srivastava & Lata 

Morphological Description: Colonies are fast growing, white, becoming brownish 

grey with age, downy with no reverse pigment, and are composed of broad, sparsely 

septate (coenocytic) hyphae. Sporangiophores are unbranched, straight or curved, 

slightly tapering towards the apex, up to 540 µm long, 3-6 µm in width near the 

apophysis, and hyaline when young but developing a light to dark brown pigmentation 

and a conspicuous subapical thickening 10-16 µm below the apophysis with age. 

Sporangiophores arise at right angles from the aerial hyphae and often have a septate 

basal segment resembling the “foot cell” commonly seen in Aspergillus. Rhizoids are 

thin-walled, subhyaline and predominantly unbranched. Sporangia are multispored, 

small (20-58 µm diameter), typically pyriform in shape, hyaline at first, sepia-coloured 

when mature, with distinct apophyses and columellae. Columellae are hemispherical 

in shape and the apophyses are distinctly funnel or bell-shaped. Sporangiospores are 

smooth-walled, subspherical to cylindrical, (5-8 x 4-6 µm), subhyaline to sepia in mass. 

Good growth at 26 O C, 37 O C and 42 O C. 


Apophysomyces variabilis Alvarez et al. 

Morphological Description: Colonies are fast growing, whitish with scarce aerial 

mycelium and no reverse pigment. Sporangiophores are erect, generally arising singly, 

unbranched, slightly tapering towards the apex, up to 100-400 µm long, 2-3.5 µm in 

width near the apophysis, hyaline when young but developing a light greyish brown 

pigmentation with age. Sporangia are multispored, small (15-50 µm diameter), typically 

pyriform in shape, hyaline at first, sepia-coloured when mature, with distinct apophyses 

and columellae. Columellae are hemispherical in shape and the apophyses are short 

and distinctly funnel-shaped. Sporangiospores are smooth-walled, variable in shape, 

trapezoid, ellipsoidal, sub-triangular or claviform, (5-14 x 3-6 µm), subhyaline to sepia 

in mass. Good growth at 26 O C, 37 O C and 42 O C.



10 μm 

a 

10 μm 

b 

Apophysomyces elegans/variabilis (a) young, multispored, pyriform shaped sporangium 

showing a typical funnel-shaped apophysis but without the subapical thickening of 

a more mature sporangiophore, and (b) mature sporangium showing distinct funnelshaped 

apophyses, columellae, and a conspicuous pigmented subapical thickening 

which constricts the lumen of the sporangiophore below the apophysis (arrow). 

Sporangiospores are smooth-walled, oblong and subhyaline.

8 



Comment: Apophysomyces complex is readily distinguished from other zygomycetes, 

especially the morphologically similar, strongly apophysate pathogen Lichtheimia 

corymbifera, by having sporangiophores with distinctive funnel or bell-shaped 

apophyses and hemispherical-shaped columellae. In addition, there is a conspicuous 

pigmented subapical thickening, which constricts the lumen of the sporangiophore 

below the apophysis, and distinctive foot cells. 

Laboratory identification of this fungus may be difficult or delayed because of the mould’s 

failure to sporulate on primary isolation media or on subsequent subculture onto potato 

dextrose agar. Sporulation may be stimulated by the use of nutrient deficient media, 

like cornmeal-glucose-sucrose-yeast extract agar, Czapek Dox agar, or by using the 

agar block method described by Ellis and Ajello (1982) and Ellis and Kaminski (1985). 

Molecular-based identification is particularly helpful for the definitive identification of 

poorly sporulating cultures. 

Key Features: Soil fungus with a tropical to subtropical distribution. Characteristic 

“cocktail glass” apophysate sporangial morphology with conspicuous subapical 

thickening of the sporangiophore. Resistance to cycloheximide. Rapid growth at 42 O C, 

no growth at 50 O C. 

References: Misra et al. (1979), Ellis and Ajello (1982), Padhye and Ajello (1988), 

Wieden et al. (1985), Lawrence et al. (1986), Cooter et al. (1990), Holland (1997), de 

Hoog et al. (2000, 2015), Ellis (2005b), Alvarez et al. (2010a), Chakrabarti et al. (2003, 

2010), Guarro et al. (2011). 

Antifungal Susceptibility: A. variabilis limited data (Espinel-Ingroff et al. 2015a, 

and Australian National data); MIC µg/mL. 

No 64 

AmB 10 1 1 3 5 

POSA 10 1 1 7 1 

A. variabilis data from 20 isolates (Alvarez et al. 2010 and Chakrabarti et al. 2010); 

MIC µg/mL. 

AmB Range 0.5-4; MIC 90 

= 2 VORI Range 8-16; MIC 90 

= 16 

ITRA Range 0.25-2; MIC 90 

= 2 POSA Range 0.5-2; MIC 90 

= 1


Arthroderma insingulare Padhye and Carmichael 

Synonymy: Trichophyton terrestre Durie and Frey. 

Arthroderma insingulare is a geophilic fungus of worldwide distribution which may 

occur as a saprophytic contaminant on humans and animals. Durie and Frey (1957) 

first described this soil fungus as Trichophyton terrestre from New South Wales, 

Australia. Since then T. terrestre has been described as an anamorph of three different 

species of Arthroderma; A. insingulare, A. lenticulare and A. quadrifidum (Padhye 

and Carmichael, 1972). However, ITS and D1/D2 sequencing of the original isolates 

obtained from the Mycology Laboratory at Royal North Shore Hospital, Sydney has 

now identified this fungus as Arthroderma insingulare. RG-1 organism. 

Morphological Description: Colonies are usually flat to downy with a suede-like to 

granular texture resembling T. mentagrophytes. The surface colour may range from 

white to cream, buff to yellow, or greenish-yellow. Reverse pigmentation is usually 

yellowish-brown although some variants have a deep rose red reverse. Microconidia 

are large, clavate or pedicellate, usually exhibiting transition forms to more or less 

abundant lateral macroconidia. Macroconidia are clavate to cylindrical with rounded 

ends, smooth and thin-walled, and are two to six-celled. Chlamydospores, hyphal 

spirals, racquet mycelium and antler hyphae may also be present. No growth at 37 O C. 

Molecular Identification: ITS and D1/D2 sequencing is recommended for definitive 

identification of isolates. 

a 

b 

20 µm 

Arthroderma insingulare (a) culture and (b) macroconidia.

10 


Synonymy: Trichophyton ajelloi (Vanbreuseghem) Ajello. 

Arthroderma uncinatum is a geophilic fungus with a worldwide distribution which may 

occur as a saprophytic contaminant on humans and animals but infections are doubtful. 

Not known to invade hair in vivo, but produces hair perforations in vitro. 


Arthroderma uncinatum Dawson & Gentles 

Morphological Description: Colonies are usually flat, powdery, cream, tan to orangetan 

in colour, with a blackish-purple submerged fringe and reverse. Macroconidia 

are numerous, smooth, thick-walled, elongate, cigar-shaped, 29-65 x 5-10 µm, and 

multiseptate with up to nine or ten septa. Microconidia are usually absent, but when 

present are ovate to pyriform in shape. 

Key Features: Culture characteristics, macroconidial morphology, urease positive and 

good growth on Sabouraud’s 5% salt agar. 

Molecular Identification: ITS sequencing recommended (Gräser et al. 2008). 

References: Rebell and Taplin (1970), Rippon (1988), de Hoog et al. (2015, 2016). 

a 

b 

20 µm 

Arthroderma uncinatum (a) culture and (b) macroconidia.


Arthrographis kalrae (Tewari & Macpherson) Sigler & Carmichael 

Arthrographis is an arthroconidial mould comprising four species: A. kalrae, A. lignicola, 

A. pinicola and A. alba. These fungi are commonly found in environmental samples 

(soil, wood, air and water), but are isolated rarely from clinical specimens (Sandoval- 

Denis et al. 2014a). 


Morphological Description: Colonies with slow to moderate growth, creamy white 

to tan-coloured. Initially, yeast-like then developing hyphal growth and conidiophores 

subhyaline, narrow, branched, often in bundles, occasionally forming whitish, large 0.5 

cm, linear synnemata. Arthroconidia are one-celled, hyaline, smooth-walled, oblong to 

cylindrical, with truncate ends, 2.5-9x 1-2 µm. Spherical blastoconidia 2-4 x 2-3 µm, 

may also be formed laterally and sessile on undifferentiated hyphae. Chlamydospores 

may also be present. Very rarely immature ascomata submerged in the agar are 

produced. Growth at 42 O C, and on media containing cycloheximide. 

Molecular Identification: ITS and D1/D2 sequencing may be used for accurate 

species identification (Sugiura and Hironaga 2010, Halliday et al. 2015). 

Key Features: Keratinolytic, in vitro hair perforation positive, growth at 37 O C and 

tolerance to cycloheximide. 

References: Sugiura and Hironaga (2010), Giraldo et al. (2014), Sandoval-Denis et 

al. (2014a), de Hoog et al. (2015). 

10 μm 

10 μm 

a b b 

Arthrographis kalrae (a) culture and (b) arthroconidia. 

Antifungal Susceptibility: A. kalrae (Australian National data); MIC µg/mL. 

No 8 

AmB 7 1 5 1 

VORI 7 1 3 2 1 

POSA 7 1 2 2 2 

ITRA 7 1 4 2

12 


Aspergillus Micheli ex Link 

Aspergillus is a very large genus containing about 250 species, which are currently 

classified into seven subgenera that are in turn subdivided into several sections 

comprised of related species (Raper and Fennell 1965, Gams et al. 1985, Geiser 

et al. 2007). Traditionally, clinical microbiology laboratories have relied heavily 

on morphology-based identification methods to differentiate Aspergillus species. 

However many species, especially members of the section Fumigati have overlapping 

morphological characteristics, which has allowed several genetically distinct species 

to be misidentified (Balajee et al. 2005, 2007). This has led to the clustering of species 

with overlapping morphologies into “species complexes”, so that laboratories may 

report more accurately morphology-based identifications. 

Identification of clinical isolates of Aspergillus to species level may be important given 

that different species have variable susceptibilities to multiple antifungal drugs. For 

example, in vitro and in vivo studies have demonstrated that A. terreus isolates are 

largely resistant to the antifungal drug amphotericin B, A. ustus isolates appear to 

be refractory to azoles, and A. lentulus and Petromyces alliaceus have low in vitro 

susceptibilities to a wide range of antifungals including amphotericin B, azoles, and 

echinocandins (Balajee et al. 2005, 2007). 

Molecular Identification: Recommended barcoding gene: β-tubulin. General criteria 

for identification were outlined by Balajee et al. (2007). Phylogenetic relationships of 

the entire genus were presented by Wang et al. (1999) and Peterson (2000, 2008). 

MALDI-TOF MS: A comprehensive ‘in-house’ database of reference spectra allows 

accurate identification of species of Aspergillus even within complexes e.g. A. fumigatus 

sensu stricto and A. lentulus (Lau et al. 2013, Sleiman et al. 2015). 

a 

b 

c 

d 

Four species in the Aspergillus fumigatus complex showing overlapping morphological 

characteristics; (a) Aspergillus fumigatus, (b) Aspergillus lentulus, (c) Neosartorya 

fischeri and (d) Aspergillus felis.


Aspergillus Micheli ex Link 

Morphological Description: Colonies are usually fast growing, white, yellow, yellowbrown, 

brown to black or shades of green, mostly consisting of a dense felt of erect 

conidiophores. Conidiophores terminate in a vesicle covered with either a single 

palisade-like layer of phialides (uniseriate) or a layer of subtending cells (metulae) 

which bear small whorls of phialides (the biseriate structure). The vesicle, phialides, 

metulae (if present) and conidia form the conidial head. Conidia are one-celled, smooth 

or rough-walled, hyaline or pigmented, are produced in long dry chains which may be 

divergent (radiate) or aggregated in compact columns (columnar). Some species may 

produce Hülle cells or sclerotia. 

For morphological identification, isolates are usually inoculated at three points on 

Czapek Dox agar and 2% malt extract agar and incubated at 25 O C. Most species 

sporulate within 7 days. Descriptions are primarily based on colony pigmentation and 

morphology of the conidial head. Microscopic mounts are best made using cellotape 

flag or slide culture preparations mounted in lactophenol cotton blue. A drop of alcohol 

is usually needed to remove bubbles and excess conidia. 

Key Features: Hyaline hyphomycete showing distinctive conidial heads with flaskshaped 

phialides arranged in whorls on a vesicle. 

References: Raper and Fennell (1965), Domsch et al. (1980), McGinnis (1980), 

Onions et al. (1981), Samson and Pitt (1990, 2000), Samson et al. (1995), Samson 

(1979), Vanden Bossche et al. (1988), Klich (2002), Steinbach et al. (2005), Samson 

et al. (2011a, 2014), de Hoog et al. (2000, 2015). 

conidia 

phialides 

vesicle 

metulae 

stipe 

a 

b 

Conidial head morphology in Aspergillus (a) uniseriate, (b) biseriate.

14 


Aspergillus flavus complex 

Aspergillus section Flavi historically includes species with conidial heads in shades 

of yellow-green to brown and dark sclerotia. Hedayati et al. (2007) reviewed the A. 

flavus complex and included 23 species or varieties, including two sexual species, 

Petromyces alliaceus and P. albertensis. Several species of section Flavi produce 

aflatoxins, among which aflatoxin B1 is the most toxic of the many naturally occurring 

secondary metabolites produced by fungi. Aflatoxins are mainly produced by A. flavus 

and A. parasiticus, which coexist and grow on almost any crop or food (Varga et al. 

2011). Within the complex, A. flavus is the principle medically important pathogen of 

both humans and animals. However, some other species in the A. flavus complex, 

notably A. oryzae, A. avenaceus, A. tamari, A. alliaceus and A. nomius, may cause 

rare mostly superficial infections (Hedayati et al. 2007, de Hoog et al. 2015). 

Note: Accurate species identification within A. flavus complex remains difficult due 

to overlapping morphological and biochemical characteristics. For morphological 

identifications, it is recommended to report as Aspergillus flavus complex. 

Molecular Identification: ITS sequence analysis is sufficient to identify to species 

complex level only. Definitive identification requires analysis of β-tubulin, calmodulin 

and actin genes (Samson et al. 2007, Balajee et al. 2005a). 

Aspergillus flavus Link ex Grey 

Aspergillus flavus has a worldwide distribution and normally occurs as a saprophyte in soil 

and on many kinds of decaying organic matter, however, it is also a recognised pathogen 

of humans and animals. It is a causative agent of otitis, keratitis, acute and chronic 

invasive sinusitis, and pulmonary and systemic infections in immunocompromised 

patients. A. flavus is second only to A. fumigatus as the cause of human invasive 

aspergillosis (Hedayati et al. 2007). 


Morphological Description: On Czapek Dox agar, colonies are granular, flat, often 

with radial grooves, yellow at first but quickly becoming bright to dark yellow-green with 

age. Conidial heads are typically radiate, later splitting to form loose columns (mostly 

300-400 µm in diameter), biseriate but having some heads with phialides borne directly 

on the vesicle (uniseriate). Conidiophore stipes are hyaline and coarsely roughened, 

often more noticeable near the vesicle. Conidia are globose to subglobose (3-6 µm in 

diameter), pale green and conspicuously echinulate. Some strains produce brownish 

sclerotia. 

Key Features: Spreading yellow-green colonies, rough-walled stipes, mature vesicles 

bearing phialides over their entire surface and conspicuously echinulate conidia. 

Antifungal Susceptibility: A. flavus complex (Australian National data); MIC µg/ 

mL. 

No 16 

AmB 68 1 5 7 30 22 3 

VORI 68 1 1 6 25 24 11 

POSA 57 2 1 5 16 26 7 

ITRA 68 1 3 11 43 10


Aspergillus flavus Link ex Grey 

a 

b 

10 μm 

b 

10 μm 

b 

10 μm 

Aspergillus flavus (a) culture and (b) conidial heads. 

Note: Rough-walled stipe near vesicle (arrow) and both 

uniseriate and biseriate conidial heads may be present.

16 


Aspergillus fumigatus complex 

Aspergillus section Fumigati includes species characterised by uniseriate aspergilla 

with columnar conidial heads in shades of blue-green and flask-shaped vesicles 

(Raper and Fennell, 1965). Teleomorphic species belonging to the “Aspergillus fischeri 

series” of the A. fumigatus group (Raper and Fennell, 1965) were placed in the genus 

Neosartorya (family Trichocomaceae) by Malloch and Cain (1972). Section Fumigati 

includes more than 23 Neosartorya species and 10 anamorphic species (Samson et 

al. 2007). 

Although A. fumigatus is recognised as the major human pathogen within the complex, 

recent phylogenetic studies have demonstrated that some human and animal 

infections may be caused by A. lentulus, A. fumigatiaffinis, A. fumisynnematus, A. felis, 

Neosartorya fischeri, N. pseudofischeri, N. udagawae, N. hiratsukae and N. spinosa 

(Coriglione et al. 1990; Summerbell et al. 1992; Padhye et al. 1994a; Lonial et al. 1997; 

Jarv et al. 2004; Balajee et al. 2005, 2006; Barrs et al. 2013). 

Aspergillus felis Barrs, van Doorn, Varga & Samson 

Aspergillus felis has been reported as a causative agent of invasive aspergillosis and 

rhinosinusitis in humans, dogs and cats. Disease in all host species is often refractory 

to aggressive antifungal therapeutic regimens. 


Morphological Description: Colonies of A. felis are suede-like to floccose, white with 

interspersed grey green patches of conidia (conidiation is slow to poor). Conidial heads 

of A. felis are short, columnar and uniseriate. Conidiophore stipes are smooth-walled 

and vesicles are usually subglobose in shape. Conidia globose (2-3 µm in diameter), 

smooth to finely roughened. 

Molecular Identification: A. felis can be distinguished from other members of the 

section Fumigati by sequence analysis of β-tubulin, calmodulin and actin genes (Barrs 

et al. 2013). ITS sequencing is not recommended. 

Comment: A. felis is phenotypically similar to Aspergillus viridinutans, but differs by 

its ability to grow at 45°C. This species is phylogenetically related to Neosartorya 

aureola and N. udagawae and differs to N. aureola in having a heterothallic mode of 

reproduction. 

Antifungal Susceptibility: A. felis (Barrs et al. 2013); MIC µg/mL. 

No 16 

AmB 13 1 11 1 

VORI 13 1 3 1 5 3 

POSA 13 4 3 2 1 2 1 

ITRA 13 1 2 2 4 1 3


Aspergillus felis Barrs, van Doorn, Varga & Samson 

a 

b 

10 μm 

b 

10 μm 


Aspergillus felis (a) culture and (b) conidial head morphology. 

Aspergillus fumigatus Fresenius 

Morphological Description: On Czapek Dox agar, colonies are typically blue-green 

with a suede-like surface consisting of a dense felt of conidiophores. Conidial heads 

are typically columnar (up to 400 x 50 µm but often much shorter and smaller) and 

uniseriate. Conidiophore stipes are short, smooth-walled and have conical-shaped 

terminal vesicles which support a single row of phialides on the upper two thirds of 

the vesicle. Conidia are produced in basipetal succession forming long chains and are 

globose to subglobose (2.5-3.0 µm in diameter), green and finely roughened. Note: 

This species is thermotolerant with a maximum growth temperature of 55 O C. 

Key Features: Uniseriate and columnar conidial heads with the phialides limited to the 

upper two thirds of the vesicle and curving to be roughly parallel to each other. 

Molecular Identification: Sequence analysis of ITS is sufficient to identify to species 

complex level only. For definitive identification analysis, β-tubulin, calmodulin and actin 

genes is required (Samson et al. 2007; Balajee et al. 2005).

18 


Aspergillus fumigatus Fresenius 

a 

b 

10 μm 

b 

10 μm b 

10 μm 

Aspergillus fumigatus (a) culture and (b) conidial head morphology. 

Note: Uniseriate row of phialides on the upper two thirds of the vesicle. 

Antifungal Susceptibility: A. fumigatus complex (Australian National data); MIC 

µg/mL. 

No 16 

AmB 523 2 40 122 167 130 58 3 1 

VORI 486 1 1 27 112 259 54 11 13 5 3 

POSA 415 7 27 50 69 162 79 13 7 0 0 1 

ITRA 523 1 6 17 41 74 244 115 15 5 1 4 

ANID 249 5 170 52 18 1 1 2 

MICA 249 91 95 48 12 2 1 

CAS 264 2 22 91 106 24 12 1 1 5


Aspergillus lentulus Balajee & Marr 

Aspergillus lentulus appears to be widely distributed in soil and is now well documented 

as a causative agent of invasive aspergillosis in immunosuppressed patients. It is part 

of the A. fumigatus complex. 


Morphological Description: Colonies of A. lentulus are suede-like to floccose, white 

with interspersed grey-green patches of conidia (conidiation is slow to poor in most 

strains). Conidial heads are short, columnar and uniseriate. Conidiophore stipes are 

smooth-walled, sometimes sinuous and are often constricted at the neck. Vesicles 

are usually subglobose in shape. Conidia globose to broadly ellipsoidal (2-3.2 µm in 

diameter), smooth to finely roughened. 

Molecular Identification: A. lentulus can be distinguished from other members of 

the section Fumigati by sequence analysis of β-tubulin, calmodulin and actin genes 

(Samson et al. 2007, Balajee et al. 2005b). ITS sequencing is not recommended. 

a 

b 

10 μm 

b 

10 μm 

Aspergillus lentulus (a) culture and (b) conidial head morphology.

20 


Aspergillus lentulus Balajee & Marr 

Antifungal Susceptibility: A. lentulus (Australian National data); MIC µg/mL. 

No 16 

AmB 5 1 1 3 

VORI 5 3 2 

POSA 5 1 1 3 

ITRA 5 2 1 1 1 

Neosartorya fischeri (Wehmer) Malloch & Cain 

Neosartorya fischeri is mostly found in canned foodstuffs and is now documented as a 

causative agent of invasive aspergillosis in immunosuppressed patients. 


Morphological Description: Colonies of N. fischeri are suede-like to floccose, white 

to pale yellow with slow to poor conidiation. Conidial heads are short, columnar and 

uniseriate. Conidiophore stipes are smooth-walled and vesicles are usually subglobose 

to flask-shaped. Conidia globose to subglobose (2-2.5 µm in diameter), smooth to 

finely roughened. Good growth at 37 O C. 

a 

b 

b 

10 μm 

10 μm 

Neosartorya fischeri (a) culture and 

(b) conidial head morphology.


Neosartorya fischeri (Wehmer) Malloch & Cain 

Molecular Identification: N. fischeri can be distinguished from other members of 

the section Fumigati by sequence analysis of β-tubulin, calmodulin and actin genes 

(Samson et al. 2007; Balajee et al. 2005b). ITS sequencing is not recommended. 

Antifungal Susceptibility: N. fischeri (Australian National data); MIC µg/mL. 

No 16 

AmB 8 1 5 2 

VORI 8 1 3 3 1 

POSA 8 4 1 1 2 

ITRA 8 1 2 2 3 

Aspergillus nidulans complex 

Aspergillus subgenus Nidulantes; Gams et al. (1985) includes species with biseriate 

conidial heads, brown pigmented often short stipes, and green conidia. Cleistothecia 

are soft-walled, surrounded by Hülle cells, and ascospores are red to purple in colour. 

Section Nidulantes is one of the largest subgenera of the genus Aspergillus, and 

includes about 80 species. Several species have been reported as medical pathogens 

principally Aspergillus nidulans, but also A. sydowii, A. unguis, A. rugulovalvus and A. 

tetrazonus. 

Molecular Identification: ITS sequencing is sufficient to identify to species complex 

only. A. nidulans can be distinguished from other members of the section Nidulantes 

by sequence analysis of β-tubulin, calmodulin and actin genes. 

Aspergillus nidulans (Eidam) Wint. 

Aspergillus nidulans is a typical soil fungus with a worldwide distribution, it has also 

been reported to cause disease in human and animals. 


Morphological Description: On Czapek Dox agar, colonies are typically plain green 

in colour with dark red-brown cleistothecia developing within and upon the conidial 

layer. Reverse may be olive to drab-grey or purple-brown. Conidial heads are short, 

columnar (up to 70 x 30 µm in diameter) and biseriate. Conidiophore stipes are usually 

short, brownish and smooth-walled. Conidia are globose (3-3.5 µm in diameter) and 

rough-walled. 

Key Features: Conidial heads are short, columnar and biseriate. Stipes are usually 

short, brownish and smooth-walled. Conidia are globose and rough-walled.

22 


Aspergillus nidulans (Eidam) Wint. 

a 

b 

10 μm 

b 

20μm 

c 

20 μm 

d 

10 μm 

Aspergillus nidulans (a) culture and (b) conidial head morphology, (c) cleistothecium 

of Emericella nidulans (anamorph A. nidulans) showing numerous reddish-brown 

ascospores and (d) thick-walled Hülle cells. 

Antifungal Susceptibility: A. nidulans (Australian National data); MIC µg/mL. 

No 16 

AmB 24 5 10 1 6 2 

VORI 23 3 7 13 

POSA 20 1 6 6 5 2 

ITRA 24 1 3 6 10 4


The black aspergilli, Aspergillus section Nigri (Gams et al. 1985) includes species 

with uniseriate or biseriate conidial heads, spherical to pyriform vesicles, smoothwalled 

stipes and black or near black-coloured conidia. This group contains about 26 

species with Aspergillus niger being the most common species isolated. A. niger can 

be isolated from all continents and is not very selective with respect to environmental 

conditions. Other species within this group that have been linked to human and animal 

infection include A. acidus, A. aculeatus, A. brasiliensis and A. tubingensis. 

Molecular Identification: In Aspergillus section Nigri, all species can be distinguished 

from each other using calmodulin sequence data, and all except one can be 

distinguished using β-tubulin sequence data. ITS sequencing can only be used for a 

rough classification of the uni- and biseriate species (Samson et al. 2007). 

Aspergillus niger van Tieghem 

Aspergillus niger is one of the most common and easily identifiable species of the genus 

Aspergillus, with its white to yellow mycelial culture surface later bearing black conidia. 

This species is very commonly found in aspergillomas and is the most frequently 

encountered agent of otomycosis. It is also a common laboratory contaminant. 


Aspergillus niger complex 

Morphological Identification: On Czapek Dox agar, colonies consist of a compact 

white or yellow basal felt covered by a dense layer of dark-brown to black conidial 

heads. Conidial heads are large (up to 3 mm by 15 to 20 µm in diameter), globose, 

dark brown, becoming radiate and tending to split into several loose columns with age. 

Conidiophore stipes are smooth-walled, hyaline or turning dark towards the vesicle. 

Conidial heads are biseriate with the phialides borne on brown, often septate metulae. 

Conidia are globose to subglobose (3.5-5 µm in diameter), dark brown to black and 

rough-walled. 

Key Features: Conidial heads are dark brown to black, radiate and biseriate with 

metulae twice as long as the phialides. Conidia brown and rough-walled. 

Antifungal Susceptibility: A. niger (Australian National data); MIC µg/mL. 

No 16 

AmB 75 16 27 16 13 3 

VORI 71 3 5 8 16 28 10 1 

POSA 60 1 7 7 15 18 12 

ITRA 75 1 3 8 13 34 14 1 1

24 


Aspergillus niger van Tieghem 

a 

b 

10 μm 

Aspergillus niger (a) Culture and (b) conidial head morphology. 

Note: Conidial heads are biseriate, large, globose, dark brown, 

becoming radiate with the phialides borne on metulae.


Aspergillus terreus complex 

Aspergillus section Terrei (Gams et al. 1985); Aspergillus terreus complex includes 

species with biseriate, columnar conidial heads in shades of buff to brown (Raper 

and Fennell 1965). The most important species of this section is A. terreus, which is 

ubiquitous in the environment (Samson et al. 2011). Two other species have been 

reported as medical pathogens, A. alabamensis and A. niveus. 

Molecular Identification: A. terreus can be distinguished from other members of 

the section Terrei by sequence analysis of β-tubulin, calmodulin and actin genes. ITS 

sequencing is sufficient to identify to species complex level only. 

Aspergillus terreus Thom 

Aspergillus terreus occurs commonly in soil and is occasionally reported as a pathogen 

of humans and animals. 


Morphological Identification: On Czapek Dox agar, colonies are typically suedelike 

and cinnamon-buff to sand-brown in colour with a yellow to deep dirty brown 

reverse. Conidial heads are compact, columnar (up to 500 x 30-50 µm in diameter) 

and biseriate. Metulae are as long as the phialides. Conidiophore stipes are hyaline 

and smooth-walled. Conidia are globose to ellipsoidal (1.5-2.5 µm in diameter), hyaline 

to slightly yellow and smooth-walled. 

Key Features: Cinnamon-brown cultures, conidial heads biseriate with metulae as 

long as the phialides. 

References: Raper and Fennell (1965), Domsch et al. (1980), McGinnis (1980), 

Onions et al. (1981), Samson and Pitt (1990), Samson et al. (1995), de Hoog et al. 

(2000) and Klich (2002). 

Antifungal Susceptibility: A. terreus (Australian National data); MIC µg/mL. 

No 16 

AmB 72 1 3 11 29 24 3 1 

VORI 69 4 13 32 16 1 2 1 

POSA 59 1 10 8 23 13 2 2 

ITRA 72 4 3 9 17 35 4

26 


Aspergillus terreus Thom 

a 

b 

10 μm 

Aspergillus terreus (a) culture and (b) conidial head morphology 

Note: Conidial heads are biseriate.


Aureobasidium pullulans has a worldwide distribution and is usually isolated as 

a saprophyte, occasionally from skin and nails. It has also been reported as a rare 

causative agent of phaeohyphomycosis, mycotic keratitis and peritonitis in patients on 

continuous ambulatory peritoneal dialysis (CAPD). 


Aureobasidium pullulans (de Bary) Arnaud 

Morphological Description: Colonies are fast growing, smooth, soon covered with 

slimy masses of conidia, cream or pink, later becoming brown or black. Hyphae are 

hyaline and septate, frequently becoming dark-brown with age and forming chains of 

one to two-celled, thick-walled, darkly pigmented arthroconidia. These arthroconidia 

actually represent the Scytalidium anamorph of Aureobasidium and are only of 

secondary importance in recognising members of this genus. Conidia are produced 

synchronously in dense groups from indistinct scars or from short denticles on 

undifferentiated, hyaline to subhyaline hyphae. Conidia are hyaline, smooth-walled, 

single-celled, ellipsoidal but of variable shape and size (8-12 x 4-6 µm), often with an 

indistinct hilum (i.e. a mark or scar at the point of attachment). Temperature: optimum 

25 O C; maximum 35-37 O C. 

Molecular Identification: Recommended barcoding genes are ITS, EF-1α and D1/D2 

(de Hoog et al. 2015). 

Key Features: Hyphomycete (so-called black yeast) producing hyaline blastoconidia 

simultaneously from the vegetative hyphae, which may also form chains of darkly 

pigmented, thick-walled arthroconidia. 

References: Hermanides-Nijhof (1977), Domsch et al. (2007), McGinnis (1980), de 

Hoog et al. (2000, 2015), Najafzadeh et al. (2014). 

20 μm 

Aureobasidium pullulans showing one to two-celled, darkly pigmented arthroconidia 

and hyaline, single-celled, ovoid-shaped conidia which are produced on short denticles. 

Antifungal Susceptibility: A. pullulans data from 108 isolates (Najafzadeh et al. 

2014 and Australian National data); MIC µg/mL. 



AmB 0.008-16 1 VORI 0.008-16 2 

ITRA 0.008-16 0.5 POSA 0.008-4 0.5

28 


Synonymy: Basidiobolus meristosporus Drechsler. 

Basidiobolus heterosporus Srinivasan & Thirumalachar. 

Basidiobolus haptosporus Drechsler. 

Basidiobolus ranarum is commonly present in decaying fruit and vegetable matter, and 

as a commensal in the intestinal tract of frogs, toads and lizards. It has been reported 

from tropical regions of Africa and Asia including India, Indonesia and Australia. 


Basidiobolus ranarum Eidem 

Morphological Description: Colonies are moderately fast growing at 30 O C, flat, 

yellowish-grey to creamy-grey, glabrous, becoming radially folded and covered by a fine, 

powdery, white surface mycelium. Satellite colonies are often formed by germinating 

conidia ejected from the primary colony. Microscopic examination usually shows the 

presence of large vegetative hyphae (8-20 µm in diameter) forming numerous round (20- 

50 µm in diameter), smooth, thick-walled zygospores that have two closely appressed 

beak-like appendages. The production of “beaked” zygospores is characteristic of the 

genus. Two types of asexual conidia are formed, although isolates often lose their ability 

to sporulate with subculture. Special media incorporating glucosamine hydrochloride 

and casein hydrolsate may be needed to stimulate sporulation (Shipton and Zahari, 

1987). Primary conidia are globose, one-celled, solitary and are forcibly discharged 

from a sporophore. The sporophore has a distinct swollen area just below the conidium 

that actively participates in the discharge of the conidium. Secondary (replicative) 

conidia are clavate, one-celled and are passively released from a sporophore. These 

sporophores are not swollen at their bases. The apex of the passively released spore 

has a knob-like adhesive tip. These spores may function as sporangia, producing 

several sporangiospores. 

References: Strinivasan and Thirumalachar (1965), Greer and Friedman (1966), 

Dworzack et al. (1978), McGinnis (1980), King (1983), Rippon (1988), Davis et al. 

(1994), Jong and Dugan (2003), de Hoog et al. (2000, 2015) and Ellis (2005a). 

20 μm 

Basidiobolus ranarum showing thick-walled zygospores.


Basidiobolus ranarum Eidem 

Basidiobolus ranarum culture showing satellite colonies formed 

by germinating conidia ejected from the primary colony. 

20 μm 

Basidiobolus ranarum showing conidia and a sporophore with 

a distinct swollen area just below the conidium (arrow).

30 


Three species are recognised, two of which are well known pathogens of insects. 

Beauvaria bassiana is the most common species and is best known as the causal agent 

of muscardine disease in silkworms. Beauveria species are occasionally isolated in the 

clinical laboratory as saprophytic contaminants. Infections in humans are extremely 

rare. 


Beauveria Vuillemin 

Morphological Description: Colonies are usually slow growing, usually not exceeding 

2 cm in ten days at 20 O C, downy, at first white, but later often becoming yellow to 

pinkish. The genus Beauveria is characterised by the sympodial development of singlecelled 

conidia (ameroconidia) on a geniculate or zig-zag rachis. Conidiogenous cells 

are flask-shaped, rachiform, proliferating sympodially and are often aggregated into 

sporodochia or synnemata. Conidia are hyaline and globose or ovoid in shape. 

Key Features: Hyphomycete showing sympodial development of single-celled conidia 

on a geniculate or zig-zag rachis emanating from a flask-shaped conidiophore. 

Molecular Identification: Specific primers were developed by Hegedus and 

Khachatourians (1996). Full phylogeny of the genus was provided by Rehner and 

Buckley (2005). Biogeography of molecular types was characterised by Ghikas et al. 

(2010). 

MALDI-TOF MS: Cassagne et al. (2011) published a standardised procedure for mould 

identification in the clinical laboratory. 

References: de Hoog (1972), Domsch et al. (2007), McGinnis (1980), de Hoog et al. 

(2000, 2015). 

20 μm 

Beauveria bassiana showing sympodial development of conidia on a geniculate or zigzag 

rachis. Conidiogenous cells are flask-shaped, rachiform, proliferating sympodially 

and are often aggregated into sporodochia or synnemata. Conidia are hyaline and 

globose or ovoid in shape, 2-3 µm diameter (phase contrast image).


The genus Bipolaris contains about 45 species, which are mostly subtropical and tropical 

plant parasites. Recent molecular studies have recognised Bipolaris cynodontis, B. 

micropus, and B. setariae as species isolated from clinical samples (da Cunha et al. 

2014). However recent phylogenetic studies have transferred several well-documented 

human pathogens, notably B. australiensis, B. hawaiiensis and B. spicifera to the genus 

Curvularia (Manamgoda et al. 2012) 


Bipolaris Shoemaker 

Morphological Description: Colonies are moderately fast growing, effuse, grey to 

blackish brown, suede-like to floccose with a black reverse. Microscopic morphology 

shows sympodial development of hyaline to deep olivaceous pigmented, pseudoseptate 

conidia on a geniculate or zig-zag rachis. Conidia mostly curved, canoe-shaped, fusoid 

or obclavate, rarely straight, 2–14 pseudoseptate (usually more than 6), germinating 

only from the ends (bipolar). 

Key Features: Dematiaceous hyphomycete producing sympodial, pseudoseptate, 

pale brown, long slender, gently curving conidia, which are rounded at both ends. 

Comment: The genera Drechslera, Bipolaris, Curvularia and Exserohilum are all 

closely related. In the past, morphological differentiation of the genera relied upon 

a combination of characters including conidial shape, the presence or absence of a 

protruding hilum, the contour of the basal portion of the conidium and its hilum, the 

point at which the germ tube originates from the basal cell and, to a lesser degree, the 

sequence and location of the first three conidial septa. 

However, Manamgoda et al. (2012) have found that there is no clear morphological 

boundary between genera Bipolaris and Curvularia and some species show 

intermediate morphology. These authors recommend using a combined ITS and GPDH 

gene analysis for definitive identification of species (Manamgoda et al. 2012). 

Molecular Identification: ITS sequencing may be used to identify clinical species (da 

Cunha et al. 2012a). GPDH has been determined to be the best single phylogenetic 

marker of Bipolaris species (Manamgoda et al. 2012, 2014). 

References: Ellis (1971, 1976), Luttrell (1978), Domsch et al. (2007), Alcorn (1983), 

McGinnis et al. (1986b), Sivanesan (1987), Rippon (1988), de Hoog et al. (2000, 2015), 

Manamgoda et al. (2012, 2014), da Cunha et al. (2012a).

32 


Blastomyces dermatitidis Gilchrist & Stokes 

At present the genus Blastomyces contains two species, Blastomyces dermatitidis 

and Blastomyces gilchristi, which are morphologically identical but distinguishable 

by sequence analysis of the ITS region (Brown et al. 2013). B. dermatitidis lives in 

soil and in association with decaying organic matter such as leaves and wood. It is 

the causal agent of blastomycosis a chronic granulomatous and suppurative disease, 

having a primary pulmonary stage that is frequently followed by dissemination to other 

body sites, typically the skin and bone. Although the disease was long thought to be 

restricted to the North American continent, in recent years autochthonous cases have 

been diagnosed in Africa, Asia and Europe. 

WARNING: RG-3 organism. Cultures of B. dermatitidis represent a biohazard to 

laboratory personnel and must be handled in a Class II Biological Safety Cabinet 

(BSCII). 

Morphological Description: Colonies at 25 O C have variable morphology and growth 

rate. They may grow rapidly, producing a fluffy white mycelium or slowly as glabrous, tan, 

nonsporulating colonies. Growth and sporulation may be enhanced by yeast extract. 

Most strains become pleomorphic with age. Microscopically, hyaline, ovoid to pyriform, 

one-celled, smooth-walled conidia (2-10 µm in diameter) of the Chrysosporium type, 

are borne on short lateral or terminal hyphal branches. 

Colonies on blood agar at 37 O C are wrinkled and folded, glabrous and yeast-like. 

Microscopically, the organism produces the characteristic yeast phase seen in tissue 

pathology; ie. B. dermatitidis is a dimorphic fungus. 

Comment: In the past, conversion from the mould form to the yeast form was 

necessary to positively identify this dimorphic pathogen from species of Chrysosporium 

or Sepedonium. However, culture identification by exoantigen test and/or molecular 

methods is now preferred to minimise manipulation of the fungus. 

Key Features: Clinical history, tissue pathology, culture identification by positive 

exoantigen test and/or by molecular methods. 

a 

b 

Blastomyces dermatitidis (a) culture and (b) one-celled, smooth-walled 

conidia borne on short lateral or terminal hyphal branches.


Blastomyces dermatitidis Gilchrist & Stokes 

10 μm 

Histopathology: Blastomyces dermatitidis tissue sections show large, broad-based, 

unipolar budding yeast-like cells, which may vary in size from 8-15 µm, with some 

larger forms up to 30 µm in diameter. Tissue sections need to be stained by Grocott’s 

methenamine silver method to clearly see the yeast-like cells, which are often difficult 

to observe in H&E preparations. 

Molecular Diagnostics: A DNA probe assay (AccuProbe, Gen-Probe, Inc., San Diego, 

CA) for identification of B. dermatitidis in clinical isolates is available (Scalarone et al. 

1992 and Padhye et al. 1994b). However this has limited application as it can be used 

only with pure cultures of B. dermatitidis (yeast or mould) (Sidamonidze et al. 2012). 

Several conventional PCR assays have been developed for the identification of B. 

dermatitidis from clinical specimens (Bialek et al. 2003) and soil (Burgess et al. 2006). 

Sidamonidze et al. (2012) developed a real-time PCR targeting the BAD1 (formerly 

known as WI-1) gene for the identification of B. dermatitidis in culture and tissue and 

Morjaria et al. (2015) used rDNA sequencing for identification from paraffin embedded 

tissue. 

References: McGinnis (1980), Chandler et al. (1980), Kaufman and Standard (1987), 

Rippon (1988), Brown et al. (2013). 

Antifungal Susceptibility: B. dermatitidis limited data available (Sugar and Liu 

1996, Espinel-Ingroff et al. 2001, Espinel-Ingroff 2003, Gonzales et al. 2005 and 

Sabatelli et al. 2006). Antifungal susceptibility testing not recommended. 

For treatment options see Clinical Practice Guidelines for the Management of 

Blastomycosis (Chapman et al. 2008); MIC µg/mL. 



FLU 0.125-64 4-16 AmB 0.03-1 0.5 

ITRA 0.03->16 0.125-2 VORI 0.03-16 0.25 

POSA 0.03-2 0.125 CAS 0.5-8 2

34 


Candida Berkhout 

The genus Candida is characterised by globose to elongate yeast-like cells or 

blastoconidia that reproduce by narrow-based multilateral budding. Pseudohyphae and 

occasionally true hyphae may also be present. Colony pigmentation is usually absent. 

Ballistoconidia are not formed. Arthroconidia may be formed, but not extensively. 

Sexual reproduction is absent. Glucose may be fermented. Nitrate may be assimilated. 

Starch-like compounds are not produced. The diazonium blue B reaction is negative. 

The genus is highly polyphyletic, as it comprises mitosporic species that are devoid of 

special distinguishing features (Lachance et al. 2011). 

Recently, several taxonomic rearrangements have been made and many well-known 

Candida species have been renamed and moved to other genera, notably Pichia 

kudriavzevii (formerly Candida krusei), Meyerozyma guilliermondii (formerly Candida 

guilliermondii), Clavispora lusitaniae (formerly Candida lusitaniae), Kluyveromyces 

marxianus (formerly Candida kefyr) and Wickerhamomyces anomalus (formerly 

Candida pelliculosa). C. glabrata and C. parapsilosis are now recognised as species 

complexes (Tavanti 2005; Correia 2006; Alcoba-Florez 2005). 

Several species may be aetiological agents, most commonly Candida albicans, followed 

by C. parapsilosis, C. glabrata, C. tropicalis and Pichia kudriavzevii. Altogether, these 

five species account for >95% of human infections. However a number of other species 

may also be isolated. All are ubiquitous and occur naturally on humans. 

a 

b 

10 μm 

Candida albicans showing (a) typical cream-coloured, smooth surfaced, waxy 

colonies and (b) narrow based budding spherical to ovoid blastoconidia.



Identification: see Kurtzman, Fell and Boekhout. 2011. The Yeasts, a Taxonomic 

Study. 5th Edition Elsevier B.V. 

Ensure that you start with a fresh growing pure culture; streak for single colony isolation 

if necessary. 

Chromogenic Agars are used for primary isolation for rapid species identification and 

detection of mixed flora, especially from non-sterile sites. Depending on the brand 

of chromogenic media presumptive identification of C. albicans, C. tropicalis and P. 

kudriavzevii is possible. It is particularly useful for detection of mixed infections. 

CHROMagar Candida plate showing chromogenic colour change for C. albicans 

(green), C. tropicalis (blue), C. parapsilosis (white) and C. glabrata (mauve). 

Germ Tube Test. A rapid screening test for C. albicans and C. dubliniensis. 0.5 mL 

of serum, containing 0.5% glucose, is lightly inoculated with the test organism and 

incubated at 35 O C for 2-3 hours. On microscopy, the production of germ tubes by the 

cells is presumptive for C. albicans and C. dubliniensis. 

10 μm 

Candida albicans showing production of germ tubes.

36 



Dalmau Plate Culture: To set up a yeast morphology plate, dip a flamed sterilised 

straight wire into a culture and then lightly scratch the wire onto the surface of a 

cornmeal/tween 80, rice/tween 80 or yeast morphology agar plate, then place a flamed 

coverslip onto the agar surface covering the scratches. Dalmau morphology plates 

are examined in-situ directly under the low power of a microscope for the presence 

of pseudohyphae which may take up to 4-5 days at 26 O C to develop. C. albicans 

also produces characteristic large, round, terminal, thick-walled vesicles (often called 

chlamydospores). For best results a light inoculum should be scratched into the agar 

surface using a wire. 

10 μm 

a 

5 mm 

b 

Dalmau plate culture of Candida albicans showing (a) colonies growing out from 

scratches on the surface of a cornmeal/tween 80 agar plate, and (b) the production of 

large round, thick-walled chlamydospores. Note: A coverslip has been placed onto the 

agar surface covering the scratches. 

Physiological and Biochemical Tests: including fermentation and assimilation studies 

should be performed based on those used at the Centraalbureau voor Schimmelcultures 

(CBS), Delft, The Netherlands (Kurtzman et al. 2011). Reliable commercially available 

yeast identification systems are the API 20C AUX, API ID 32C, Biolog YT Station and 

Vitek 2 YST ID systems. However, they can only be used to identify those species in 

their respective databases, and may misidentify yeasts that are not represented. 

Other Supplementary Tests include growth at 37 O C, cycloheximide resistance and 

hydrolysis of urea. 

MALDI-TOF MS: The Bruker MALDI-TOF database is useful for identification of most 

clinical yeasts. The MALDI-TOF Vitek MS has been reported to misidentify some 

yeasts, notably Candida metapsilosis as Candida parapsilosis (Nobrega et al. 2014). 

Molecular Identification: ITS sequencing is useful for the identification of most clinical 

yeasts. 

References: Barnett et al. (1983), Kurtzman and Fell (1998, 2011), de Hoog et al. 

(2000, 2015).


Candida albicans is a commensal of mucous membranes and the gastrointestinal 

tract. Environmental isolations have been made from sources contaminated by human 

or animal excreta, such as polluted water, soil, air and plants. 


Candida albicans (Robin) Berkhout 

Culture: Colonies (SDA) white to cream-coloured smooth, glabrous, yeast-like. 

Microscopy: Spherical to subspherical budding blastoconidia, 2-7 x 3-8 µm in size. 

India Ink Preparation: Negative - no capsules present. 

Dalmau Plate Culture: Branched pseudohyphae with dense verticils of blastoconidia. 

Spherical chlamydospores, mostly terminal, often on a slightly swollen subtending cell, 

are formed near the edge of the cover slip. 

Physiological Tests: + Positive, - Negative, v Variable, w Weak, s Slow 

Germ Tube + L-Sorbose v L-Arabinose v D-Glucitol v 

Fermentation Sucrose v D-Arabinose v α-M-D-glucoside v 

Glucose + Maltose + D-Ribose v D-Gluconate v 

Galactose v Cellobiose - L-Rhamnose - DL-Lactate + 

Sucrose v Trehalose v D-Glucosamine v myo-Inositol - 

Maltose + Lactose - N-A-D-glucosamine v 2-K-D-gluconate + 

Lactose - Melibiose - Glycerol v D-Glucuronate - 

Trehalose v Raffinose - Erythritol - Nitrate - 

Assimilation Melezitose v Ribitol v Urease - 

Glucose + Soluble Starch + Galactitol - 0.1% Cycloheximide + 

Galactose + D-Xylose + D-Mannitol + Growth at 40 O C + 

Key Features: Germ tube positive, production of chlamydospores on Dalmau plate 

culture, fermentation of glucose, sugar assimilation profile and a distinctive green 

colour on CHROMagar. Note: Germ tube negative variants (previously known as C. 

claussenii), and sucrose-negative variants (previously described as C. stellatoidea) 

may occur. 

Antifungal Susceptibility: C. albicans (Australian National data); MIC µg/mL. 

CLSI clinical breakpoints are marked where available (Pfaller and Diekema 2012). 

No 64 

AmB 1725 2 16 162 644 548 305 48 

FLU 1728 2 2 2 83 468 706 314 62 12 11 18 8 40 

VORI 1445 739 404 156 75 18 17 18 5 5 1 1 6 

POSA 1095 88 416 367 137 50 18 10 6 1 1 

ITRA 1728 20 122 443 661 378 43 30 10 3 1 17 

ANID 821 5 280 320 146 64 5 0 0 1 

MICA 819 470 261 73 11 4 

CAS 1171 3 13 207 490 327 112 17 2 

5FC 1728 4 147 765 362 164 171 62 16 7 5 3 3 19

38 


Synonymy: Candida brumptii (Guerra) Langeron & Guerra. 

Although most isolates of Candida catenulata originate from human sources, cases of 

candidaemia are uncommon. 


Candida catenulata Diddens & Lodder 

Culture: Colonies (SDA) white to cream-coloured smooth, soft and wrinkled, yeastlike. 

Microscopy: Ovoid to cylindrical budding blastoconidia, 1.5-4.5 x 4-12 µm. 


Dalmau Plate Culture: pseudohyphae consisting of chains of ovoid or cylindroid cells, 

and sometimes small verticils of ovoid blastoconidia. 


Germ Tube - L-Sorbose - L-Arabinose - D-Glucitol v 

Fermentation Sucrose - D-Arabinose - α-M-D-glucoside - 

Glucose v Maltose v D-Ribose v D-Gluconate v 

Galactose -,s Cellobiose - L-Rhamnose - DL-Lactate - 

Sucrose - Trehalose v D-Glucosamine v myo-Inositol - 

Maltose -,s Lactose - N-A-D-glucosamine + 2-K-D-gluconate v 

Lactose - Melibiose - Glycerol + D-Glucuronate - 

Trehalose - Raffinose - Erythritol - Nitrate - 

Assimilation Melezitose - Ribitol v Urease - 

Glucose + Soluble Starch v Galactitol - 0.1% Cycloheximide +,s 

Galactose + D-Xylose v D-Mannitol + Growth at 37 O C v 

Key Features: Separation from most physiologically similar species can be 

accomplished based on positive growth responses on D-mannitol, D-glucitol and 

resistance to 0.1% cycloheximide, combined with negative responses for sorbose and 

erythritol utilisation or growth in vitamin-free medium. 

Antifungal Susceptibility: C. catenulata (Australian National data); MIC µg/mL. 

No 64 

AmB 3 2 1 

FLU 3 1 1 1 

VORI 3 1 1 1 

POSA 3 2 1 

ITRA 3 1 1 1 

ANID 3 1 2 

MICA 3 1 2 

CAS 3 1 2 

5FC 3 3


Candida dubliniensis Sullivan et al. 

Candida dubliniensis is an occasional cause of candidaemia and mucosal infection, 

especially in HIV patients. 



Microscopy: Spherical to subspherical budding blastoconidia, 3-8 x 2-7 µm in size. 


Dalmau Plate Culture: Branched pseudohyphae with dense verticils of blastoconidia 

and spherical, mostly terminal chlamydospores. 


Germ Tube + L-Sorbose - L-Arabinose - D-Glucitol + 

Fermentation Sucrose + D-Arabinose - M-D-glucoside +,s 

Glucose + Maltose + D-Ribose - D-Gluconate - 

Galactose +,s Cellobiose - L-Rhamnose - DL-Lactate + 

Sucrose - Trehalose s,+ D-Glucosamine v myo-Inositol - 

Maltose + Lactose - N-A-D-glucosamine + 2-K-D-gluconate + 

Lactose - Melibiose - Glycerol w,s,+ D-Glucuronate - 


Assimilation Melezitose w,+ Ribitol + Urease - 

Glucose + Soluble Starch w,+ Galactitol - 0.1% Cycloheximide + 

Galactose + D-Xylose s,+ D-Mannitol + Growth at 40 O C + 

Key Features: Germ tube positive, similar to C. albicans, except for absence of growth 

at 42 O C; glycerol (mostly +), methyl-a-D-glucoside (-), trehalose (-), and D-xylose (-). 

Initial colonies dark green on CHROMagar and producing rough colonies on bird seed 

agar. ITS sequencing and MALDI-TOF can reliably distinguish C. dubliniensis from C. 

albicans. 

Antifungal Susceptibility: C. dubliniensis (Australian National data); MIC µg/mL. 

No 64 

AmB 74 1 1 3 28 30 10 1 

FLU 74 24 24 21 5 

VORI 71 67 4 

POSA 63 15 19 18 8 3 

ITRA 74 6 22 14 22 6 4 

ANID 49 1 7 12 9 12 2 6 

MICA 49 4 11 18 8 2 6 

CAS 66 8 23 17 9 1 1 7 

5FC 74 12 49 7 4 1 1

40 


Candida glabrata complex 

Recently Candida glabrata has been recognised as a species complex consisting of C. 

glabrata, C. bracarensis (Correia et al. 2006) and C. nivariensis (Alcoba-Flórez et al. 

2005). These three species are phenotypically indistinguishable and are best identified 

by molecular methods. C. bracarensis was described based on PCR-fingerprints and 

sequence divergence in the D1/D2 domains (Correia et al. 2006). C. nivariensis was 

differentiated from other yeasts on the basis of ITS sequences (Borman et al. 2008). 

Candida bracarensis Correia, P. Sampaio, James & Pais 



Microscopy: Ellipsoidal budding blastoconidia, 3.9-6 x 2-4 µm in size. No pseudohyphae 

or chlamydospores produced. 


Dalmau Plate Culture: No pseudohyphae produced. 


Germ Tube - L-Sorbose - L-Arabinose - D-Glucitol - 


Glucose + Maltose - D-Ribose - D-Gluconate + 

Galactose - Cellobiose - L-Rhamnose - DL-Lactate - 

Sucrose - Trehalose + D-Glucosamine - myo-Inositol - 

Maltose - Lactose - N-A-D-glucosamine - 2-K-D-gluconate - 


Trehalose s Raffinose - Erythritol - Nitrate - 

Assimilation Melezitose - Ribitol - Urease - 

Glucose + Soluble Starch - Galactitol - 0.1% Cycloheximide - 

Galactose - D-Xylose - D-Mannitol - Growth at 40 O C + 

Key Features: C. bracarensis has variable API 20C patterns that overlap with C. 

nivariensis and some C. glabrata isolates, and has variable results with a rapid trehalose 

assay. Note: C. glabrata produces mauve-coloured colonies on CHROMagar, whereas 

isolates of C. bracarensis, C. nivariensis, C. norvegensis and C. inconspicua produce 

white colonies on CHROMagar (Alcoba-Flórez et al. 2005, Bishop et al. 2008). 

Antifungal Susceptibility: C. bracarensis limited data (Australian National data); 

MIC µg/mL. 

No 64 

AmB 3 1 1 1 

FLU 3 2 1 

VORI 3 2 1 

POSA 3 2 1 

ITRA 3 2 1 

ANID 3 1 2 

MICA 3 1 2 

CAS 3 2 1 

5FC 3 1 1 1




Candida glabrata (Anderson) S.A. Meyer & Yarrow 


Microscopy: Ovoid to ellipsoidal budding blastoconidia, 3.4 x 2.0 µm in size. No 

pseudohyphae or chlamydospores produced. 


Dalmau Plate Culture: Ovoid budding yeast cells only. No pseudohyphae produced. 





Galactose - Cellobiose - L-Rhamnose - DL-Lactate v 

Sucrose - Trehalose v D-Glucosamine - myo-Inositol - 

Maltose - Lactose - N-A-D-glucosamine - 2-K-D-gluconate v 






Key Features: Germ tube negative yeast and sugar assimilation pattern. C. glabrata 

is a common yeast species found on the body surface. Approximately 10% of clinical 

isolates show azole cross-resistance. 

Antifungal Susceptibility: C. glabrata complex (Australian National data); MIC 

µg/mL. CLSI clinical breakpoints are marked where available (Pfaller and Diekema 

2012). 

No 64 

AmB 999 1 1 8 25 274 339 283 63 5 

FLU 1000 1 1 1 8 21 60 77 316 302 213 

VORI 892 1 8 16 45 90 195 278 119 45 68 26 1 

POSA 770 3 8 15 40 115 228 231 5 125 

ITRA 1000 2 7 30 88 210 316 110 32 6 199 

ANID 629 50 215 208 134 5 2 3 10 1 1 

MICA 629 167 338 95 7 4 3 2 3 3 2 5 

CAS 779 1 34 187 292 185 58 9 3 1 9 

5FC 998 3 306 631 27 7 6 5 4 1 1 7

42 



Candida nivariensis Alcoba-Flórez et al. 



Microscopy: Ellipsoidal budding blastoconidia, 3-5 x 1.8-3 µm in size. No pseudohyphae 

or chlamydospores produced. 








Sucrose - Trehalose - D-Glucosamine - myo-Inositol - 



Trehalose Raffinose - Erythritol - Nitrate - 


Glucose + Soluble Starch v Galactitol - 0.1% Cycloheximide - 


C. nivariensis is closely related to C. glabrata and C. bracarensis. These three species 

were found to differ by DNA-DNA reassociation experiments, RAPD-typing, AFLPtyping 

and D1/D2 and ITS sequence divergence (Alcoba-Flórez et al. 2005, Correia et 

al. 2006, Wahyuningsih et al. 2008). 

Antifungal Susceptibility: C. nivariensis limited data (Australian National data); 

MIC µg/mL. 

No 64 

AmB 4 1 1 2 

FLU 4 1 1 2 

VORI 4 2 1 1 

POSA 4 1 1 2 

ITRA 4 4 

ANID 4 1 1 2 

MICA 4 2 2 

CAS 4 2 2 

5FC 4 1 2 1


Candida haemulonii complex 

Candida haemulonii has recently been reclassified as a complex of three phenotypically 

identical but genotypically distinct entities: C. haemulonii, C. duobushaemulonii and C. 

haemulonii var. vulnera, based on ITS and D1/D2 sequencing. (Cendejas-Bueno et al. 

2012, Ramos et al. 2015). 

Candida haemulonii (van Uden & Kolipinski) Meyer & Yarrow 



Microscopy: Ovoid to globose, budding yeast-like cells or blastoconidia, 2-7 x 2-7 µm. 

No pseudohyphae produced. 




Germ Tube - L-Sorbose - L-Arabinose - D-Glucitol + 

Fermentation Sucrose + D-Arabinose - α-M-D-glucoside - 

Glucose + Maltose + D-Ribose - D-Gluconate + 

Galactose - Cellobiose - L-Rhamnose +,w DL-Lactate - 

Sucrose + Trehalose + D-Glucosamine +,s myo-Inositol - 

Maltose - Lactose - N-A-D-glucosamine + 2-K-D-gluconate + 

Lactose - Melibiose - Glycerol +,s D-Glucuronate - 

Trehalose +,s Raffinose +,s Erythritol - Nitrate - 

Assimilation Melezitose +,w Ribitol +,s Urease - 


Galactose +,w D-Xylose - D-Mannitol + Growth at 37 O C - 

Key Features: Germ tube negative yeast and sugar assimilation pattern. Molecular 

identification may be required. C. haemulonii has been reported from a few cases of 

fungaemia but clinical isolations remain rare. 

Antifungal Susceptibility: C. haemulonii (data from Cendejas-Bueno et al. 2012, 

Ramos et al. 2015 and Australian National data); MIC µg/mL. 

No 64 

AmB 30 3 10 7 7 1 2 

FLU 30 1 3 1 25 

VORI 28 1 1 1 1 20 4 

POSA 23 1 2 1 1 3 16 

ITRA 30 2 1 2 1 24 

ANID 21 13 1 3 1 1 2 

MICA 21 2 10 3 2 4 

CAS 28 1 2 4 6 1 14 

5FC 25 2 4 7 6 2 3 1

44 


Candida inconspicua (Lodder & Kreger-van Rij) S.A. Meyer & Yarrow 

Candida inconspicua is a rare cause of candidaemia. 



Microscopy: Ovoidal budding blastoconidia, 2.0-5 x 5.0-11.0 µm. 


Dalmau Plate Culture: Spherical to ovoid budding yeast cells only. Primitive 

pseudohyphae may be produced after 14 days. 




Glucose - Maltose - D-Ribose - D-Gluconate - 

Galactose - Cellobiose - L-Rhamnose - DL-Lactate + 

Sucrose - Trehalose - D-Glucosamine + myo-Inositol - 

Maltose - Lactose - N-A-D-glucosamine + 2-K-D-gluconate - 






Key Features: Germ tube negative yeast and sugar assimilation pattern and colonies 

are white on Candida CHROMagar. 

Antifungal Susceptibility: C. inconspicua limited data available (Guitard et al. 

2013, and Australian National data); MIC µg/mL. 

No 64 

AmB 16 2 2 1 1 3 6 1 

FLU 16 2 4 10 

VORI 13 2 4 3 2 1 1 

POSA 13 2 3 5 2 1 

ITRA 15 2 6 6 1 

ANID 2 2 

MICA 2 2 

CAS 13 2 5 5 1 

5FC 14 1 1 2 4 3 1 1 1



Candida parapsilosis complex 

Recently Candida parapsilosis has been recognised as a complex of four species: 

C. parapsilosis, C. orthopsilosis, C. metapsilosis and Lodderomyces elongisporus 

(Tavanti et al. 2005). These four species are phenotypically indistinguishable and are 

best identified by ITS sequencing or MALDI-TOF MS analysis. 

Candida metapsilosis Tavanti et al. 


Microscopy: Ellipsoid, subglobose to fusiform budding blastoconidia, 4 x 3-6 µm, with 

some larger subglobose forms present. 


Dalmau Plate Culture: Abundant, much branched pseudohyphae produced. 


Germ Tube - L-Sorbose + L-Arabinose + D-Glucitol + 

Fermentation Sucrose + D-Arabinose - M-D-glucoside + 

Glucose + Maltose + D-Ribose + D-Gluconate + 






Assimilation Melezitose + Ribitol + Urease - 



Key Features: Candida metapsilosis cannot be distinguished morphologically from C. 

parapsilosis and C. orthopsilosis, but can be identified by ITS sequencing (Asadzadeh 

et al. 2009, Borman et al. 2009, Tavanti et al. 2005) and MALDI-TOF MS analysis. 

Antifungal Susceptibility: C. metapsilosis limited data (Diekema et al. 2009 and 

Australian National data); MIC µg/mL. 

No 64 

AmB 32 1 5 12 11 2 1 

FLU 32 1 19 10 2 

VORI 32 1 4 22 3 2 

POSA 32 1 7 16 6 1 

ITRA 2 1 1 

ANID 13 2 5 3 2 1 

MICA 13 9 3 1 

CAS 26 1 5 15 4 1 

5FC 2 2 

Note: Additional data for ITRA MIC range 0.06-0.5, MIC 90 

= 0.25; and 5FC MIC range 0.06- 

64, MIC 90 

= 0.5 (Gomez-Lopez et al. 2008, Miranda-Zapico et al. 2011).

46 



Candida orthopsilosis Tavanti et al. 



Microscopy: Ellipsoid to subglobose budding blastoconidia, 2-5 x 3-7 µm, with some 

larger elongated forms present. 


Dalmau Plate Culture: Abundant, much-branched pseudohyphae produced. 


Germ Tube - L-Sorbose + L-Arabinose + D-Glucitol + 

Fermentation Sucrose + D-Arabinose - α-M-D-glucoside + 










Key Features: Candida orthopsilosis cannot be distinguished morphologically from C. 

parapsilosis and C. metapsilosis, but can be identified by ITS sequencing (Asadzadeh 

et al. 2009, Borman et al. 2009, Tavanti et al. 2005) and MALDI-TOF MS analysis. 

Antifungal Susceptibility: C. orthopsilosis (Diekema et al. 2009, Canton et al. 

2012, 2013 and Australian National data); MIC µg/mL. 

No 64 

AmB 224 3 3 30 45 60 48 23 9 

FLU 196 1 9 45 85 24 16 9 4 3 

VORI 176 28 40 51 35 6 13 2 2 

POSA 136 5 21 49 41 9 11 

ITRA 94 1 2 14 30 32 15 

ANID 86 1 2 9 20 44 10 

MICA 85 1 1 3 36 37 6 1 

CAS 146 2 4 18 45 36 27 10 4 

5FC 92 56 22 8 3 1 1 1




Candida parapsilosis (Ashford) Langeron & Talice 


Microscopy: Predominantly small, globose to ovoid budding blastoconidia, 3-4 x 5-8 

µm, with some larger elongated forms present. 


Dalmau Plate Culture: Abundant, much-branched pseudohyphae in a delicate treelike 

pattern with 2-3 blastoconidia in small clusters at intervals along the pseudohyphae. 


Germ Tube - L-Sorbose +,s L-Arabinose + D-Glucitol + 

Fermentation Sucrose + D-Arabinose - M-D-glucoside + 


Galactose + Cellobiose - L-Rhamnose - DL-Lactate - 

Sucrose + Trehalose + D-Glucosamine v myo-Inositol - 

Maltose -,s Lactose - N-A-D-glucosamine + 2-K-D-gluconate + 


Trehalose -,s Raffinose - Erythritol - Nitrate - 

Assimilation Melezitose + Ribitol v Urease - 



Key Features: Germ tube negative yeast and sugar assimilation pattern. C. parapsilosis 

is commonly found on the skin and is a causative agent of candidaemia. 

Antifungal Susceptibility: C. parapsilosis (Australian National data); MIC µg/mL. 


No 64 

AmB 607 2 8 28 131 142 210 80 2 

FLU 608 12 66 122 169 136 67 27 4 4 1 

VORI 529 145 98 120 100 48 14 3 1 

POSA 437 4 41 126 182 69 13 2 

ITRA 608 1 15 80 134 279 84 12 3 

ANID 342 3 6 7 45 149 107 18 7 

MICA 342 1 3 2 51 164 90 26 5 

CAS 459 1 1 5 38 183 177 46 4 1 3 

5FC 608 2 1 31 193 176 158 38 5 2 2

48 



Lodderomyces elongisporus (Recca & Mrak) van der Walt 

Lodderomyces elongisporus has been isolated from soft drinks and juice concentrates, 

natural fermentations of cocoa, soil, an infected fingernail, human blood infections and 

from baby cream. Initially isolates appeared to be atypical forms of C. parapsilosis, 

but sequence analysis identified them as L. elongisporus. In view of these findings, 

L. elongisporus may be more common among clinical isolates than initially thought 

(Lockhart et al. 2008a, Kurtzman). 



Microscopy: Ellipsoid to elongate budding blastoconidia, 2.6-6.3 x 4-7.4 µm, with 

occasional spherical forms present. 


Dalmau Plate Culture: Abundant, much-branched pseudohyphae produced. 

Ascospore Formation: Asci are unconjugated, persistent, and are transformed from 

budding cells. Each ascus forms one, rarely two, long-ellipsoid ascospores. Ascospores 

observed on V8 agar after 7-10 days at 25 O C. 


Germ Tube - L-Sorbose + L-Arabinose - D-Glucitol + 


Glucose + Maltose + D-Ribose - D-Gluconate +,w 





Trehalose + Raffinose - Erythritol - Nitrate - 



Galactose + D-Xylose +,w D-Mannitol + Growth at 37 O C + 

Key Features: In the absence of ascospores, L. elongisporus cannot be distinguished 

physiologically from C. parapsilosis, C. orthopsilosis and C. metapsilosis but can be 

identified based on ITS sequencing (Asadzadeh et al. 2009, Borman et al. 2009, 

Tavanti et al. 2005) and MALDI-TOF MS analysis.


Candida rugosa complex 

Candida rugosa has recently been recognised as a species complex of C. rugosa, C. 

pseudorugosa and another as yet undescribed species (Li et al. 2006, Paredes et al. 

2012). These species are best identified by ITS sequencing. 


Candida rugosa (Anderson) Diddens & Lodder 


Microscopy: Ellipsoidal to elongate budding blastoconidia, 5-11 x 1.5-2.5 µm. 

Sometimes short pseudohyphae may be produced. 


Dalmau Plate Culture: Densely branched pseudohyphae produced. 


Germ Tube - L-Sorbose v L-Arabinose - D-Glucitol v 


Glucose - Maltose - D-Ribose - D-Gluconate v 

Galactose - Cellobiose - L-Rhamnose - DL-Lactate v 







Galactose + D-Xylose + D-Mannitol v Growth at 37 O C + 

Key Features: Germ tube negative yeast and sugar assimilation pattern (D-Xylose 

and Glycerol +ve; Ribitol -ve.). C. rugosa has been associated with catheter related 

fungaemia and has been isolated from human and bovine faeces, sea water and soil. 

Antifungal Susceptibility: C. rugosa limited data (Diekema et al. 2009, Espinel- 

Ingroff et al. 2014 and Australian National data); MIC µg/mL. 

No 64 

AmB 21 1 1 5 5 7 1 1 

FLU 97 1 3 15 24 29 8 8 6 1 2 

VORI 80 4 8 38 16 4 7 3 

POSA 66 1 4 12 27 9 8 5 

ITRA 5 1 1 1 1 1 

ANID 20 3 4 4 4 3 2 

MICA 20 2 3 5 6 2 2 

CAS 25 1 1 2 3 10 1 1 2

50 


Candida tropicalis is a major cause of septicaemia and disseminated candidiasis. It is 

also found as part of the normal human mucocutaneous flora and environmental isolations 

have been made from faeces, shrimp, kefir and soil. 


Candida tropicalis (Castellani) Berkhout 


Microscopy: Spherical to subspherical budding yeast-like cells or blastoconidia, 3.5-7 

x 5.5-10 µm. 


Dalmau Plate Culture: Abundant, long, wavy, branched pseudohyphae with numerous 

ovoid blastoconidia, budding off. Terminal vesicles (chlamydospores) are not produced. 


Germ Tube - L-Sorbose v L-Arabinose - D-Glucitol + 

Fermentation Sucrose v D-Arabinose - M-D-glucoside v 

Glucose + Maltose + D-Ribose v,s D-Gluconate v 

Galactose + Cellobiose v L-Rhamnose - DL-Lactate v 

Sucrose v Trehalose + D-Glucosamine v myo-Inositol - 

Maltose + Lactose - N-A-D-glucosamine + 2-K-D-gluconate + 


Trehalose +,s Raffinose - Erythritol - Nitrate - 


Glucose + Soluble Starch + Galactitol - 0.1% Cycloheximide + 


Key Features: Germ tube negative yeast and sugar assimilation pattern. Colonies are 

dark blue on Candida CHROMagar. 

Antifungal Susceptibility: C. tropicalis (Australian National data); MIC µg/mL. 


No 64 

AmB 284 1 8 45 94 97 38 1 

FLU 284 1 10 46 98 65 32 14 4 4 10 

VORI 251 10 17 37 64 58 34 14 6 5 1 4 1 

POSA 190 4 7 28 35 53 33 17 6 2 5 

ITRA 284 2 13 22 94 98 43 2 1 1 1 7 

ANID 126 9 8 29 67 11 1 1 

MICA 126 8 28 69 16 2 1 1 1 

CAS 207 1 15 68 67 40 9 3 1 

5FC 284 49 139 54 21 5 2 1 1 2 1 2 7


Chaetomium Kunze ex Fries 

The genus Chaetomium contains between 160 and 180 species. All are saprophytic 

being isolated from soil, straw, dung and plant debris. Several species are thermophilic 

and can grow at temperatures above 37 O C. Chaetomium species are important agents 

for the decomposition of cellulose waste and plant materials, and are only rarely 

isolated in medical mycology laboratories. RG-1 organisms. 

Morphological Description: Chaetomium is a common ascomycete characterised 

by the formation of darkly-pigmented, globose, ovoid, barrel to flask-shaped, ostiolate 

ascocarps (perithecia) beset with dark-coloured terminal hairs (setae) which are 

straight, branched or curved. Asci are clavate to cylindrical, typically eight-spored and 

evanescent. Ascospores are one-celled, darkly-pigmented, smooth-walled, of varying 

shape, mostly ovoid, ellipsoidal or lemon-shaped. Chlamydospores and solitary conidia 

may also be produced. 

Molecular Identification: Lee and Hanlin (1999) established the phylogenetic 

relationships of Chaetomium based on ribosomal DNA sequences. ITS sequencing 

may be useful for identification of some clinical species. 

Key Features: Ascomycete producing darkly-pigmented ostiolate perithecia beset 

with long dark terminal setae. 

References: Ames (1963), Seth (1970), Millner (1975), Domsch et al. (2007), Ellis and 

Keane (1981), Ellis (1981), von Arx (1986), de Hoog et al. (2000, 2015). 

a 

100 μm 10 μm 

b 

Chaetomium spp. (a) ascocarps (perithecia) and (b) ascus with ascospores. 

Antifungal Susceptibility: Chaetomium very limited data (McGinnis and Pasarell 

1998a, Serena et al. 2003, Barron et al. 2003, Australian National Data); MIC µg/mL. 



AmB 0.125-16 4 VORI 0.125-0.5 0.5 

ITRA 0.03-0.25 0.125 POSA

52 


Chrysosporium Corda 

Species of Chrysosporium are occasionally isolated from skin and nail scrapings, 

especially from feet, but because they are common soil saprophytes they are usually 

considered contaminants. There are about 70 species of Chrysosporium, several are 

keratinolytic with some also being thermotolerant, and cultures may closely resemble 

some dermatophytes, especially Trichophyton mentagrophytes. Some strains may 

also resemble cultures of Histoplasma and Blastomyces. 

Morphological Description: Colonies are moderately fast growing, flat, white to tan 

to beige in colour, often with a powdery or granular surface texture. Reverse pigment 

absent or pale brownish-yellow with age. Hyaline, one-celled conidia are produced 

directly on vegetative hyphae by non-specialised conidiogenous cells. Conidia are 

typically pyriform to clavate with truncate bases and are formed either intercalary 

(arthroconidia), laterally (often on pedicels) or terminally. 

Molecular Identification: Chrysosporium is phylogenetically heterogeneous; the 

polyphyletic origin of the genus was first demonstrated by Vidal et al. (2000) on the basis 

of ITS sequences, and further elaborated by Stchigel et al. (2014). ITS sequencing can 

assist in identification of clinical isolates. 

Chrysosporium tropicum Carmichael 

Morphological Descriptions: Colonies are flat, white to cream-coloured with a 

very granular surface. Reverse pigment absent or pale brownish-yellow with age. 

Microscopically, conidia are numerous, hyaline, single-celled, clavate to pyriform, 

smooth, slightly thick-walled (6-7 x 3.5-4 µm), and have broad truncate bases and 

pronounced basal scars. The conidia are formed at the tips of the hyphae, on short or 

long lateral branches, or sessile along the hyphae (intercalary). No macroconidia or 

hyphal spirals are seen. RG-2 organism. 

References: Carmichael (1962), Rebell and Taplin (1970), Sigler and Carmichael 

(1976), van Oorschot (1980), Domsch et al. (2007), de Hoog et al. (2000, 2015). 

a 

10 μm 

Chrysosporium tropicum (a) culture and (b) typical pyriform to clavate-shaped conidia 

with truncated bases which may be formed either intercalary, laterally or terminally. 

b


Cladophialophora Borelli 

The genus Cladophialophora is characterised by: (1) the absence of conidiophores, 

“shield cells,” or prominent hila (attachment points); (2) the ability to grow on media 

containing cycloheximide; and (3) having dry, non-fragile chains of conidia (Revankar 

and Sutton 2010). It has recently been re-evaluated by multilocus sequencing and 

currently contains seven species associated with human infection (Badali et al. 2008). 

Cladophialophora bantiana is the causative agent of numerous cases of cerebral 

phaeohyphomycosis many of which occur in immunocompetent individuals and most 

of which are fatal (Chakrabarti et al. 2016). C. carrionii and the recently described C. 

samoensis are agents of chromoblastomycosis. Less common species occasionally 

implicated in deep and superficial mycoses include, C. arxii, C. boppii, C. devriesii, C. 

emmonsii, C. modesta and C. saturnica. C. yegresii is a closely related environmental 

sister species to C. carrionii (Revankar and Sutton 2010, de Hoog et al. 1995, 2015). 

Cladophialophora bantiana (Saccardo) de Hoog et al. 

Synonymy: Xylohypha bantiana (Saccardo) McGinnis, Borelli and Ajello. 

Cladosporium bantianum (Sacc.) Borelli. 

Cladosporium trichoides Emmons. 

Cladophialophora bantiana has been isolated from soil and is a recognised agent of 

cerebral phaeohyphomycosis. The fungus is neurotropic and may cause brain abscess 

in both normal and immunosuppressed patients and is usually fatal. The fungus is likely 

introduced via inhalation and direct transfer to the brain via the paranasal sinuses, or 

traumatic head injury. 

WARNING: RG-3 organism. Cultures of C. bantiana represent a potential biohazard 

to laboratory personnel and must be handled with extreme caution in Class II Biological 

Safety Cabinet (BSCII). 

Morphological Description: Colonies are moderately fast growing, olivaceousgrey, 

suede-like to floccose and grow at temperatures up to 42-43 O C. Conidia are 

formed in long, sparsely branched, flexuose, acropetal chains from undifferentiated 

conidiophores. Conidia are one-celled (very occasionally two-celled), pale brown, 

smooth-walled, ellipsoid to oblong-ellipsoid and are 2-3 x 4-7 µm in size. 

C. bantiana may be distinguished from Cladosporium species by the absence of conidia 

with distinctly pigmented hila, the absence of shield cells and by growth at >40 O C 

(compared with C. carrionii which has a maximum growth temperature of 35-37 O C, and 

Cladosporium species which have a maximum of

54 


Cladophialophora bantiana (Saccardo) de Hoog et al. 

a 

b 

10 μm 

Cladophialophora bantiana (a) culture and (b) conidiophore and conidia. 

Antifungal Susceptibility: C. bantiana limited data available (Australian National 

data); MIC µg/mL. 

No. 64 

AmB 14 1 3 2 5 1 2 

VORI 14 3 2 7 1 1 

POSA 12 3 2 4 3 

ITRA 14 5 2 5 2 

C. bantiana limited data (McGinnis and Pasarell 1998a, 1998b, Espinel-Ingroff et al. 

2001, Chakrabarti et al. 2015); MIC µg/mL. 


= 2 VORI Range 0.03-1; MIC 90 

= 0.125 


= 0.125 POSA Range 0.03-0.125; MIC 90 

= 0.125 

TERB Range 0.03-1; Geometric Mean = 0.08


Cladophialophora carrionii (Trejos) de Hoog et al. 

Synonymy: Cladosporium carrionii Trejos 

Cladophialophora carrionii is a recognised agent of chromoblastomycosis and it 

has been isolated from soil and fence posts made from Eucalyptus spp. Cases of 

chromoblastomycosis caused by C. carrionii are commonly found in Australia, 

Venezuela, Madagascar and South America. Isolates from phaeomycotic cysts and 

opportunistic infections have also been reported. 


Morphological Description: Colonies are slow growing, reaching 3-4 cm in diameter 

after one month, with a compact suede-like to downy surface and are olivaceous-black 

in colour. Microscopy shows ascending to erect, olivaceous-green, apically branched, 

elongate conidiophores producing branched acropetal chains of conidia. Conidia are 

pale olivaceous, smooth-walled or slightly verrucose, limoniform to fusiform, 1.5-3.0 x 

2.0-7.0 µm in size. Bulbous phialides with large collarettes and minute, hyaline conidia 

are occasionally formed on nutritionally poor media. Maximum growth temperature 

35-37 O C. 

Molecular Identification: ITS sequencing is recommended (Abliz et al. 2004; de Hoog 

et al. 2007). 

Key Features: Conidia are smaller and comprise heavily branched chains which fall 

apart much more easily than in the other Cladophialophora species. 

References: McGinnis (1980), Rippon (1988), de Hoog et al. (1995, 2000, 2015). 

Cladophialophora carrionii culture.

56 


Cladophialophora carrionii (Trejos) de Hoog et al. 

10 μm 

Cladophialophora carrionii conidiophores and conidia. 

Antifungal Susceptibility: C. carrionii limited data available (Australian National 


No. 64 

AmB 2 1 1 

VORI 2 1 1 

POSA 2 1 1 

ITRA 2 1 1 

C. carrionii limited data available (McGinnis and Pasarell 1998a,1998b, Espinel- 

Ingroff et al. 2001, Gonzales et al. 2005); MIC µg/mL. 


= 1 VORI Range 0.03-0.5; MIC 90 

= 0.25 

ITRA Range 0.06-0.5; MIC 90 

= 0.125 POSA Range 0.06-0.5; MIC 90 

= 0.25 

TERB Range 0.03-0.125; Geometric Mean = 0.03


Cladosporium species are ubiquitous worldwide, and commonly isolated from soil and 

organic matter. They represent the most frequently isolated airborne fungi. The genus 

has undergone a number of revisions. The well-known thermotolerant ‘true humanpathogenic 

species, formerly known as C. bantiana, C. carrionii and C. devriesii, 

characterised by the absence of conidiophores, and unpigmented conidial scars, were 

reclassified in Cladophialophora (de Hoog et al. 1995, Bensch et al. 2012). The remaining 

species of medical interest were C. cladosporioides, C. herbarum, C. oxysporum, 

and C. sphaerospermum. More recently, extensive revisions based on polyphasic 

approaches have recognised 169 species, and demonstrated that C. cladosporioides, 

C. herbarum and C. sphaerospermum are species complexes encompassing several 

sibling species that can only be distinguished by phylogenetic analyses (Crous et al. 

2007, Schubert et al. 2007, Zalar et al. 2007, Bensch et al. 2010, 2012). 

Sandoval-Denis et al. (2015) analysed 92 clinical isolates from the United States 

using phenotypic and molecular methods, which included sequence analysis of the 

ITS and D1/D2 regions, partial EF-1α and actin genes. Surprisingly, the most frequent 

species was Cladosporium halotolerans (15%), followed by C. tenuissimum (10%), C. 

subuliforme (6%), and C. pseudocladosporioides (5%). However, 40% of the isolates 

did not correspond to any known species and were deemed to represent at least 17 

new lineages for Cladosporium. The most frequent anatomic site of isolation was the 

respiratory tract (55%), followed by superficial (28%) and deep tissues and fluids (15%). 

Species of the two recently described Cladosporium-like genera Toxicocladosporium 

and Penidiella were also reported for the first time from clinical samples (Sandoval- 

Denis et al. 2015). 


Cladosporium Link ex Fries 

Morphological Description: Colonies are slow growing, mostly olivaceous-brown 

to blackish-brown but also sometimes grey, buff or brown, suede-like to floccose, 

often becoming powdery due to the production of abundant conidia. The reverse is 

olivaceous-black. Vegetative hyphae, conidiophores and conidia are equally pigmented. 

Conidiophores are more or less distinct from the vegetative hyphae, being erect, 

straight or flexuose, unbranched or branched only in the apical region, with geniculate 

sympodial elongation in some species. Conidia are produced in branched acropetal 

chains, being smooth, verrucose or echinulate, one to four-celled, and have a distinct 

dark hilum. The term blastocatenate is often used to describe chains of conidia where 

the youngest conidium is at the apical or distal end of the chain. Note: The conidia 

closest to the conidiophore, and where the chains branch, are usually “shield-shaped”. 

The presence of shield-shaped conidia, a distinct hilum, and chains of conidia that 

readily disarticulate, are characteristic of the genus Cladosporium. 

Key Features: Dematiaceous hyphomycete forming branched acropetal chains of 

conidia, each with a distinct hilum. 

Molecular Identification: Genus level identification is usually sufficient and 

morphological identification can be confirmed by ITS and D1/D2 sequence analysis. 

Multilocus gene analysis of the ITS, D1/D2, EF-1α and actin gene loci is necessary for 

accurate species identification (Bensche et al. 2012).

58 


Cladosporium Link ex Fries 

a 

b 

10 μm 

Cladosporium cladosporioides complex (a) culture, (b) conidiophores and conidia. 

Antifungal Susceptibility: Cladosporium species (Sandoval-Denis et al. 2015 and 




AmB 0.03-2 2 POSA 0.03-4 0.5 

ITRA 0.03-16 0.5 VORI 0.25-16 4 

References: Ellis (1971, 1976), Domsch et al. (1980), McGinnis (1980), de Hoog et al. 

(2000, 2015), Crous et al. (2007), Schubert et al. (2007), Zalar et al. (2007), Bensch et 

al. (2010 and 2012), Sandoval-Denis et al. (2015).


Clavispora lusitaniae Rodrigues de Miranda 

Synonymy: Candida lusitaniae van Uden & do Carmo-Sousa. 

Clavispora lusitaniae is a known cause of disseminated candidiasis, including 

septicaemia and pyelonephritis. C. lusitaniae was first isolated from the digestive 

tract of warm-blooded animals and environmental isolations have been made from 

cornmeal, citrus peel, fruit juices, and milk from cows with mastitis. RG-2 organism. 


Microscopy: Ovoid to ellipsoidal budding blastoconidia, 1.5-6.0 x 2.5-10µm. 


Dalmau Plate Culture: Abundant pseudohyphae with short chains of blastoconidia. 

Molecular Identification: ITS sequencing recommended. 

MALDI-TOF MS: Able to accurately identify this species. 

Physiological Tests: + Positive, - Negative, v Variable, w Weak, s Slow, nd No Data 

Germ Tube - L-Sorbose + L-Arabinose v D-Glucitol + 

Fermentation Sucrose + D-Arabinose - α-M-D-glucoside v 

Glucose + Maltose + D-Ribose - D-Gluconate s 

Galactose v Cellobiose + L-Rhamnose v DL-Lactate +,w 

Sucrose v Trehalose + D-Glucosamine - myo-Inositol - 

Maltose v Lactose - N-A-D-glucosamine + 2-K-D-gluconate + 

Lactose - Melibiose - Glycerol + D-Glucuronate nd 


Assimilation Melezitose + Ribitol s Urease - 



Key Features: Germ tube negative yeast and sugar assimilation pattern. 

Note: C. lusitaniae may also be difficult to distinguish from Candida tropicalis using 

some yeast identification systems. 

Antifungal Susceptibility: C. lusitaniae (Diekema et al. 2009, Pfaller et al. 2013, 


No. 64 

AmB 214 1 9 31 86 74 10 1 1 1 

FLU 279 12 33 66 82 33 21 8 4 1 5 4 

VORI 262 169 53 15 12 3 5 3 2 

POSA 252 5 40 77 83 26 15 2 4 

ITRA 99 1 1 3 21 33 20 15 4 1 

ANID 175 1 13 32 56 59 13 1 

MICA 159 1 2 13 22 57 46 11 6 1 

CAS 247 2 4 12 86 91 38 12 1 1 

5FC 44 15 20 1 2 2 1 1 2

60 


Coccidioides immitis/posadasii complex 

WARNING: RG-3 organism. Cultures of Coccidioides immitis/posadasii represent a 

severe biohazard to laboratory personnel and must be handled with extreme caution 

in Class II Biological Safety Cabinet (BSCII). 

Coccidioides immitis has been separated into two distinct species: C. immitis and C. 

posadasii (Fisher et al. 2002). The two species are morphologically identical and can be 

distinguished only by genetic analysis and different rates of growth in the presence of 

high salt concentrations (C. posadasii grows more slowly). C. immitis is geographically 

limited to California’s San Joaquin Valley region and Mexico, whereas C. posadasii is 

found in California, Arizona, Texas, Mexico and South America. 

Morphological Description: Colonies of C. immitis and C. posadasii grown at 25 O C 

are initially moist and glabrous, but rapidly become suede-like to downy, greyishwhite 

with a tan to brown reverse, however considerable variation in growth rate and 

culture morphology has been noted. Microscopy shows typical single-celled, hyaline, 

rectangular to barrel-shaped, alternate arthroconidia, 2.5-4 x 3-6 µm in size, separated 

from each other by a disjunctor cell. This arthroconidial state has been classified in the 

genus Malbranchea and is similar to that produced by many non-pathogenic soil fungi, 

e.g. Gymnoascus species. 

Comment: Coccidioides immitis and C. posadasii dimorphic fungi, existing in living 

tissue as spherules and endospores, and in soil or culture in a mycelial form. Culture 

identification by either exoantigen test or DNA sequencing is preferred to minimise 

exposure to the infectious propagule. 

Key Features: Clinical history, tissue pathology, culture identification by ITS sequence 

analysis. 

20 μm 

Coccidioides immitis tissue morphology showing typical endosporulating spherules. 

Young spherules have a clear centre with peripheral cytoplasm and a prominent 

thick-wall. Endospores (sporangiospores) are later formed within the spherule by 

repeated cytoplasmic cleavage. Rupture of the spherule releases endospores into the 

surrounding tissue where they re-initiate the cycle of spherule development. 

References: Ajello (1957), Steele et al. (1977), McGinnis (1980), Chandler et al. 

(1980), Catanzaro (1986), Rippon (1988), de Hoog et al. (2015), Fisher et al. (2002).


Coccidioides immitis/posadasii complex 

Molecular Identification: In endemic areas a DNA probe for recognition of the species 

is commercially available (Padhye et al. 1994b). ITS sequencing is recommended for 

differentiation of species (Tintelnot et al. 2007, Binnicker et al. 2011). 

a 

b 

5 μm 

Coccidioides immitis (a) culture and (b) arthroconidia with disjunctor cells. 

Antifungal Susceptibility: C. immitis (Ramani and Chaturvedi 2007); MIC µg/mL. 

Antifungal susceptibility testing not recommended. For treatment options see 

Clinical Practice Guidelines for the Management of Coccidioidomycosis (Galgiani et 

al. 2005). 

No. 16 

AmB 45 7 25 8 4 1 

FLU 45 1 4 10 27 3 

ITRA 45 13 9 15 8 

POSA 45 25 13 3 4 

VORI 45 23 22

62 


Colletotrichum coccodes (Wallroth) S. Hughes 

Over 500 Colletotrichum species have been reported. C. coccodes is a common soil 

and plant pathogen widely distributed in Africa, Asia, Australasia, Europe, and the 

Americas. It has been reported from a case of human mycotic keratitis. 


Morphological Description: Colonies usually darkly pigmented with white aerial 

mycelium, consisting of numerous black sclerotia and light brown-coloured conidial 

masses, reverse is dark brown. Sclerotia are usually abundant, setose, spherical and 

are often confluent. Conidia are straight, fusiform, attenuated at the ends, 16-22 x 3-4 

µm. Appressoria are common, clavate, brown, 11-16.5 x 6-9.5 µm, variable in shape. 

Molecular Identification: ITS and/or D1/D2 sequencing may be used for species 

identification (Cano et al. 2004). 

References: Domsch et al. (1980), McGinnis (1980), de Hoog et al. (2000, 2015). 

a 

b 

50 μm 

c 

20 μm 

d 

10 μm 

Colletotrichum coccodes (a) culture, (b) sclerotia with setae, 

(c) conidia and (d) appressoria.


Synonymy: Entomophthora coronata (Costantin) Kevorkian. 

The species of the genus Conidiobolus produce characteristic multinucleate primary 

and secondary (replicative) conidia on top of unbranched conidiophores. Each 

subspherical conidium is discharged as a result of the pressure developed within the 

conidium, and each bears a more or less prominent papilla after discharge (King 1983). 

The genus contains 27 species, however only Conidiobolus coronatus, C. incongruus 

and C. lamprauges have been reported as causative agents of human and animal 

infection. A morphological identification key for clinical isolates was given by Vilela et 

al. (2010). 


Conidiobolus coronatus (Costantin) Batko 

Morphological Description: Colonies of C. coronatus grow rapidly and are flat, 

cream-coloured, glabrous becoming radially folded and covered by a fine, powdery, 

white surface mycelium and conidiophores. The lid of the petri dish soon becomes 

covered with conidia, which are forcibly discharged by the conidiophores. The colour 

of the colony may become tan to brown with age. Conidiophores are simple forming 

solitary, terminal conidia which are spherical, 10 to 25 µm in diameter, single-celled 

and have a prominent papilla. Conidia may also produce hair-like appendages, called 

villae. Conidia germinate to produce either: (1) single or multiple hyphal tubes that 

may also become conidiophores which bear secondary conidia; or (2) replicate by 

producing multiple short conidiophores, each bearing a small secondary conidium. 

C. coronatus is commonly present in soil and decaying leaves. It has a worldwide 

distribution especially in tropical rain forests of Africa. Human infections are usually 

restricted to the rhinofacial area. However, there are occasional reports of dissemination 

to other sites. All human infections have been confined to the tropics. 

References: Emmons and Bridges (1961), King (1983), McGinnis (1980), Rippon 

(1988), Kwon-Chung and Bennett (1992), de Hoog et al. (2000, 2015), Ellis (2005a). 

Conidiobolus coronatus culture showing satellite colonies formed 

by germinating conidia ejected from the primary colony.

64 


Conidiobolus coronatus (Costantin) Batko 

a 

10 μm 

b 

10 μm 

Conidiobolus coronatus (a) spherical conidium with hair-like 

appendages (villae) and (b) conidia with prominent papillae. 

Coniochaeta hoffmannii (J.F.H. Beyma) Z.U. Khan, Gené & Guarro 

Synonymy: Lecythophora hoffmannii (J.F.H. Beyma) W. Gams & McGinnis. 

Phialophora hoffmannii (J.F.H. Beyma) Schol-Schwarz. 

In response to recent changes in the nomenclature for pleomorphic fungi, Khan 

et al. (2013) transferred all Lecythophora species to Coniochaeta. The genus 

Coniochaeta is morphologically similar to Phialemonium. It also forms adelophialides, 

but in Coniochaeta, these conidiogenous cells show conspicuous collarettes, and the 

colonies are usually pink-salmon to dark brown, although discrete phialides like those of 

Acremonium may also be present (Perdomo et al. 2011b). Coniochaeta hoffmannii has 

been associated with cases of subcutaneous infections, keratitis, sinusitis, peritonitis, 

and canine osteomyelitis. Coniochaeta mutabilis has been described to be a causative 

agent of human peritonitis, endocarditis, endophthalmitis, and keratitis (Perdomo et al. 

2011b). 


Morphological Description: Colonies are flat, smooth, moist, pink to orange, with 

regular and sharp margin; reverse pink. Hyphae are narrow, hyaline, producing conidia 

laterally from small collarettes directly on the hyphae, or from lateral cells which are 

sometimes arranged in dense groups; lateral cells flask-shaped or nearly cylindrical. 

Collarettes are unpigmented, about 1.5 µm wide. Conidia are hyaline, smooth and thinwalled, 

broadly ellipsoidal to cylindrical or allantoid, 3.0-3.5 x 1.5-2.5 µm, produced in 

slimy heads.


Coniochaeta hoffmannii (J.F.H. Beyma) Z.U. Khan, Gené & Guarro 

Note: Coniochaeta and Phialemonium species are poorly differentiated morphologically, 

and are difficult to identify. They may also be confused with poorly sporulating Fusarium 

or Acremonium species. 

Molecular Identification: Khan et al. (2013) used a combined sequence data set of 

the ITS region, D1/D2, actin and β-tubulin genes to resolve the unique phylogenetic 

status of this species. 

References: de Hoog (1983), de Hoog et al. (2000, 2015), Perdomo et al. (2011b), 

Khan et al. (2013). 

a 

b 

10 µm 

b 

10 µm 

Coniochaeta hoffmannii (a) culture, (b) hyphae with small collarettes and conidia. 

Antifungal Susceptibility: Coniochaeta hoffmannii very limited data (McGinnis and 

Pasarell 1998a, Perdomo et al. 2011b and Australian National data); MIC µg/mL. 



AmB 0.06-2 2 POSA 0.125-1 1 

ITRA 0.06-32 1 VORI 0.25-1 1

66 


Cryptococcus Kützing emend. Phaff & Spencer 

The genus Cryptococcus is characterised by globose to elongate yeast-like cells or 

blastoconidia that reproduce by narrow-necked budding. Pseudohyphae are absent or 

rudimentary. Most species are encapsulated, although the extent of capsule formation 

depends on the medium. Under certain conditions of growth, the capsule may contain 

starch-like compounds, which are released into the medium by many strains. Within 

tissue sections, mucicarmine or Alcian blue stains the capsule of Cryptococcus species 

to distinguish it from other yeasts with similar morphologies. 

On solid media the cultures are generally mucoid or slimy in appearance; red, orange or 

yellow carotenoid pigments may be produced, but young colonies of most species are 

usually non-pigmented, and cream in colour. All Cryptococcus species produce urease 

and are non-fermentative. Nitrate may be assimilated or not; inositol assimilated. The 

genus Cryptococcus differs from the genus Rhodotorula in its inositol assimilation. 

Cryptococcosis is a chronic, subacute to acute pulmonary, systemic or meningitic 

disease, initiated by the inhalation of infectious propagules (basidiospores and/or 

desiccated yeast cells) from the environment. Primary pulmonary infections have no 

diagnostic symptoms and are usually subclinical. On dissemination, the fungus usually 

shows a predilection for the central nervous system, however skin, bones and other 

visceral organs may also become involved. Although C. neoformans and C. gattii are 

regarded as the principle pathogenic species, Cryptococcus albidus and C. laurentii 

have on occasion also been implicated in human infection. 

Molecular Identification: Requires ITS and/or D1/D2 sequencing, particularly for 

identification of unusual species. 

MALDI-TOF MS: Can provide reliable species and subspecies level identification of 

Cryptococcus species, but its accuracy is dependent on database quality (Arendrup et 

al. 2014). 

a 

b 

5 μm 

Cryptococcus neoformans (a) culture appearances on bird seed agar (brown colonies) 

and Candida albicans (white colonies) and (b) India Ink preparation of C. neoformans 

surrounded by a characteristic wide gelatinous capsule. 

References: Rippon (1982), Barnett et al. (1983), Kurtzman et al. (2011), Casadevall 

and Perfect (1998), de Hoog et al. (2000, 2015), McTaggart et al. (2013).


Cryptococcus albidus (Saito) Skinner 

Synonymy: Cryptococcus diffluens (Zach) Lodder & Kreger-van Rij. 


Culture: Colonies (SDA) are cream-coloured smooth, mucoid, glabrous, yeast-like. 

Microscopy: Globose to ovoid budding yeast-like cells, 3.5-8.8 x 5.5-10.2 μm. 

Pseudohyphae are absent. 

India Ink Preparation: Positive - distinct thin capsules are present. 


Germ Tube - L-Sorbose v L-Arabinose + D-Glucitol + 

Fermentation Sucrose + D-Arabinose v α-M-D-glucoside v 

Glucose - Maltose + D-Ribose v D-Gluconate + 

Galactose - Cellobiose + L-Rhamnose v DL-Lactate v 

Sucrose - Trehalose +,w D-Glucosamine - myo-Inositol + 

Maltose - Lactose v N-A-D-glucosamine - 2-K-D-gluconate + 

Lactose - Melibiose v Glycerol v D-Glucuronate + 

Trehalose - Raffinose + Erythritol v Nitrate + 

Assimilation Melezitose + Ribitol v Urease + 

Glucose + Soluble Starch v Galactitol v 0.1% Cycloheximide - 

Galactose v D-Xylose + D-Mannitol + Growth at 37 O C v 

Cryptococcus albidus has variable growth at 37 O C, and infections in humans are 

rare. Along with C. laurentii, C. albidus accounts for 80% of the non-neoformans/gattii 

infections. Impaired cellular immunity is the most common risk factor with HIV infection 

and low CD4 counts a common comorbidity. 

Antifungal Susceptibility: C. albidus (Australian National data); MIC µg/mL. 

Note: All Cryptococcus species are intrinsically resistant to echinocandins. 

No. 64 

AmB 1 1 

FLU 1 1 

VORI 1 1 

POSA 1 1 

ITRA 1 1 

5FC 1 1

68 


Cryptococcus gattii (Vanbreus. & Takashio) Kwon-Chung & Boekhout 

Synonymy: Filobasidiella bacillispora Kwon-Chung. 

Cryptococcus neoformans var. gattii Vanbreus. & Takashio. 


Cryptococcus gattii has two serotypes (B and C) and was reclassified as a separate 

species from C. neoformans in 2002 (Kwon-Chung et al. 2002). C. gattii generally has a 

more restricted geographical distribution than C. neoformans, causing human disease 

in climates ranging from temperate to tropical Australia, Papua New Guinea, parts of 

Africa, India, Southeast Asia, Mexico, Brazil, Paraguay and Southern California, although 

recent infections have also been reported from Vancouver Island, Canada and in the 

Pacific Northwest, USA (Pfaller & Diekema, 2010, Espinel-Ingroff and Kidd, 2015). C. 

gattii has a specific ecological association with numerous species of Eucalyptus trees, 

although the Canadian isolates are associated with a range of native non-Eucalyptus 

species (Kidd et al. 2007). Historically considered a pathogen in immunocompetent 

hosts, a recent review in Australia noted an increase in C. gattii infections in HIVnegative 

immunocompromised patients (Chen et al. 2012). Cryptococcosis caused by 

C. gattii is often associated with large mass lesions (cryptococcomas) in the lung and/ 

or brain (Sorrell, 2001). 

Canavanine glycine bromothymol blue (CGB) agar (Kwon-Chung et al. 1982) is the 

media of choice to differentiate C. gattii from C. neoformans. This simple biotype test is 

based on the ability of C. gattii isolates to grow in the presence of L-canavanine and to 

assimilate glycine as a sole carbon source. A heavy inoculum is important. 

Cryptococcus gattii turns CGB agar blue within 2-5 days; 

Cryptococcus neoformans does not grow on this medium


Cryptococcus gattii (Vanbreus. & Takashio) Kwon-Chung & Boekhout 

Culture: Colonies (SDA) cream-coloured smooth, mucoid, yeast-like colonies. 

Microscopy: Globose to ovoid budding yeast-like cells 3.0-7.0 x 3.3- 7.9 µm. 

India Ink Preparation: Positive - distinct, wide gelatinous capsules are present. Some 

strains may not produce apparent capsules from culture. 

Dalmau Plate Culture: Budding yeast cells only. No pseudohyphae present. 

Bird Seed Agar: Colonies turn dark brown in colour as colonies selectively absorb a 

brown pigment from this media. Colonies are often more mucoid when compared with 

C. neoformans (Staib, 1987). 

Canavanine Glycine Bromothymol Blue (CGB) Agar: Turns blue within 2-5 days. 


Germ Tube - L-Sorbose - L-Arabinose +,w D-Glucitol + 

Fermentation Sucrose + D-Arabinose + M-D-glucoside + 


Galactose - Cellobiose +,w L-Rhamnose + DL-Lactate - 

Sucrose - Trehalose + D-Glucosamine v myo-Inositol + 

Maltose - Lactose - N-A-D-glucosamine v 2-K-D-gluconate nd 

Lactose - Melibiose - Glycerol - D-Glucuronate nd 

Trehalose - Raffinose +,w Erythritol - Nitrate - 


Glucose + Soluble Starch + Galactitol + 0.1% Cycloheximide - 


Key Features: Encapsulated yeast; absence of pseudohyphae; growth at 37 O C; 

positive hydrolysis of urea; negative fermentation of sugars and positive assimilation 

of glucose, maltose, sucrose, galactose, trehalose, raffinose, inositol, cellobiose, 

rhamnose, arabinose, melezitose and xylose, and negative assimilation of nitrate, 

lactose, melibiose, erythritol and soluble starch; growth on bird seed (Guizotia 

abyssinica seed) or caffeic acid agar - colonies turn a dark brown colour; growth on 

CGB agar turning it blue within 2-5 days. 

Antifungal Susceptibility: C. gattii (Australian National data); MIC µg/mL. 


No. 64 

AmB 152 1 3 18 52 55 12 10 1 

FLU 152 2 13 29 48 38 19 2 1 

VORI 130 5 12 32 44 20 13 4 

POSA 90 2 9 12 23 26 16 1 1 

ITRA 152 7 22 38 61 23 1 

5FC 152 2 10 38 52 39 7 4

70 



Cryptococcus laurentii (Kufferath) Skinner 

Culture: Colonies (SDA) are cream-coloured, often becoming a deeper orange-yellow 

with age, with a smooth mucoid texture. 

Microscopy: Spherical and elongated budding yeast-like cells or blastoconidia, 2.0- 

5.5 x 3.0-7.0 μm. No pseudohyphae present. 

India Ink Preparation: Positive - narrow but distinct capsules are present. 


Germ Tube - L-Sorbose v L-Arabinose + D-Glucitol + 

Fermentation Sucrose + D-Arabinose + α-M-D-glucoside + 

Glucose - Maltose + D-Ribose + D-Gluconate + 

Galactose - Cellobiose + L-Rhamnose + DL-Lactate v 

Sucrose - Trehalose + D-Glucosamine - myo-Inositol + 

Maltose - Lactose + N-A-D-glucosamine - 2-K-D-gluconate + 

Lactose - Melibiose + Glycerol v D-Glucuronate + 

Trehalose - Raffinose + Erythritol v Nitrate - 

Assimilation Melezitose + Ribitol + Urease + 

Glucose + Soluble Starch v Galactitol + 0.1% Cycloheximide - 

Galactose v D-Xylose + D-Mannitol + Growth at 37 O C -,w 

Note: Some strains of C. laurentii may develop brown pigment on bird seed agar and 

turn CGB media blue, similar to C. gattii, however C. laurentii assimilates both lactose 

and melibiose while C. gattii does not. Along with C. albidus, C. laurentii accounts for 

80% of the non-neoformans/gattii infections. Impaired cellular immunity is the most 

common risk factor with HIV infection and low CD4 counts a common comorbidity. 

Invasive devices are an additional risk factor. 

Antifungal Susceptibility: C. laurentii (Australian National data); MIC µg/mL. 


No. 64 

AmB 7 1 2 3 1 

FLU 6 1 1 3 1 

VORI 6 2 2 1 1 

POSA 5 1 1 2 1 

ITRA 7 1 2 2 1 1 

5FC 7 7


Cryptococcus neoformans (Sanfelice) Vuillemin 

Synonymy: Filobasidiella neoformans Kwon-Chung. 

Cryptococcus neoformans var. neoformans (San Felice) Vuill. 


This species comprises two varieties: C. neoformans var. grubii (serotype A) and C. 

neoformans var. neoformans (serotype D). 

C. neoformans var. grubii has a worldwide distribution, causing 95% of all C. neoformans 

infections. It has been isolated from various sources in nature and is noted for its 

association with accumulations of avian guano, especially with pigeon excreta. The 

fungus has also been isolated from the dung of caged birds including canaries, parrots 

and budgerigars. Other environmental isolations of C. neoformans var. grubii include 

rotting vegetables, fruits and fruit juices, wood, dairy products and soil. 

C. neoformans var. neoformans has a more restricted distribution with infections being 

more prevalent in Europe, including France, Italy and Denmark, where it accounts 

for 30% of isolates. Moreover, C. neoformans var. neoformans infections are more 

strongly correlated with older patients, the skin, and the use of corticosteroids (Franzot 

et al. 1999). 

Culture: Colonies (SDA) cream-coloured smooth, mucoid, yeast-like colonies. 

Microscopy: Globose to ovoid budding yeast-like cells 3.0-7.0 x 3.3-7.9 µm. 

India Ink Preparation: Positive - distinct, wide gelatinous capsules are present on 

direct microscopy. Some strains may not produce apparent capsules from culture. 

Dalmau Plate Culture: Budding yeast cells only. No pseudohyphae present. 

Bird Seed Agar: Colonies turn dark brown in colour as colonies selectively absorb a 

brown pigment from this media (Staib, 1987). 

Canavanine Glycine Bromothymol Blue (CGB) Agar: No growth or colour change. 

Creatinine Dextrose Bromothymol Blue Thymine (CDBT) Agar may be used 

to differentiate C. neoformans var. neoformans and C. neoformans var. grubii. C. 

neoformans var. neoformans grows as bright red colonies, turning the medium a bright 

orange after 5 days while no colour change is observed for C. neoformans var. grubii 

(Irokanulo et al. 1994).

72 


Cryptococcus neoformans (Sanfelice) Vuillemin 


Germ Tube - L-Sorbose - L-Arabinose +,w D-Glucitol + 

Fermentation Sucrose + D-Arabinose + α-M-D-glucoside + 


Galactose - Cellobiose +,w L-Rhamnose + DL-Lactate - 

Sucrose - Trehalose + D-Glucosamine v myo-Inositol + 

Maltose - Lactose - N-A-D-glucosamine v 2-K-D-gluconate nd 

Lactose - Melibiose - Glycerol - D-Glucuronate nd 

Trehalose - Raffinose +,w Erythritol - Nitrate - 


Glucose + Soluble Starch + Galactitol + 0.1% Cycloheximide - 


Key Features: Encapsulated yeast; absence of pseudohyphae; growth at 37 O C; 

positive hydrolysis of urea; negative fermentation of sugars and positive assimilation 

of glucose, maltose, sucrose, galactose, trehalose, raffinose, inositol, cellobiose, 

rhamnose, arabinose, melezitose and xylose, and negative assimilation of nitrate, 

lactose, melibiose, erythritol and soluble starch; growth on bird seed (Guizotia 

abyssinica seed) or caffeic acid agar - colonies turn a dark brown colour; does not 

grow on CGB agar (no colour change). 

Antifungal Susceptibility: C. neoformans (Australian National data); MIC µg/mL. 


No. 64 

AmB 236 2 5 17 82 57 57 16 

FLU 236 1 10 32 40 65 65 16 6 1 

VORI 197 27 25 54 63 23 4 1 

POSA 152 1 9 29 39 46 24 4 

ITRA 236 2 10 37 72 90 20 4 1 

5FC 236 1 1 5 20 45 66 61 33 2 2


Cunninghamella bertholletiae Stadel 

Synonymy: Cunninghamella elegans Lendner. 

Cunninghamella echinulata var. elegans (Lendner) Lunn & Shipton. 

The genus Cunninghamella is characterised by white to grey, rapidly growing colonies, 

producing erect, straight, branching sporangiophores. These sporangiophores end in 

globose or pyriform-shaped vesicles from which several one-celled, globose to ovoid, 

echinulate or smooth-walled sporangiola develop on swollen denticles. Chlamydospores 

and zygospores may also be present. 

Cunninghamella species are mainly soil fungi of the Mediterranean and subtropical 

zones; they are only rarely isolated in temperate regions. The genus now contains 

seven species with C. bertholletiae the only known species to cause disease in humans 

and animals, often in association with trauma and immunosuppression. 


Morphological Description: Colonies are very fast growing, white at first, but 

becoming dark grey and powdery with sporangiola development. Sporangiophores 

up to 20 μm wide, straight, with verticillate or solitary branches. Vesicles subglobose 

to pyriform, the terminal ones up to 40 µm and the lateral ones 10-30 µm in diameter. 

Sporangiola are globose (7-11 µm diameter), or ellipsoidal (9-13 x 6-10 μm), verrucose 

or short-echinulate, hyaline singly but brownish in mass. Temperature: optimum 25- 

30 O C, maximum up to 50 O C. 

Key Features: Mucorales, clinical isolates grow at 40 O C, one-celled, globose to ovoid, 

echinulate sporangiola borne on swollen terminal or lateral globose to clavate fertile 

vesicles. 

Molecular Identification: ITS sequencing is recommended (Yu et al. 2015). 

References: McGinnis (1980), Weitzman and Crist (1980), Weitzman (1984), Lunn 

and Shipton (1983), Domsch et al. (1980), Samson (1969), de Hoog et al. (2000, 

2015), Ellis (2005b), Zheng and Chen (2001). 

Antifungal Susceptibility: C. bertholletiae (Espinel-Ingroff et al. 2015a, includes 

Australian data); MIC µg/mL. 

No. 16 

AmB 32 1 1 5 16 8 1 

POSA 30 4 18 8 

ITRA 25 4 4 10 7

74 


Cunninghamella bertholletiae Stadel 

10 μm 

10 μm 

Cunninghamella bertholletiae showing simple sporangiophores forming a swollen, 

terminal vesicle around which single-celled, globose to ovoid sporangiola develop 

on swollen denticles.


The genus Curvularia contains about 80 species, which are mostly soil or plant 

pathogens. Recent studies have shown that morphological identification does not 

correlate with molecular identification (Manamgoda et al. 2012; Yanagihara et al. 2010, 

da Cunha et al. 2013). A phylogenetic analysis of the genera Bipolaris and Curvularia 

has resulted in a re-alignment of several species. In particular, clinical isolates previously 

identified as Bipolaris species, notably B. australiensis, B. hawaiiensis and B. spicifera 

have now been transferred to Curvularia (Manamgoda et al. 2012). 

Previously Curvularia lunata was the most frequently reported clinical species, however 

other species, such as C. americana, C. brachyspora, C. chlamydospora, C. clavata, 

C. hominis, C. inaequalis, C. muehlenbeckiae, C. pallescens, C. pseudolunata, C. 

senegalensis and C. verruculosa have now also been reported from clinical cases 

(Revankar and Sutton, 2010, da Cunha et al. 2013, Madrid et al. 2014). 


Curvularia Boedijn 

Morphological Description: Colonies are fast growing, suede-like to downy, brown to 

blackish brown with a black reverse. Conidiophores erect, straight to flexuous, septate, 

often geniculate (producing conidia in sympodial succession) sometimes nodulose. 

Conidia are ellipsoidal, often curved or lunate, rounded at the ends or sometimes 

tapering slightly towards the base, pale brown, medium reddish brown to dark brown, 

3–10 (usually 3–5) septa, conidial wall smooth to verrucose. Hilum protuberant in some 

species. 

Key Features: Dematiaceous hyphomycete producing sympodial, pale brown, 

cylindrical or slightly curved phragmoconidia. 

Comment: There is no clear morphological boundary between the genera Bipolaris 

and Curvularia and some species show intermediate morphology (Manamgoda et al. 

2012). ITS and GPDH gene analysis is recommended for definitive identification of 

species (Manamgoda et al. 2012). 

Molecular Identification: GPDH (Manamgoda et al. 2012) and/or ITS (da Cunha et 

al. 2013, Irinyi et al. 2015). 

References: Ellis (1971), McGinnis (1980), Rippon (1988), de Hoog et al. (2000, 2015), 

Revankar and Sutton (2010), Yanagihara et al. (2010), Manamgoda et al. (2012); da 

Cunha et al. (2013), Madrid et al. (2014). 

Antifungal Susceptibility: Curvularia australiensis (da Cunha et al. 2012a and 


No 16 

AmB 13 1 1 6 3 2 

VORI 13 1 2 6 3 1 

POSA 11 1 2 6 2 

ITRA 13 1 3 2 6 1

76 


Curvularia australiensis (M.B. Ellis) Manamgoda, L.Cai. & K.D. Hyde 

Synonymy: Bipolaris australiensis (M.B. Ellis) Tsuda & Ueyama. 


Morphological Description: Colonies grey to blackish-brown, suede-like. 

Conidiophores brown, solitary, flexuose or geniculate, smooth-walled, up to 150 µm 

long, mostly 3-7 µm wide. Conidia straight, rounded at the ends, pale brown to mid 

reddish-brown, mostly 3-, rarely 4-5-distoseptate, ellipsoidal or oblong, 14-40 x 6-11 

µm, smooth-walled to finely roughened. 

10 μm 

Curvularia australiensis showing sympodial development of pale brown, fusiform to 

ellipsoidal, pseudoseptate, conidia on a geniculate or zig-zag rachis.


Curvularia hawaiiensis (Bugnic.) Manamgoda, L. Cai & K.D. Hyde 

Synonymy: Bipolaris hawaiiensis Bugnic. 


Morphological Description: Colonies powdery to hairy, black. Conidiophores erect, 

unbranched, septate, apically flexuose with flat conidial scars on the edges, up to 80 

µm long. Conidia smooth- and rather thick-walled, brown, with (3-) 5 (-7) distosepta, 

cylindrical to cigar-shaped, 18-35 × 6-9 µm. 

Antifungal Susceptibility: C. hawaiiensis (da Cunha et al. 2012a); MIC µg/mL. 



AmB 0.125-0.25 0.25 VORI 0.25-2 1 

ITRA

78 


Curvularia lunata Boedijn 

Antifungal Susceptibility: Curvularia lunata (Australian National data); MIC µg/ 

mL. 

No 16 

AmB 7 1 3 1 1 1 

VORI 7 1 2 3 1 

POSA 5 1 3 1 

ITRA 7 1 1 3 1 1 

Curvularia spicifera (Bainier) Boedijn 

Synonymy: Bipolaris spicifera Bainier. 


Morphological Description: Colonies appearing glassy with sooty powder of conidia, 

or hairy if sporulation is poor. Conidiophores erect, unbranched, septate, up to 250 µm 

long and 4-8 µm wide, regularly zig-zagged in the apical part, with flat, dark brown scars 

on the edges. Conidia brown, cylindrical with rounded ends, medium brown except for 

narrow subhyaline spots at the extremites, 20-40 × 9-14 µm, with 3 distosepta. 

Antifungal Susceptibility: C. spicifera (da Cunha et al. 2012a); MIC µg/mL. 



AmB


Cyberlindnera fabianii (Wick.) Minter 

Synonymy: Candida fabianii (Hartmann) S.A. Meyer & Yarrow. 

Cyberlindnera fabianii is a rare cause of candidaemia. 



Microscopy: Spheroidal to ellipsoidal budding blastoconidia, 3.0-6.5 x 2-5.5 µm in 

size. No pseudohyphae are produced. Asci when present, are spherical, containing 

one to four spherical, finely roughened ascospores. 


Dalmau Plate Culture: Spherical to ovoid budding yeast cells and occasional 

pseudohyphae produced. 




Germ Tube - L-Sorbose - L-Arabinose - D-Glucitol + 



Galactose - Cellobiose + L-Rhamnose - DL-Lactate + 

Sucrose + Trehalose + D-Glucosamine - myo-Inositol - 

Maltose +,s Lactose - N-A-D-glucosamine - 2-K-D-gluconate - 


Trehalose - Raffinose + Erythritol - Nitrate + 

Assimilation Melezitose + Ribitol - Urease - 

Glucose + Soluble Starch + Galactitol - 0.1% Cycloheximide nd 

Galactose - D-Xylose + D-Mannitol + Growth at 37 O C + 

Key Features: Germ tube negative yeast and sugar assimilation pattern. Molecular 

identification may be required. 

Antifungal Susceptibility: C. fabianii very limited data (Pfaller et al. 2015, Australian 

National data); MIC µg/mL. 

No. 64 

AmB 1 1 

FLU 1 1 

VORI 5 1 3 1 

POSA 5 3 2 

ITRA 1 1 

MICA 4 2 1 1 

CAS 1 1 

5FC 1 1

80 


Cylindrocarpon Wollenw. 

The genus contains 35 species, mostly from soil and as an occasional human and 

animal pathogen. Cylindrocarpon differs from Fusarium by lacking an asymmetrical 

foot-cell on the macroconidia. 

RG-2 organism (if isolated from humans). 

Morphological Description: Colonies are fast growing, hyaline or bright-coloured, 

suede-like or woolly. Sporodochia may occasionally be present. Conidiophores 

consist of simple or repeatedly verticillate phialides, arranged in brush-like structures. 

Phialides are cylindrical to subulate, with small collarettes producing hyaline, smoothwalled 

conidia, arranged in slimy masses. Two types of conidia may be produced: (1) 

macroconidia which are one to several septate, hyaline, straight or curved, cylindrical 

to fusiform, with a rounded apex and flat base; and (2) microconidia which are onecelled, 

and usually clearly distinct from the macroconidia. Chlamydospores may be 

present or absent, hyaline to brown, spherical, formed singly, in chains or in clumps, 

intercalary or terminal. 

References: Booth (1966), Domsch et al. (1980), de Hoog et al. (2000, 2015). 

a 

b 

15 µm 

c 

15 µm 

Cylindrocarpon spp. (a) culture, (b) chlamydospores and (c) macroconidia.


Debaryomyces hansenii (Zopf) Lodder & Kreger-van Rij. 

Synonymy: Candida famata (Harrison) S.A. Meyer & Yarrow. 

Debaryomyces hansenii is a common environmental isolate. It may be isolated from 

human skin, and is only rarely recovered from blood stream infections. RG-1 organism. 


Microscopy: Ovoid to broadly ellipsoidal budding blastoconidia, 3.5-5 x 2-3.5 µm 

in size. No pseudohyphae produced. Asci when present are spherical, persistent, 

containing one to two spherical ascospores with rough walls. 


Dalmau Plate Culture: Spherical to ovoid budding yeast cells only. Pseudohyphae are 

usually lacking. 




Germ Tube - L-Sorbose v L-Arabinose +,w D-Glucitol +,w 

Fermentation Sucrose + D-Arabinose v α-M-D-glucoside + 

Glucose -,w Maltose + D-Ribose v D-Gluconate +,w 

Galactose -,w Cellobiose + L-Rhamnose v DL-Lactate v 

Sucrose -,w Trehalose + D-Glucosamine v myo-Inositol - 

Maltose -,w Lactose v N-A-D-glucosamine v 2-K-D-gluconate + 

Lactose - Melibiose v Glycerol + D-Glucuronate v 

Trehalose -,w Raffinose + Erythritol v Nitrate - 

Assimilation Melezitose v Ribitol + Urease - 

Glucose + Soluble Starch v Galactitol v 0.1% Cycloheximide v 

Galactose + D-Xylose + D-Mannitol + Growth at 40 O C - 


Antifungal Susceptibility: D. hansenii (Diekema et al. 2009, Beyda et al. 2013, 

Espinel-Ingroff et al. 2014, Australian National data); MIC µg/mL. 

No. 64 

AmB 27 1 3 7 13 2 1 

FLU 76 9 18 13 9 8 11 2 3 3 

VORI 79 8 11 27 16 9 4 2 1 1 

POSA 72 8 11 20 12 8 8 2 3 

ITRA 11 2 1 3 2 1 2 

ANID 23 1 2 1 1 0 8 10 

MICA 23 1 3 1 2 8 5 3 

CAS 26 1 2 3 8 5 4 1 2 

5FC 11 1 5 1 1 1 2

82 


McGinnis et al. (1986b) have reviewed the isolates from human and animal disease 

purported to be Drechslera or Helminthosporium and concluded that all pathogenic 

isolates examined actually belong to the genera Bipolaris or Exserohilum. 


Drechslera Ito 

Morphological Description: Colonies are fast growing, suede-like to downy, brown 

to blackish brown with a black reverse. Conidia are pale to dark brown, usually 

cylindrical or subcylindrical, straight, smooth-walled, and are formed apically through 

a pore (poroconidia) in a sympodially elongating, geniculate conidiophore. Conidia 

are transversely septate (phragmoconidia), with the septum delimiting the basal cell 

formed first during conidium maturation. Germinating is from any or all cells and the 

hilum is not protuberant. 

Key Features: Dematiaceous hyphomycete producing sympodial, pale brown, 

cylindrical or subcylindrical, transversely septate poroconidia. 

References: Luttrell (1978), Ellis (1971, 1976), McGinnis (1980), McGinnis et al. 

(1986b), Sivanesan (1987), Rippon (1988), de Hoog et al. (2000, 2015). Also see 

Descriptions for Bipolaris, Curvularia and Exserohilum. 

20 µm 

Drechslera spp. conidia.


Synonymy: Epicoccum purpurascens Ehrenb. ex Schlecht. 

Epicoccum nigrum is a cosmopolitan saprophyte of worldwide distribution which is 

occasionally isolated as a contaminant from clinical specimens like skin. 


Epicoccum nigrum Link 

Morphological Description: Colonies are fast growing, suede-like to downy, with a 

strong yellow to orange-brown diffusible pigment. When sporulating, numerous black 

sporodochia (aggregates of conidiophores) are visible. Conidia are formed singly on 

densely compacted, non-specialised, determinant, slightly pigmented conidiophores. 

Conidia are globose to pyriform, mostly 15-25 µm diameter with a funnel-shaped base 

and broad attachment scar, often seceding with a protuberant basal cell; i.e. aleuric or 

rhexolytic dehiscence of conidia. Conidia become multicellular (dictyoconidia), darkly 

pigmented and have a verrucose external surface. 

Key Features: Dematiaceous hyphomycete producing darkly pigmented, large globose 

to pyriform, verrucose dictyoconidia on a sporodochium. 

References: Ellis (1971), Domsch et al. (1980), McGinnis (1980), Samson et al. (1995). 

a 

b 

15 µm 

Epicoccum nigrum (a) culture and (b) conidia.

84 


Epidermophyton floccosum (Harz) Langeron et Milochevitch 

Epidermophyton floccosum is an anthropophilic dermatophyte with a worldwide 

distribution which often causes tinea pedis, tinea cruris, tinea corporis and 

onychomycosis. It is not known to invade hair in vivo and no specific growth requirements 

have been reported. 


Morphological Description: Colonies are usually slow growing, greenishbrown 

or khaki-coloured with a suede-like surface, raised and folded in the centre, 

with a flat periphery and submerged fringe of growth. Older cultures may develop 

white pleomorphic tufts of mycelium. A deep yellowish-brown reverse pigment is 

usually present. Microscopic morphology shows characteristic smooth, thin-walled 

macroconidia which are often produced in clusters growing directly from the hyphae. 

Numerous chlamydospores are formed in older cultures. Microconidia are not formed. 

Key Features: Culture characteristics, microscopic morphology and clinical disease. 

References: Rebell and Taplin (1970), Mackenzie et al. (1987), Rippon (1988), de 

Hoog et al. (2000, 2015). 

a 

b 

20 µm 

c 

15 µm 

Epidermophyton floccosum (a) culture, (b) chlamydospores and (c) macroconidia.


Exophiala dermatitidis has been isolated from plant debris and soil and is a recognised 

causative agent of mycetoma and phaeohyphomycosis in humans (Zeng et al. 2007). 


Exophiala dermatitidis (Kano) de Hoog 

Morphological Description: Colonies are slow growing, initially yeast-like and black, 

becoming suede-like, olivaceous-grey with the development of aerial mycelium with 

age. A brown pigment is often produced in the agar. The initial yeast-like phase is 

characterised by unicellular, ovoid to elliptical, budding yeast-like cells. The yeastlike 

cells are hyaline and thin-walled when young becoming darkly pigmented 

(dematiaceous) and thick-walled when mature. With the development of mycelium, 

flask-shaped to cylindrical annellides are produced. Conidia are hyaline to pale brown, 

one-celled, round to obovoid, 2-4 x 2.5-6 µm, smooth-walled and accumulate in slimy 

balls at the apices of the annellides or down their sides. Cultures grow at 42 O C and on 

media containing 0.1% cycloheximide. 

Molecular Identification: ITS and/or D1/D2 sequencing is recommended for species 

identification (Halliday et al. 2015). 

References: de Hoog and Hermanides-Nijhof (1977), McGinnis (1980), Hohl et al. 

(1983), Nishimura and Miyaji (1983), Matsumoto et al. (1984), Dixon and Polak-Wyss 

(1991), de Hoog et al. (2000, 2015). 

10 µm 

Exophiala dermatitidis annellides and conidia.

86 


Exophiala dermatitidis (Kano) de Hoog 

Antifungal Susceptibility: E. dermatitidis (Duarte et al. 2013 and Australian 


No. 64 

AmB 44 1 2 25 16 

VORI 44 4 12 20 1 4 2 1 

POSA 1 1 

ITRA 44 10 13 6 9 4 1 1 

E. dermatitidis data from 27 isolates (Fothergill et al. 2009); MIC µg/mL. 


= 1 VORI Range 0.06-1; MIC 90 

= 0.25 

ITRA Range



Exophiala jeanselmei complex 

Exophiala jeanselmei McGinnis & Padhye 

Morphological Description: Colonies are initially smooth, greenish-grey to black, 

mucoid and yeast-like, becoming raised and developing tufts of aerial mycelium with 

age, often becoming dome-shaped and suede-like in texture. Reverse is olivaceousblack. 

Numerous ellipsoidal, yeast-like, budding cells are usually present, especially in 

young cultures. Scattered amongst these yeast-like cells are larger, inflated, subglobose 

to broadly ellipsoidal cells (germinating cells) which give rise to short torulose hyphae 

that gradually change into unswollen hyphae. Conidia are formed on lateral pegs either 

arising apically or laterally at right or acute angles from essentially undifferentiated 

hyphae or from strongly inflated detached conidia. Conidiogenous pegs are 1-3 µm 

long, slightly tapering and imperceptibly annellate. Conidia are hyaline, smooth, thinwalled, 

broadly ellipsoidal, 3.2-4.4 x 1.2-2.2 µm, and with inconspicuous basal scars. 

Cultures grow at 37 O C but not at 40 O C. 

a 

5 µm 

b 

15 µm 

5 µm 

Exophiala jeanselmei complex showing annellides, conidia and conidiogenous 

pegs (annellides) on (a) yeast-like cells and (b) torulose hyphae. 

References: de Hoog and Hermanides-Nijhof (1977), de Hoog (1977, 1985), McGinnis 

and Padhye (1977), McGinnis (1978b, 1980), Domsch et al. (1980), Nishimura and 

Miyaji (1983), Matsumoto et al. (1987), Dixon and Polak-Wyss (1991), Badali et al. 

2010, de Hoog et al. (2000, 2003, 2006, 2015).

88 


Exophiala jeanselmei complex 

Antifungal Susceptibility: E. jeanselmei limited data (Australian National data); 

MIC µg/mL. 

No. 64 

AmB 9 1 3 2 2 1 

VORI 9 2 2 1 1 1 2 

POSA 6 1 2 2 1 

ITRA 9 2 3 2 2 

E. jeanselmei data from eight isolates (Fothergill et al. 2009); MIC µg/mL. 


= 1 VORI Range 0.06-0.5; MIC 90 

= 0.5 

ITRA Range


Exophiala spinifera complex 

Synonymy: Phialophora spinifera Nielsen & Conant 

Rhinocladiella spinifera (Nielsen & Conant) de Hoog 

E. spinifera has a worldwide distribution and is a recognised causative agent of 

mycetoma and phaeohyphomycosis in humans. Zeng et al. (2007) presented an 

overview of the medically important Exophiala species. 

Recent molecular studies have re-examined Exophiala spinifera and have recognised 

two species: E. spinifera and E. attenuata (Vitale and de Hoog, 2002). These two 

species are morphologically very similar and can best be distinguished by genetic 

analysis. 

Molecular Identification: ITS sequencing is recommended for accurate species 

identification (Zeng and de Hoog, 2008). 

Morphological Description: Conidiogenous cells are predominately annellidic and 

erect, multicellular conidiophores that are darker than the supporting hyphae are 

present. No growth at 40 O C. 

E. spinifera Annellated zones are long with clearly visible, frilled annellations. 

E. attenuata Annellated zones are inconspicuous and degenerate. 


Exophiala spinifera (Nielsen & Conant) McGinnis 

Morphological Description: Colonies are initially mucoid and yeast-like, black, 

becoming raised and developing tufts of aerial mycelium with age, finally becoming 

suede-like to downy in texture. Reverse is olivaceous-black. Conidiophores are 

simple or branched, erect or sub-erect, spine-like with rather thick brown pigmented 

walls. Conidia are formed in basipetal succession on lateral pegs either arising 

apically or laterally at right or acute angles from the spine-like conidiophores or from 

undifferentiated hyphae. Conidiogenous pegs are 1-3 µm long, slightly tapering and 

imperceptibly annellate. Conidia are one-celled, subhyaline, smooth, thin-walled, subglobose 

to ellipsoidal, 1.0-2.9 x 1.8-2.5 µm, and aggregate in clusters at the tip of each 

annellide. Toruloid hyphae and yeast-like cells with secondary conidia are typically 

present. 

Note: Yeast cells show the presence of capsules in India Ink stained mounts and 

cultures will grow on media containing 0.1% cycloheximide. No growth at 40 O C. 

References: de Hoog and Hermanides-Nijhof (1977), McGinnis and Padhye (1977), 

Domsch et al. (1980), McGinnis (1980), Nishimura and Miyaji (1983), de Hoog (1985), 

Matsumoto et al. (1987), Dixon and Polak-Wyss (1991), de Hoog et al. (2000, 2003, 

2006, 2015).

90 


Exophiala spinifera complex 

a 

b 

10 µm 

Exophiala spinifera (a) culture showing typical black, mucoid yeast-like growth, and 

(b) conidia being formed on erect, multiseptate conidiophores that are darker than the 

supporting hyphae, with long annellated zones. 

Antifungal Susceptibility: E. spinifera limited data (Australian National data); MIC 

µg/mL. 

No. 64 

AmB 5 1 2 1 1 

VORI 5 1 2 2 

POSA 4 1 3 

ITRA 5 1 4 

E. spinifera data from eight isolates (Fothergill et al. 2009); MIC µg/mL. 


= 1 VORI Range 0.06-0.5; MIC 90 

= 0.25 

ITRA Range


The genus Exserohilum contains about 35 species and may be differentiated from 

the closely related genera Bipolaris and Dreschlera by forming conidia with a strongly 

protruding truncate hilum (i.e. exserted hilum). In Drechslera species, the hilum does 

not protrude; in Bipolaris species the hilum protrudes only slightly. Several species 

of Exserohilum have been reported as agents of phaeohyphomycosis, notably E. 

rostratum, E. mcginnisii and E. longirostratum. Although recent molecular studies have 

demonstrated that the latter two species are probable synonyms of E. rostratum (de 

Cunha et al. 2012b, Katragkou et al. 2014). E. rostratum was recently implicated in an 

outbreak of fungal meningitis associated with contaminated methylprednisolone in the 

United States. 


Exserohilum Leonard and Suggs 

Exserohilum rostratum (Drechsler) Leonard & Suggs 

Morphological Description: Colonies are grey to blackish-brown, suede-like to 

floccose in texture and have an olivaceous-black reverse. Conidia are straight, 

curved or slightly bent, ellipsoidal to fusiform and are formed apically through a pore 

(poroconidia) on a sympodially elongating geniculate conidiophore. Conidia have a 

strongly protruding, truncate hilum and the septum above the hilum is usually thickened 

and dark, with the end cells often paler than other cells, walls often finely roughed. 

Conidial germination is bipolar. 

Key Features: Dematiaceous hyphomycete producing sympodial, transverse septate, 

ellipsoidal to fusiform conidia with dark bands on both ends and a strongly protruding, 

truncate hilum. 

Molecular Identification: ITS and D1/D2 sequencing is recommended. 

References: Domsch et al. (1980), Alcorn (1983), Adam et al. (1986), McGinnis et al. 

(1986b), Rippon (1988), Burges et al. (1987), Dixon and Polak-Wyss (1991), de Hoog 

et al. (2000, 2015), de Cunha et al. (2012b), Katragkou et al. (2014). 

Antifungal Susceptibility: E. rostratum limited data (Australian National data); MIC 

µg/mL. 

No. 64 

AmB 8 4 2 2 

VORI 8 1 1 6 

POSA 6 5 1 

ITRA 8 4 4 

E. rostratum data from 34 isolates (da Cunha et al. 2012); MIC µg/mL. 

AmB Range

92 


Exserohilum rostratum (Drechsler) Leonard & Suggs 

20 µm 

20 µm 

Exserohilum rostratum conidiophores and conidia with a distinctive hilum (arrow).


Morphologically the genus Fonsecaea is defined by the presence of indistinct 

melanised conidiophores with blunt, scattered denticles bearing conidia singly or in 

short chains that eventually become branched. de Hoog et al. (2004b) revised the 

genus on the basis of ITS sequencing data. Three species from humans are currently 

recognised, F. monophora, F. nubica, and F. pedrosoi, although they are morphologically 

indistinguishable (Najafzadeh et al. 2009, 2010b; Xi et al. 2009, de Hoog et al. 2015). 

All strains grow at 37 O C but not at 40 O C and the three species are recognised as 

aetiological agents of chromoblastomycosis. 

Morphological Description: Colonies are slow growing, flat to heaped and folded, 

suede-like to downy, olivaceous to black with black reverse. Conidiogenous cells pale 

olivaceous, arranged in loosely branched systems, with prominent denticles. Conidia 

pale olivaceous, clavate to ellipsoidal, in short chains, subhyaline, smooth and thinwalled, 

3.5-5 x 1.5-2 µm. 


Fonsecaea complex 

Molecular Identification: ITS sequencing is recommended for species identification 

(Abliz et al. 2003, Najafzadeh et al. 2009, 2010b, Xi et al. 2009). 

References: McGinnis (1980), Dixon and Polak-Wyss (1991), de Hoog et al. (2000, 

2004b, 2015), Abliz et al. 2003, Najafadeh et al. (2009, 2010a, 2010b). 

10 µm 

Fonsecaea complex conidiophores and conidia. 

Antifungal Susceptibility: F. pedrosoi (Australian National data); MIC µg/mL. 

No. 16 

AmB 4 1 3 

VORI 4 1 3 

POSA 4 1 2 1 

ITRA 4 1 3

94 


Fusarium Link ex Fries 

Most Fusarium species are soil fungi and have a worldwide distribution. Some are plant 

pathogens, causing root and stem rot, vascular wilt or fruit rot. Several species have 

emerged as important opportunistic pathogens in humans causing hyalohyphomycosis 

(especially in burn victims and bone marrow transplant patients), mycotic keratitis and 

onychomycosis (Guarro 2013). Other species cause storage rot and are important 

mycotoxin producers. 

Multi-locus sequence analysis of EF-1α, β-tubulin, calmodulin, and RPB2 have revealed 

the presence of multiple cryptic species within each “morphospecies” of medically 

important fusaria (Balajee et al. 2009). For instance, Fusarium solani represents a 

complex (i.e. F. solani complex) of over 45 phylogenetically distinct species of which 

at least 20 are associated with human infections. Similarly, members of the Fusarium 

oxysporum complex are phylogenetically diverse, as are members of the Fusarium 

incarnatum-equiseti complex and Fusarium chlamydosporum complex (Balajee et al. 

2009, Tortorano et al. 2014, Salah et al. 2015). 

Currently the genus Fusarium comprises at least 300 phylogenetically distinct 

species, 20 species complexes and nine monotypic lineages (Balajee et al. 2009, 

O’Donnell et al. 2015). Most of the identified opportunistic Fusarium pathogens 

belong to the F. solani complex, F. oxysporum complex and F. fujikuroi complex. Less 

frequently encountered are members of the F. incarnatum-equiseti, F. dimerum and F. 

chlamydosporum complexes, or species such as F. sporotrichioides (O’Donnell et al. 

2015, van Diepeningen et al. 2015). 

Morphological Description: Colonies are usually fast growing, pale or brightcoloured 

(depending on the species) with or without a cottony aerial mycelium. The 

colour of the thallus varies from whitish to yellow, pink, red or purple shades. Species 

of Fusarium typically produce both macro- and microconidia from slender phialides. 

Macroconidia are hyaline, two to several-celled, fusiform to sickle-shaped, mostly with 

an elongated apical cell and pedicellate basal cell. Microconidia are one or two-celled, 

hyaline, smaller than macroconidia, pyriform, fusiform to ovoid, straight or curved. 

Chlamydospores may be present or absent. 

Identification of Fusarium species is often difficult due to the variability between isolates 

(e.g. in shape and size of conidia and colony colour) and because not all features 

required are always well developed (e.g. the absence of macroconidia in some isolates 

after subculture). Note: Sporulation may need to be induced in some isolates and a 

good slide culture is essential. The important characters used in the identification of 

Fusarium species are as follows. 

1. Colony growth diameters on potato dextrose agar and/or potato sucrose agar after 

incubation in the dark for four days at 25 O C. 

2. Culture pigmentation on potato dextrose agar and/or potato sucrose agar after 

incubation for 10-14 days with daily exposure to light. 

3. Microscopic morphology including shape of the macroconidia; presence or 

absence of microconidia; shape and mode of formation of microconidia; nature 

of the conidiogenous cell bearing microconidia; and presence or absence of 

chlamydospores.


Fusarium Link ex Fries 

a 

b 

Cultures of (a) Fusarium oxysporum complex showing purple pigmentation 

and (b) Fusarium fujikuroi complex showing pink pigmentation. 

Molecular Identification: Current species identification is on the basis of multilocus 

sequence data (Guarro 2013, O’Donnell et al. 2015, van Diepeningen et al. 2015). 

Internet-accessible validated databases dedicated to the identification of fusaria via 

nucleotide BLAST queries are available at FUSARIUM-ID at Pennsylvania State 

University (http://www.fusariumdb.org) and Fusarium MLST at the CBS-KNAW Fungal 

Biodiversity Centre (http://www.cbs.knaw.nl/Fusarium/). 

For sequence-based identification of Fusarium species (O’Donnell et al. 2015). 

1. Use EF-1α, RPB1 and/or RPB2. Use of at least two independent loci will increase 

the accuracy of identification. 

2. Fusarium MLST or FUSARIUM-ID are the recommended sequence databases, 

rather than GenBank. 

3. Ensure sequences are carefully edited and free of ambiguities. 

4. Ensure the species names associated with the top BLASTn matches are the same. 

If multiple species names have similar scores it may be necessary to sequence 

additional loci. 

Note: ITS and D1/D2 sequences are too conserved to resolve species limits of most 

fusaria. O’Donnell et al. (2015) recommend avoiding ITS or D1/D2 sequences from an 

unknown isolate to query GenBank, because >50% of the sequences from Fusarium 

species are misidentified in this database. 

Identifications based on morphology and/or ITS and D1/D2 sequences should 

be reported as species complexes. Sequencing of EF-1α, RPB1 and/or RPB2 is 

required for accurate species identification. 


accurate identification of Fusarium species complexes (Lau et al. 2013). 

References: Booth (1971, 1977), Domsch et al. (1980), McGinnis (1980), Burgess 

and Liddell (1983), Rippon (1988), Samson et al. (1995), de Hoog et al. (2000, 2015), 

O’Donnell et al. (2008, 2009a, 2009b, 2015), Balajee et al. (2009), Guarro (2013), 

Geiser et al. (2013), van Diepeningen et al. (2015), Salah et al. (2015), Tortorano et al. 

(2014).

96 


Fusarium chlamydosporum complex 

Fusarium chlamydosporum complex contains five phylogenetically distinct species 

and is common in soils and the rhizosphere of numerous vascular plants worldwide. 

It is occasionally isolated from human and animal infections (O’Donnell et al. 2009b, 

Guarro 2013). 


Morphological Description: Colonies growing rapidly, with abundant aerial mycelium, 

deep pink, red or ochraceous to brownish; reverse carmine red or tan to brown. 

Sporodochia orange, flesh-coloured or ochraceous. Conidiophores scattered over the 

aerial mycelium, branched; numerous polyblastic conidiogenous cells are present. 

Macroconidia rarely produced and appearing only on sporodochial phialides, usually 

three-(some up to five)-septate, slightly curved, 30-38 x 3.0-4.5 μm, with no distinct 

foot-shaped cell. Microconidia and blastoconidia fusiform, rounded apically and 

tapered towards the base, single-celled to one-(some up to three)-septate, 6-26 x 2-4 

μm. Chlamydospores abundant, intercalary, often roughened. 

Fusarium chlamydosporum complex, culture showing pink to 

ochraceous to brownish surface and a carmine red reverse. 

Antifungal Susceptibility: F. chlamydosporum complex (Australian National 


No. 64 

AmB 5 1 2 2 

VORI 5 1 2 2 

POSA 4 2 2 

ITRA 4 1 1 1 1


Fusarium dimerum complex 

The Fusarium dimerum complex contains 12 phylogenetically distinct species including 

F. delphinoides, F. penzigii and F. dimerum. These are regarded as cosmopolitan 

saprotrophs in soil and on plant materials (Domsch et al. 2007). They have also been 

isolated from human corneal ulcers after trauma and from disseminated or localised 

infections in immunocompromised patients (Schroers et al. 2009, Guarro 2013). 


Morphological Description: Colonies growing slowly; surface usually orange to 

deep apricot due to confluent conidial slime; aerial mycelium sometimes floccose and 

whitish. Conidiophores loosely branched, with short, often swollen phialides, 10-18 x 

4-5 μm. Macroconidia strongly curved and pointed at the apex, mostly one-(some up to 

three)-septate, 5-25 (-32) x 1.5-4.2 μm. Microconidia absent. Chlamydospores mostly 

intercalary, exceptionally terminal, spherical to ovoidal, 6-12 μm diam, smooth-walled, 

single or in chains. 

a 

b 

20 μm 

Fusarium dimerum complex (a) culture showing orange to deep apricot 

colour due to confluent conidial slime, and (b) macroconidia. 

Antifungal Susceptibility: F. dimerum complex (Australian National data); MIC 

µg/mL. 

No. 64 

AmB 21 1 6 6 5 6 2 1 

VORI 20 5 8 6 3 3 1 

POSA 18 1 4 2 11 

ITRA 21 3 24

98 


Synonymy: Gibberella fujikuroi complex. 

Fusarium fujikuroi complex 

Fusarium fujikuroi complex consists of 50 phylogenetically distinct species including 

13 of which have been reported to cause human infection; F. acutatum, F. ananatum, 

F. andiyazi, F. fujikuroi, F. guttiforme, F. napiforme, F. nygamai, F. verticillioides, F. 

proliferatum, F. sacchari, F. subglutinans, F. temperatum and F. thapsinum (Guarro, 

2013, Al-Hatmi et al. 2015). 


Morphological Descriptrion: Colonies growing rapidly, pink or vinaceous to violet; 

aerial mycelium abundant. Sporodochia present or absent, when present they are tan 

to orange. Conidiophores usually erect and branched. Macroconidia abundant, falcate 

to rather straight, three to five-septate, with a distinct foot-cell, 27-73 x 3.4-5.2 μm. 

Blastoconidia straight or slightly curved, two to three-septate, fusiform to lanceolate, 

with a somewhat pointed, often slightly asymmetrical apical cell and a truncate basal 

cell, 16-43 x 3.0-4.5 μm. Microconidia produced on polyphialides and aggregating 

in heads, usually unicellular, ovoidal, ellipsoidal or allantoid, 4-20 x 1.5-4.5 μm. 

Chlamydospores absent. 

Antifungal Susceptibility: F. fujikuroi complex (Castanheir et al. 2012, Australian 


No. 64 

AmB 39 3 19 15 2 

VORI 39 2 12 14 8 3 

POSA 39 4 9 7 3 16 

ITRA 30 2 4 2 22 

Fusarium incarnatum-equiseti complex 

Fusarium incarnatum-equiseti complex consists of 40 phylogenetically distinct species. 

They occasionally cause infections in humans and animals (O’Donnell et al. 2009b, 

Guarro 2013). 


Morphological Description: Colonies growing rapidly; aerial mycelium floccose, 

at first whitish, later becoming avellaneous to buff-brown; reverse pale, becoming 

peach-coloured. Conidiophores scattered in the aerial mycelium, loosely branched; 

polyblastic conidiogenous cells abundant. Sporodochial macroconidia slightly 

curved, with foot-cell, three to seven-septate, 20-46 x 3.0-5.5 µm. Conidia on aerial 

conidiophores (blastoconidia) usually borne singly on scattered denticles, fusiform 

to falcate, mostly three to five-septate, 7.5-35 x 2.5-4.0 µm. Microconidia sparse or 

absent. Chlamydospores sparse, spherical, 10-12 µm diameter, becoming brown, 

intercalary, single or in chains.


Fusarium incarnatum-equiseti complex 

Antifungal Susceptibility: F. incarnatum-equiseti complex (Australian National 


No. 64 

AmB 6 1 1 3 1 

VORI 6 1 1 3 1 

POSA 5 1 3 1 

ITRA 4 1 3 

Fusarium oxysporum complex 

This complex contains at least five phylogenetically distinct species and accounts for 

about 20% of human infections caused by fusaria (Guarro 2013, Tortorano et al. 2014, 

Salah et al. 2015). All are ubiquitous soil borne pathogens responsible for vascular 

wilts, rots, and damping-off diseases of a broad range of plants. A number of these 

fusaria are also clinically important, causing localised or deeply invasive life threatening 

infections in humans and other animals (O’Donnell et al. 2009a). Mortality in patients 

who are persistently and severely neutropenic is typically 100% (Nucci and Anaissie, 

2007). 


Morphological Description: Colonies growing rapidly, 4.5 cm in four days, aerial 

mycelium white, becoming purple, with discrete orange sporodochia present in some 

strains; reverse hyaline to dark blue or dark purple. Conidiophores are short, single, 

lateral monophialides in the aerial mycelium, later arranged in densely branched 

clusters. Macroconidia are fusiform, slightly curved, pointed at the tip, mostly three 

septate, basal cells pedicellate, 23-54 x 3-4.5 µm. Microconidia are abundant, never 

in chains, mostly non-septate, ellipsoidal to cylindrical, straight or often curved, 5-12 

x 2.3-3.5 µm. Chlamydospores are terminal or intercalary, hyaline, smooth or rough 

walled, 5-13 µm. In contrast to F. solani complex, the phialides are short and mostly 

non-septate. 

Antifungal Susceptibility: F. oxysporum complex (Australian National data); MIC 

µg/mL. 

No. 64 

AmB 52 1 4 6 12 14 9 4 2 

VORI 49 5 6 10 19 7 3 

POSA 37 1 1 7 6 1 15 6 

ITRA 39 3 1 1 34

100 


Fusarium oxysporum complex 

a 

15 µm 

b 

15 µm 

Fusarium oxysporum complex (a)microconidia on short phialides 

and (b) macroconidia. 

Fusarium solani complex 

Antifungal Susceptibility: F. solani complex (Australian National data); MIC µg/ 

mL. 

No. 64 

AmB 130 1 2 18 29 40 29 11 

VORI 126 7 24 36 34 25 

POSA 114 2 1 2 1 71 37 

ITRA 93 2 1 90


The Fusarium solani complex contains at least 60 species and accounts for about 50% 

of human infections caused by fusaria (Guarro 2013, Tortorano et al. 2014, Salah et al. 

2015). All are ubiquitous soil borne pathogens responsible for vascular wilts, rots, and 

damping-off diseases of a broad range of plants. A number of these fusaria, notably 

F. keratoplasticum, F. petroliphilum, F. lichenicola and F. solani are clinically important, 

causing localised or deeply invasive life threatening infections in humans and other 

animals (Guarro 2013, O’Donnell et al. 2008). 


Fusarium solani complex 

Morphological Description: Colonies growing rapidly, 4.5 cm in four days, aerial 

mycelium white to cream, becoming bluish-brown when sporodochia are present. 

Macroconidia are formed after 4-7 days from short multiple branched conidiophores 

which may form sporodochia. They are three to five-septate (usually three-septate), 

fusiform, cylindrical, often moderately curved, with an indistinct pedicellate foot cell and 

a short blunt apical cell, 28-42 x 4-6 µm. Microconidia are usually abundant, cylindrical 

to oval, one to two-celled and formed from long lateral phialides, 8-16 x 2-4.5 µm. 

Chlamydospores are hyaline, globose, smooth to rough-walled, borne singly or in pairs 

on short lateral hyphal branches or intercalary, 6-10 µm. 

a 

15 µm 

b 

15 µm 

c 

15 µm 

Fusarium solani complex (a) microconidia on long phialides, 

(b) macroconidia and (c) chlamydospores.

102 


Geotrichum candidum Link. 

Synonymy: Galactomyces candidus de Hoog & M.Th. Smith. 

The genus Geotrichum and related species have undergone extensive taxonomic 

revision (de Hoog and Smith 2004, 2011a, 2011b, 2011c). The three species of prime 

interest to medical mycology are Geotrichum candidum (Galactomyces candidus), 

Magnusiomyces capitatus (previously known as Geotrichum capitatum), and 

Saprochaete clavata (previously known as Geotrichum clavatum). 

Geotrichum candidum is an extremely common fungus with a worldwide distribution. It 

is commonly isolated from soil, air, water, milk, silage, plant tissues, and the digestive 

tract in humans and other mammals (Pottier et al. 2008). Pulmonary involvement is the 

most frequently reported form of the disease in humans and animals, but bronchial, 

oral, vaginal, cutaneous and alimentary infections have also been noted (Arendrup et 

al. 2014). 


Morphological Description: Colonies are fast growing, flat, white to cream, dry and 

finely suede-like with no reverse pigment. Hyphae are hyaline, septate, branched 

and break up into chains of hyaline, smooth, one-celled, subglobose to cylindrical 

arthroconidia. Arthroconidia are 6-12 x 3-6 µm in size and are released by the separation 

of a double septum. 

Note: True blastoconidia production is not found in this genus. This characteristic 

distinguishes Geotrichum from Trichosporon, which usually does produce blastoconidia. 

Molecular Identification: ITS sequencing recommended for accurate species 

identification (de Hoog and Smith 2004). 


Germ Tube - L-Sorbose + L-Arabinose - D-Glucitol + 


Glucose v Maltose - D-Ribose - D-Gluconate - 

Galactose v Cellobiose - L-Rhamnose - DL-Lactate + 


Maltose - Lactose - N-A-D-glucosamine nd 2-K-D-gluconate - 




Glucose + Soluble Starch - Galactitol - 0.1% Cycloheximide nd 

Galactose + D-Xylose + D-Mannitol + Growth at 37 O C v 

References: Gueho (1979), Domsch et al. (1980), McGinnis (1980), Barnett et al. 

(1983), Buchta and Otcenasek (1988), Samson et al. (1995), de Hoog et al. (1986, 

2015), de Hoog and Smith (2004, 2011a, 2011b, 2011c).


Geotrichum candidum Link. 

15 µm 

15 µm 

Geotrichum candidum arthroconidium formation. Hyphal elements are progressively 

compartmentalised by fragmentation of septa. Conidial secession is by the centripetal 

separation (schizolysis) of a so called double septum and concomitant rupture of the 

original outer hyphal wall layer. 

Antifungal Susceptibility: Geotrichum candidum limited data (Sfakianakis et al. 

2007, Henrich et al. 2009, Australian National data); MIC µg/mL. 

No. 64 

AmB 6 2 4 

FLU 5 4 1 

VORI 6 2 2 1 1 

POSA 3 3 

ITRA 5 1 2 2 

ANID 2 2 

MICA 2 2 

CAS 3 1 2 

5FC 5 1 3 1

104 


Gliocladium species have a worldwide distribution and are commonly isolated from a 

wide range of plant debris and soil. 


Gliocladium Corda 

Morphological Description: The genus Gliocladium is often described as a 

counterpart of Penicillium with slimy conidia. Colonies are fast growing, suede-like to 

downy in texture, white at first, sometimes pink to salmon, becoming pale to dark green 

with sporulation. The most characteristic feature of the genus is the distinctive erect, 

often densely penicillate conidiophores with phialides which bear slimy, one-celled 

hyaline to green, smooth-walled conidia in heads or columns. Although, penicillate 

conidiophores are always present, Gliocladium species may also produce verticillate 

branching conidiophores which can be confused with Verticillium or Trichoderma. 

Key Features: Hyphomycete producing distinctive erect penicillate conidiophores with 

phialides bearing clusters of single-celled conidia. 

References: Domsch et al. (2007), McGinnis (1980), Onions et al. (1981), Rippon 

(1988), de Hoog et al. (2000). 

10 µm 

Gliocladium spp. conidiophore and conidia.


The genus Graphium is characterised by the formation of synnemata which consist 

of a more or less compact group of erect conidiophores that are cemented together, 

usually splaying out and bearing conidia at the apex. Graphium species are commonly 

found on woody plant material. Graphium basitruncatum has been reported as causing 

fungaemia in an immunosuppressed child post stem-cell transplantation (El Feghaly 

et al. 2012). 

Note: Many other fungi such as Scedosporium species may also produce synnemata. 


Graphium Corda 

Morphological Description: Synnemata are darkly pigmented, erect and occur 

solitarily or in clusters. Conidia are hyaline, one-celled, smooth, subglobose to ovoid 

and are usually aggregated in slimy heads at the apex of the synnemata. Colonies are 

effuse, grey, olivaceous brown or black. 

Molecular diagnostics: The genus is phylogenetically close to Scedosporium but ITS 

sequencing can be used to resolve all species (Okada et al. 2000, Lackner and de 

Hoog 2011). 

Key Features: Dematiaceous hyphomycete producing erect synnemata with apical 

aggregates of single-celled conidia in slimy heads. 

References: Barron (1968), Ellis (1971), McGinnis (1980), de Hoog et al. (2000, 2015). 

20 µm 

Graphium spp. synnemata and conidia.

106 


Histoplasma capsulatum Darling 

WARNING: RG-3 organism. Cultures of Histoplasma capsulatum represent a severe 

biohazard to laboratory personnel and must be handled with extreme caution in a 

Class II Biological Safety Cabinet (BSCII). 

Histoplasma capsulatum has a worldwide distribution, however the Mississippi-Ohio 

River Valley in the USA is recognised as a major endemic region. Environmental 

isolations of the fungus have been made from soil enriched with excreta from 

chicken, starlings and bats. Histoplasmosis is an intracellular mycotic infection of the 

reticuloendothelial system caused by the inhalation of the fungus. Approximately 95% 

of cases of histoplasmosis are inapparent, subclinical or benign. The remaining 5% of 

cases may develop chronic progressive lung disease, chronic cutaneous or systemic 

disease or an acute fulminating fatal systemic disease. All stages of this disease may 

mimic tuberculosis. Sporadic cases have been reported in Australia. 

Morphological Description: Histoplasma capsulatum exhibits thermal dimorphism 

growing in living tissue or in culture at 37 O C as a budding yeast-like fungus and in soil 

or culture at temperatures below 30 O C as a mould. 

Colonies at 25 O C are slow growing, white or buff-brown, suede-like to cottony with 

a pale yellow-brown reverse. Other colony types are glabrous or verrucose, and a 

red pigmented strain has been noted (Rippon, 1988). Microscopic morphology shows 

the presence of characteristic large, rounded, single-celled, 8-14 µm in diameter, 

tuberculate macroconidia formed on short, hyaline, undifferentiated conidiophores. 

Small, round to pyriform microconidia, 2-4 µm in diameter, borne on short branches or 

directly on the sides of the hyphae may also be present. 

Colonies at 37 O C grown on brain heart infusion (BHI) agar containing blood are 

smooth, moist, white and yeast-like. Microscopically, numerous small round to oval 

budding yeast-like cells, 3-4 x 2-3 µm in size are observed. 

Three varieties of Histoplasma capsulatum are recognised, depending on the clinical 

disease: var. capsulatum is the common cause of histoplasmosis; var. duboisii is the 

African type and var. farciminosum causes lymphangitis in horses. Histoplasma isolates 

may also resemble species of Sepedonium and Chrysosporium. Traditionally, positive 

identification required conversion of the mould form to the yeast phase by growth at 

37 O C on enriched media, however for laboratory safety, culture identification by either 

exoantigen test or DNA sequencing is now preferred. 

Key Features: Clinical history, tissue morphology, culture morphology and positive 

exoantigen test or DNA sequencing. 

Molecular Identification: A probe for species recognition is commercially available 

(Padhye et al. 1992, Chemaly et al. 2001) and Elias et al. (2012) developed a multiplex- 

PCR for identification from cultures. Scheel et al. (2014) developed a loop-mediated 

isothermal amplification (LAMP) assay for detection directly in clinical samples which is 

affordable and useful in resource poor facilities. ITS sequencing may also be used for 

accurate identification (Estrada-Bárcenas et al. 2014, Irinyi et al. 2015). 

References: McGinnis (1980), Chandler et al. (1980), George and Penn (1986), 

Rippon (1988), de Hoog et al. (2000, 2015).


Histoplasma capsulatum Darling 

a 

b 

20 µm 

Histoplasma capsulatum (a) culture and (b) microscopic morphology of the saprophytic 

or mycelial form showing characteristic large, rounded, single-celled, tuberculate 

macroconidia and smaller microconidia. 

Antifungal Susceptibility: H. capsulatum (Espinel-Ingroff 2003, Gonzalez et al. 

2005, Sabatelli et al. 2006, Brilhante et al. 2012, Kathuria et al. 2014); MIC µg/mL. 

Antifungal 

Filamentous form 

Yeast form 

Range MIC 90 

Range MIC 90 

AmB

108 


Hortaea werneckii (Horta) Nishimura & Miyaji 

Synonymy: Phaeoannellomyces werneckii (Horta) McGinnis & Schell; Exophiala 

werneckii (Horta) v. Arx; Cladosporium werneckii Horta. 

Hortaea werneckii is a common saprophytic fungus believed to occur in soil, compost, 

humus and on wood in humid tropical and subtropical regions and is the causative 

agent of tinea nigra in humans. RG-1 organism. 

Morphological Description: Colonies are slow growing, initially mucoid, yeast-like 

and shiny-black. However with age they develop abundant aerial mycelia and become 

dark olivaceous in colour. Microscopically, colonies consist of brown to dark olivaceous, 

septate hyphal elements and numerous two-celled, pale brown, cylindrical to spindleshaped 

yeast-like cells that taper towards the ends to form an annellide. Most yeastlike 

cells also have prominent darkly-pigmented septa. Annellides may also arise from 

the hyphae. Conidia are one to two-celled, cylindrical to spindle-shaped, hyaline to 

pale brown and usually occur in aggregated masses. Chlamydospores also present. 

Key Features: Hyphomycete, two-celled yeast-like cells producing annelloconidia. 

Molecular Identification: An ITS-primer specific for H. werneckii was developed by 

Abliz et al. (2003). ITS sequencing can also assist identification. 

References: Mok (1982), McGinnis (1980), McGinnis et al. (1985), Rippon (1988), de 

Hoog et al. (2000), Abliz et al. (2003), Ng et al. (2005). 

Antifungal Susceptibility: H. wernickii (Ng et al. 2005, Formoso et al. 2015); MIC 

µg/mL. 

No. 64 

AmB 6 1 1 1 1 2 

FLU 6 2 1 3 

VORI 6 2 1 3 

POSA 4 2 2 

ITRA 8 2 2 2 2 

a 

20 µm 

b 

Hortaea werneckii (a) culture and (b) conidia.


Kluyveromyces marxianus (Hansen) van der Walt 

Synonymy: Candida kefyr (Beijerinck) van Uden & Buckley. 

Candida pseudotropicalis (Castellani) Basgal. 

Kluyveromyces marxianus is a rare cause of candidiasis and is usually associated 

with superficial cutaneous manifestations rather than systemic disease. Environmental 

isolations have been made from cheese and dairy products. RG-1 organism. 


Microscopy: Short-ovoid to long-ovoid, budding blastoconidia, 3.0-6.5 x 5.5-11.0 µm, 

sometimes becoming elongate (up to 16.0 µm). 


Dalmau Plate Culture: Abundant, long, wavy, branched pseudohyphae usually formed, 

with ovoid blastoconidia, budding off singly, in pairs or chains, often in a verticillated 

position. Note: In some strains pseudohyphae may be scarce or almost absent. 




Germ Tube - L-Sorbose v L-Arabinose v D-Glucitol v 

Fermentation Sucrose + D-Arabinose - α-M-D-glucoside - 

Glucose + Maltose - D-Ribose v D-Gluconate - 

Galactose +,s Cellobiose v L-Rhamnose - DL-Lactate + 

Sucrose + Trehalose -,w D-Glucosamine - myo-Inositol - 

Maltose - Lactose v N-A-D-glucosamine - 2-K-D-gluconate - 

Lactose v Melibiose - Glycerol s D-Glucuronate nd 

Trehalose - Raffinose + Erythritol - Nitrate - 

Assimilation Melezitose - Ribitol s Urease - 

Glucose + Soluble Starch - Galactitol - 0.1% Cycloheximide + 

Galactose s D-Xylose s D-Mannitol v Growth at 40 O C + 


Antifungal Susceptibility: K. marxianus (Diekema et al. 2009, Pfaller et al. 2013, 


No. 64 

AmB 95 6 28 50 10 1 

FLU 111 1 22 62 19 6 1 

VORI 111 82 23 4 2 

POSA 106 1 6 23 33 31 10 2 

ITRA 37 5 6 12 12 2 

ANID 86 1 14 37 29 4 

MICA 71 4 29 42 4 1 1 

CAS 106 12 70 13 5 3 2 1 

5FC 21 4 8 2 1 1 3 2

110 


Lasiodiplodia theobromae (Pat.) Griffon & Maublanc 

Synonymy: Botryosphaeria rhodina (Berk & Curt) v. Arx. 

Botryodiplodia theobromae Patouillard. 

Lasiodiplodia theobromae is a well known plant pathogen reported from about 500 

host plants, mainly confined to an area 40 O north to 40 O south of the equator. It has 

also been associated with ulcerated human cornea, lesions on nail and subcutaneous 

tissue. 


Morphological Description: Colonies are greyish sepia to mouse grey to black, 

fluffy with abundant aerial mycelium; reverse fuscous to black. Pycnidia are simple or 

compound, often aggregated, stromatic, ostiolate, frequently setose, up to 5 mm wide. 

Conidiophores are hyaline, simple, sometimes septate, rarely branched cylindrical, 

arising from the inner layers of cells lining the pycnidial cavity. Conidiogenous cells 

are hyaline, simple, cylindrical to sub-obpyriform, holoblastic, annellidic. Conidia are 

initially unicellular, hyaline, granulose, sub-ovoid to ellipsoid-oblong, thick-walled, base 

truncate; mature conidia one-septate, cinnamon to fawn, often longitudinally striate, 20- 

30 x 10-15 µm. Paraphyses when present are hyaline, cylindrical, sometimes septate, 

up to 50 µm long. 

Key Features: Coelomycete, with pycnidia producing characteristic two-celled, dark 

brown, striated conidia. 

Molecular Identification: Recommended genetic marker: EF-1α (de Hoog et al. 2015). 

ITS sequencing is useful for identifying clinically important species (Bagyalakshmi 

2008). 

References: de Hoog et al. (2000, 2015), Liu et al. (2012), Phillips et al. (2013). 

a 

b 

10 µm 

Lasiodiplodia theobromae (a) pycnidia growing on carnation leaf agar, and 

(b) mature two-celled dark brown conidia with typical longitudinal striations.


Synonymy: Mycocladus corymbifera (Cohn) J.H. Mirza. 

Absidia corymbifera (Cohn) Saccardo & Trotter. 

Mucor corymbifera Cohn. 

Recent taxonomic revisions of the genus Absidia have placed the thermotolerant 

species into the genus Lichtheimia (Hoffmann et al. 2007, 2009). The genus Lichtheimia 

currently contains five mostly saprophytic plant decaying and soil-borne species. 

Lichtheimia corymbifera is the principle pathogen causing human and animal infections, 

however L. ramosa and L. ornata have also been reported as human pathogens (often 

misidentified morphologically as L. corymbifera) (Alastruey-Izquierdo et al. 2010). 


Lichtheimia corymbifera (Cohn) Vuill. 

Morphological Description: Colonies are fast growing, floccose, white at first 

becoming pale grey with age, and up to 1.5 cm high. Sporangiophores are hyaline to 

faintly pigmented, simple or sometimes branched, arising solitarily or in groups. Subsporangial 

septa are absent or rare. Rhizoids are very sparingly produced and may be 

difficult to find without the aid of a dissecting microscope to examine the colony on the 

agar surface. Sporangia are small (10-40 µm in diameter) and are typically pyriform in 

shape with a characteristic conical-shaped columella and pronounced apophysis, often 

with a short projection at the top. Sporangiospores vary from subglobose to oblongellipsoidal 

(3-7 x 2.5-4.5 µm), hyaline to light grey and smooth-walled. Intercalary giant 

cells may also be present. Temperature: optimum 35-37 O C; maximum 46 O C. 

Key Features: Mucorales, small pyriform-shaped sporangia with a characteristic 

conical-shaped columellae and pronounced apophyses, rapid growth at 40 O C. 

Comment: Morphological characteristics alone are not sufficient to reliably differentiate 

between L. corymbifera, L. ramosa and L. ornata. While L. ornata develops large, densely 

branched giant cells and L. ramosa has more ellipsoidal to cylindrical sporangiospores 

and a faster growth rate, these characters are often difficult to interpret. Molecular 

methods are needed to accurately separate these species. 

Molecular Identification: Species recognition in Lichtheimia is based on ITS and/or 

D1/D2 sequencing (Garcia-Hermoso et al. 2009, Alastruey-Izquierdo et al. 2010). 

MALDI-TOF MS: Direct identification of Lichtheimia species was described by Schrödl 

et al. (2012). 

References: Ellis and Hesseltine (1965, 1966), Hesseltine and Ellis (1964a, 1966), 

Nottebrock et al. (1974), O’Donnell (1979), Samson et al. (1995), Domsch et al. (1980), 

McGinnis (1980), Ellis (2005b), de Hoog et al. (2000, 2015).

112 


Lichtheimia corymbifera (Cohn) Vuill. 

a 

b 

15 μm 

c 

Lichtheimia corymbifera (a) culture and (b) typical pyriform-shaped sporangium with 

a conical-shaped columella and pronounced apophysis (arrow), and (c) Grocott’s 

methenamine silver (GMS) stained tissue section from a lung biopsy showing a typical 

sporangium of L. corymbifera. 

Antifungal Susceptibility: L. corymbifera (Espinel-Ingroff et al. 2015a, Australian 


No. 16 

AmB 136 7 17 36 53 19 3 1 

POSA 112 3 9 26 51 21 1 1 

ITRA 93 5 10 24 21 23 6 3 1


Synonymy: Scedosporium prolificans (Hennebert & Desai) Gueho & de Hoog. 

Scedosporium inflatum Malloch & Salkin. 

Lomentospora prolificans (formerly Scedosporium prolificans) is phylogenetically and 

morphologically distinguishable from Scedosporium species (Lennon et al. 1994, 

Lackner et al. 2014a). 

L. prolificans appears to occupy a restricted geographic range, with infections occurring 

mainly in Australia, Spain, and the United States (Heath et al. 2009, Revankar and 

Sutton, 2010). L. prolificans infections are refractory to antifungal therapy and are 

associated with high mortality. Major risk factors include malignancy, cystic fibrosis, 

and solid organ transplantation. The main clinical presentations are disseminated 

infection and pulmonary mycoses, followed by bone and joint infections (Cortez et al. 

2008, Heath et al. 2009, Rodriguez-Tudela et al. 2009, Revankar and Sutton, 2010). 


Lomentospora prolificans Hennebert & Desai 

Morphological Description: Colonies are rapid growing, flat, spreading, olive-grey 

to black and have a suede-like to downy surface texture. Conidia are borne in small 

groups on distinctive basally swollen, flask-shaped conidiophores, which occur singly 

or in clusters along the vegetative hyphae. Conidia are aggregated in slimy heads, 

single-celled, hyaline to pale-brown, ovoid to pyriform, 3-7 x 2-5 µm, and have smooth 

thick walls. Growth at 45 O C. 

Key Features: Dematiaceous hyphomycete with initial black pasty colony, conidiophores 

with distinctly swollen bases, and the conidial mass forms apical aggregates of conidia. 

A Graphium synanamorph is absent and there is no growth on media containing 

cycloheximide (actidione). 

Molecular Identification: Recommended genetic markers: ITS and β-tubulin. 

References: Malloch and Salkin (1984), Salkin et al. (1988), Rippon (1988), Wilson 

et al. (1990), Gueho and de Hoog (1991), Lennon et al. (1994), Gilgado et al. (2005), 

Rainer and de Hoog (2006), Revankar and Sutton (2010), Lackner et al. (2014a), de 

Hoog et al. (2015). 

Antifungal Susceptibility: L. prolificans (Australian National data); MIC µg/mL. 

No. 64 

AmB 190 1 2 17 47 93 30 

VORI 183 1 6 31 62 83 

POSA 105 1 1 103 

ITRA 191 2 189

114 


Lomentospora prolificans Hennebert & Desai 

a 

b 

20 µm 

Lomentospora prolificans (a) culture and (b) conidiophores and conidia. 

Synergy testing results for L. prolificans (Australian National data). 

Antifungal Combination No. ∑FIC < 0.5 (S) ∑FIC >0.5-4 (I) ∑FIC >4 (A) 

VORI/TERB 109 94 (86%) 14 (14%) 0 

ITRA/TERB 93 56 (60%) 37 (40%) 0 

S = synergy, I = indifferent (synergy or antagonism not demonstrated), A = antagonism.


Lophophyton gallinae (Megnin) Matruchot & Dassonville 

Synonymy: Microsporum gallinae (Megnin) Grigorakis. 

Lophophyton gallinae is a zoophilic fungus causing fowl favus in chickens and other 

fowl, affecting the comb and wattles producing “white comb” lesions. A rare cause of 

tinea in humans. Invaded hairs show a sparse ectothrix infection but do not fluoresce 

under Wood’s ultra-violet light. RG-2 organism. 

Morphological Description: Colonies are flat with a suede-like texture and are 

white with a pinkish tinge in colour. Some cultures show radial folding. An orangepink 

“strawberry” reverse pigment is usually present. Macroconidia, when present, are 

usually five to six celled, thin to thick-walled, slightly echinulate, cylindrical to clavate 

with a narrow base and blunt tip, 15-60 x 6-10 µm. Microconidia are ovoidal to pyriform 

in shape. 

Key Features: Macroconidial morphology, culture characteristics and clinical lesions 

in chickens. 

Molecular Identification: ITS sequencing is recommended. 

References: Rebell and Taplin (1970), Rippon (1988), Gräser et al. (2008), Cafarchia 

et al. (2013), de Hoog et al. (2015, 2016). 

a 

b 

Lophophyton gallinae (a) culture and (b) macroconidia. 

20 µm

116 


Madurella complex 

The genus Madurella was originally based on tissue morphology (mycetoma with black 

grains) and the formation of sterile cultures on mycological media. Initially two species 

were described, M. mycetomatis and M. grisea. However recent molecular studies have 

recognised five species: Madurella mycetomatis, Trematosphaeria grisea (formerly 

M. grisea), M. fahalii, M. pseudomycetomatis and M. tropicana (Desnos-Ollivier et al. 

2006, de Hoog et al. 2004a, 2012). All species have been isolated from soil and are 

major causative agents of mycetoma. RG-2 organism. 

Madurella mycetomatis (Laveran) Brumpt 

Morphological Description: Colonies are slow growing, flat and leathery at first, 

white to yellow to yellowish-brown, becoming brownish, folded and heaped with age, 

and with the formation of aerial mycelia. A brown diffusible pigment is characteristically 

produced in primary cultures. Although most cultures are sterile, two types of conidiation 

have been observed, the first being flask-shaped phialides that bear rounded conidia, 

the second being simple or branched conidiophores bearing pyriform conidia (3-5 µm) 

with truncated bases. The optimum temperature for growth of this mould is 37 O C. 

Grains of Madurella mycetomatis (tissue microcolonies) are brown or black, 0.5-1.0 

mm in size, round or lobed, hard and brittle, composed of hyphae which are 2-5 µm in 

diameter, with terminal cells expanded to 12-15 (30) µm in diameter. 

M. mycetomatis can be distinguished from Trematosphaeria grisea by growth at 37 O C 

and its inability to assimilate sucrose. 

Key Features: Black grain mycetoma, growth at 37 O C, diffusible brown pigment 

produced on culture and the occasional presence of phialides. 

References: McGinnis (1980), Chandler et al. (1980), Rippon (1988), de Hoog et al. 

(2000, 2004a, 2012, 2015), Desnos-Ollivier et al. (2006). 

a 

b 

20 µm 

Madurella mycetomatis (a) culture showing brown diffusible 

pigment, and (b) phialides and conidia.


Molecular Identification: ITS sequencing is recommended for species separation 

(Ahmed et al. 2014b, Desnos-Olliver et al. 2006, Irinyi et al. 2015). A five locus 

phylogenetic analysis was performed by Ahmed et al. (2014a) using the ITS, D1/D2, 

RPB2 and EF-1α genes. 

Trematosphaeria grisea (MacKinnon et al.) S.A. Ahmed et al. 

Synonymy: Madurella grisea Mackinnon, Ferrada and Montemayer. 


Madurella complex 

Morphological Description: Colonies are slow growing, dark, leathery, folded 

with radial grooves and with a light brown to greyish surface mycelium. With age, 

colonies become dark brown to reddish-brown and have a brownish-black reverse. 

Microscopically, cultures are sterile, although hyphae of two widths have been 

described, thin at 1-3 µm in width or broad at 3-5 µm in width. The optimum temperature 

for growth of T. grisea is 30 O C; this fungus does not grow at 37 O C. 

Trematosphaeria grisea can be distinguished from Madurella mycetomatis by the 

inability to grow at 37 O C and to assimilate lactose. 

Key Features: Black grain mycetoma, no growth at 37 O C, no diffusible brown pigment 

produced on culture and absence of conidia. 


(2000, 2015), Ahmed et al. (2014b), Desnos-Olliver et al. (2006), Irinyi et al. (2015). 

100 µm 

Trematosphaeria grisea grains (tissue microcolonies) are black, round to 

lobed, soft to firm, up to 1.0 mm, with two distinctive zones, a hyaline to 

weakly pigmented central zone and a deeply pigmented periphery.

118 


Magnusiomyces capitatus (de Hoog et al.) de Hoog & M.Th. Smith 

Synonymy: Saprochaete capitata (Diddens & Lodder) de Hoog & M.Th. Smith; 

Geotrichum capitatum (Diddens & Lodder) v. Arx; Trichosporon capitatum Diddens & 

Lodder; Blastoschizomyces capitis (Diddens & Lodder) Salkin et al. 

Based on a phylogenetic analysis of rDNA gene sequences, de Hoog and Smith (2004) 

transferred Geotrichum capitatum to the genus Magnusiomyces. Magnusiomyces 

capitatus occurs quite commonly in humans, usually as a transient component of 

normal skin flora and sputum. Systemic infections including pulmonary, fungaemia and 

endocarditis have been reported in immunosuppressed patients. RG-1 organism. 

Morphological Description: Colonies are moderately fast growing, flat, whitish, and 

finely suede-like with no reverse pigment. Hyphae are profusely branched at acute 

angles, with terminal and intercalary conidiogenous cells which form long, cicatrised 

rachids on which conidia are borne. Conidia are hyaline, smooth, one-celled, cylindrical 

to clavate, with a rounded apex and flat base, 7-10 x 2.5-3.5 µm. Rectangular 

arthroconidia are also often present. 











Glucose + Soluble Starch - Galactitol - 0.1% Cycloheximide + 

Galactose + D-Xylose - D-Mannitol + Growth at 40 O C + 

Molecular Identification: ITS sequencing recommended (de Hoog and Smith 2004). 

Note: Magnusiomyces capitatus and Saprochaete clavata are human pathogens 

that are closely related and are frequently mistaken for each other. Desnos-Ollivier 

et al. (2014) proposed species-specific carbon assimilation patterns and MALDI-TOF 

MS profiles to enable the identification of S. clavata, M. capitatus and Geotrichum 

candidum to the species level. 

References: de Hoog and Smith (2004, 2011c), de Hoog et al. (2015), Garcia-Ruiz et 

al. (2013), Desnos-Ollivier et al. (2014), Arendrup et al. (2014). 

Antifungal Susceptibility: M. capitatus limited data (Garcia-Ruiz et al. 2013, 

Australian National data); MIC µg/mL. Note: Isolates of M. capitatus are intrinsically 

resistant to echinocandins (Arendrup et al. 2014). 

No. 64 

AmB 9 1 1 4 3 

FLU 9 1 1 2 3 2 

VORI 8 2 2 2 1 1 

POSA 8 2 1 2 2 1 

ITRA 9 1 4 4 

5FC 4 2 1 1


Malassezia Baillon 

Malassezia species are basidiomycetous yeasts and form part of the normal skin flora 

of humans and animals. The genus now includes 14 species of which 13 are lipid 

dependent. These include M. caprae (goat, horse), M. cuniculi (rabbit), M. dermatis 

(human), M. equina (horse, cow), M. furfur (human, cow, elephant, pig, monkey, ostrich, 

pelican), M. globosa (human, cheetah, cow), M. japonica (human), M. nana (cat, cow, 

dog), M. obtusa (human), M. pachydermatis (dog, cat, carnivores, birds), M. restricta 

(human), M. slooffiae (human, pig, goat, sheep), M. sympodialis (human, horse, pig 

sheep) and M. yamatoensis (human) (Cabanes et al. 2011). 

M. sympodialis, M. globosa, M. slooffiae and M. restricta are the most frequently found 

species responsible for colonisation of humans (Arendrup et al. 2014). 

Malassezia species may cause various skin manifestations including pityriasis versicolor, 

seborrhoeic dermatitis, dandruff, atopic eczema and folliculitis. M. pachydermatis is 

known to cause external otitis in dogs. Fungaemia due to lipid-dependent Malassezia 

species usually occurs in patients with central line catheters receiving lipid replacement 

therapy, especially in infants (Tragiannides et al. 2010, Gaitanis et al. 2012, Arendrup 

et al. 2014). 

Note: With the exception of M. pachydermatis, the primary isolation and culture of 

Malassezia species is challenging because in vitro growth must be stimulated by 

natural oils or other fatty substances. The most common method used is to overlay 

Sabouraud’s dextrose agar (SDA) containing cycloheximide (actidione) with olive oil or 

alternatively to use a more specialised media like modified Leeming and Notham agar 

(Kaneko et al. 2007), or modified Dixon’s agar (see specialised culture media). 

However, CHROMagar Malassezia medium is now commercially available for the 

primary isolation and differentiation of the most common Malassezia species. 

Comment: For clinical management at the level of the individual patient, species 

identification is less important, although it is obviously needed for epidemiological 

surveillance and outbreak investigation (Arendrup et al. 2014). 

a 

b 

10 μm 

Malassezia furfur (a) culture on modified Dixon’s agar and (b) direct microscopy of skin 

scrapings showing characteristic clusters of thick-walled round, budding yeast-like cells 

and short angular hyphal forms (the so called “spaghetti and meatballs” appearance) 

typically seen in pityriasis versicolor.

120 



Malassezia Baillon 

Morphological Description: On media like modified Dixon’s agar, colonies are cream 

to yellowish, smooth or lightly wrinkled, glistening or dull, and with the margin being 

either entire or lobate. Malassezia is characterised by globose, oblong-ellipsoidal to 

cylindrical yeast cells. Reproduction is by budding on a broad base and from the same 

site at one pole (unipolar). 


species identification (de Hoog et al. 2015). 

MALDI-TOF MS: Capable of identifying all 14 Malassezia species in concordance with 

those of ITS sequence analyses (Kolecka et al. 2014). 

Identification criteria for the differentiation of Malassezia species (de Hoog et. al. 2015). 

+ Positive, - Negative, v Variable, w Weak, s Slow, nd No Data 

Species Buds SDA 40 O C 

Cremophor 

EL 

Tween 

80 

Tween 

60 

Tween 

40 

Tween 

20 

Esculine 

M. caprae narrow - - - + + + + + + 

M. couiculi narrow - + - - - - - nd + 

M. dermatis wide - + nd + + + + nd + 

M. equina narrow - - - + + + + + + 

M. furfur wide - + + + + + w + 

M. globosa narrow - - - - - - - + 

M. japonica wide - - nd - + w - nd + 

M. nana narrow - v nd w + + v nd + 

M. obtusa wide - - - - - - + + 

M. pachydermatis wide + + -,w + + -,w v v 

M. restricta narrow - - - - - - - - 

M. slooffiae wide - + - +,w + + - + 

M. sympodialis narrow - + -,w + + + + + + 

M. yamatoensis wide - - nd + + + + nd + 

Antifungal Susceptibility: Very limited data available. Special growth conditions 

are needed for antifungal susceptibility testing; data from Nakamura et al. (2000), 

Velegraki et al. (2004) and Miranda et al. (2007); MIC µg/mL. 

MIC µg/mL 

MIC µg/mL 

Antifungal Range MIC Antifungal 

90 

Range MIC 90 

FLU 0.125->64 4 (8) AmB 0.03-16 1 (8) 

Catalase 

References: Guillot and Gueho (1995), Gueho et al. (1996), Guillot et al. (1996, 2000), 

Boekhout et al. (2010), Cafarchia et al. (2011), de Hoog et al. (2015). 

ITRA 0.03-16 0.125 VORI 0.03-16 0.125 (1) 

KETO 0.03-4 0.25 POSA 0.03-32 0.125 (2) 

Note: There is no standardised method and results are often variable, therefore 

susceptibility testing for guiding treatment is not recommended.


Malbranchea pulchella Sacc. & Penz. 

Malbranchea species are soil fungi of worldwide distribution which microscopically may 

resemble Coccidioides immitis/posadasii. Note: Culture identification by exoantigen 

test or ITS sequencing is the method of choice for identification of C. immitis/posadasii. 


Morphological Description: Colonies are white to sulphur-yellow to ochre-brown 

in colour, suede-like in texture, with a reddish-brown reverse, and often a reddish 

diffusible pigment. Microscopic morphology shows typical hyaline, one-celled, 

cylindrical, truncate, alternate arthroconidia produced in tightly coiled, terminal fertile 

branches of the hyphae. Arthroconidia are released by lysis of the disjunctor cells. 

These arthroconidia may be perceived as a yellow dust when released at maturity. 

Key Features: Hyphomycete producing alternate arthroconidia with disjunctor cells. 

References: Cooney and Emerson (1964), Sigler and Carmichael (1976), McGinnis 

(1980), Rippon (1988), de Hoog et al. (2000, 2015). 

20 µm 

Malbranchea pulchella arthroconidia produced in tightly 

coiled, terminal fertile branches of the hyphae.

122 


Meyerozyma guilliermondii (Wick.) Kurtzman & M. Suzuki 

Synonymy: Candida guilliermondii (Castellani) Langeron & Guerra. 

Meyerozyma guilliermondii has been isolated from numerous human infections, mostly 

of cutaneous origin. It is also found on normal skin and in sea water, faeces of animals, 

fig wasps, buttermilk, leather, fish and beer. RG-1 organism. 

Culture: White to cream-coloured smooth, glabrous, yeast-like colonies. 

Microscopy: Spherical to subspherical budding yeast-like cells or blastoconidia, 2.0- 

4.0 x 3.0-6.5 µm. 


Dalmau Plate Culture: Branched pseudohyphae with dense verticils of blastoconidia. 





Fermentation Sucrose + D-Arabinose v α-M-D-glucoside v 

Glucose + Maltose + D-Ribose + D-Gluconate v 

Galactose v Cellobiose v L-Rhamnose v DL-Lactate v 

Sucrose + Trehalose + D-Glucosamine + myo-Inositol - 


Lactose - Melibiose v Glycerol + D-Glucuronate nd 

Trehalose + Raffinose + Erythritol - Nitrate - 

Assimilation Melezitose v Ribitol + Urease - 

Glucose + Soluble Starch - Galactitol v 0.1% Cycloheximide v 

Galactose + D-Xylose + D-Mannitol v Growth at 37 O C v 


Antifungal Susceptibility: M. guilliermondii (Diekema et al. 2009, Australian 

National data); MIC µg/mL. CLSI clinical breakpoints are marked where available 

(Pfaller and Diekema 2012). 

No. 64 

AmB 198 1 1 2 9 70 70 27 9 2 1 1 5 

FLU 199 1 4 5 75 75 7 11 4 7 

VORI 197 2 11 23 88 52 9 3 1 2 6 

POSA 194 1 9 14 47 79 30 4 4 6 

ITRA 24 6 3 12 2 1 

ANID 120 1 2 6 5 9 41 48 8 

MICA 13 3 1 4 10 14 39 29 8 1 

CAS 175 2 9 24 35 63 25 8 2 3 4 

5FC 24 8 12 1 1 1 1


Microsphaeropsis arundinis (S. Ahmad) B. Sutton 

Microsphaeropsis arundinis is a coelomycete that is ubiquitous in soil and fresh water. 

It typically inhabits terrestrial plant hosts and has a well-known association with Aruno 

donax, a garden escape weed known as ‘giant reed’ or ‘elephant grass’. M. arundinis 

is an emerging cause of phaeohyphomycosis in cats and immunosuppressed humans. 


Morphological Description: Colonies growing slowly, with dense aerial mycelium, 

initially greenish-grey, later becoming dark brown to grey-brown. Hyphae are septate, 

pigmented, and irregularly shaped, with swollen segments up to 4 μm in diameter. 

Pycnidia are subspherical, 250-350 μm in diameter; with a pseudoparenchymatous 

wall composed of very densely packed cells that appear angular in cross section 

(textura angularis). Conidiogenous cells ampulliform, up to 5 μm long. Conidia brown, 

thick- and smooth-walled, cylindrical, 3.5-4.5 × 1.0-1.5 μm. 

Key Features: Coelomycete, with ostiolate pycnidia, ampulliform conidiogenous cells, 

and small, smooth-walled, brown, cylindrical conidia. 

Molecular Identification: ITS and D1/D2 sequencing is recommended, especially as 

it may take many weeks before pycnidia are produced in culture (Reppas et al. 2015). 

References: Kluger et al. (2004), Pendle et al. (2004), Krockenberger et al. (2010), 

Hall et al. (2013), Reppas et al. (2015), de Hoog et al. (2015). 

a 

b 

Microsphaeropsis arundinis (a) culture and (b) pigmented 

septate hyphae, with swollen segments.

124 


Microsporum Gruby 

A recent multilocus phylogenetic study the has reviewed the taxonomy of the 

dermatophytes. Arthroderma now contains 21 species, Epidermophyton one species, 

Lophophyton one species, Microsporum three species, Nannizzia nine species 

and Trichophyton 16 species. In addition, two new genera have been introduced: 

Guarromyces containing one species and Paraphyton three species (de Hoog et al. 

2016). 

The genus Microsporum is now restricted to just three species: M. audouinii, M. 

canis and M. ferrugineum. The remaining geophilic and zoophilic species, previously 

considered Microsporum species, have been transferred to the genera Lophophyton 

and Nannizzia. 

Microsporum species may form both macro- and microconidia, although they are not 

always present. Cultures are mostly granular to cottony, yellowish to brownish, with a 

cream-coloured or brown colony reverse. Macroconidia are hyaline, multiseptate, with 

thick rough cell walls, and are clavate, fusiform or spindle-shaped. Microconidia are 

single-celled, hyaline, smooth-walled, and are predominantly clavate in shape. 

Note: Strains of M. canis often do not produce macroconidia and/or microconidia on 

primary isolation media and subcultures onto polished rice grains or lactritmel agar 

are recommended to stimulate sporulation. These non-sporulating strains of M. canis 

are often erroneously identified as M. audouinii and it is surprising just how many 

laboratories have difficulty in differentiating M. canis and M. audouinii. 

Molecular Identification: ITS sequencing is recommended (Gräser et al. 1998, 2000, 

Brillowska-Dabrowska et al. 2013). 

References: Rebell and Taplin (1970), Rippon (1988), McGinnis (1980), Domsch et 

al. (1980), Ajello (1977), Weitzman et al. (1986), Mackenzie et al. (1986), Kane et 

al. (1997), de Hoog et al. (2000, 2015), Gräser et al. (1999a, 2008). Cafarchia et al. 

(2013). 

a 

b 

(a) Microsporum audouinii showing poor growth on rice grains, usually being 

visible only as a brown discolouration. (b) Microsporum canis on rice grains 

showing good growth, yellow pigmentation and sporulation.


Microsporum audouinii is an anthropophilic fungus causing non-inflammatory infections 

of the scalp and skin, especially in children. Once the cause of epidemics of tinea 

capitis in Europe and North America, it is now less common. Invaded hairs show an 

ectothrix infection and usually fluoresce a bright greenish-yellow under Wood’s ultraviolet 

light. Only rarely found in Australasia, most reports are in fact misidentified nonsporulating 

strains of M. canis. 


Microsporum audouinii Gruby 

Morphological Description: Colonies are flat, spreading, greyish-white to light tanwhite 

in colour, and have a dense suede-like to downy surface, suggestive of mouse 

fur in texture. Reverse can be yellow-brown to reddish-brown in colour. Some strains 

may show no reverse pigment. Macroconidia and microconidia are rarely produced, 

most cultures are sterile or produce only occasional thick-walled terminal or intercalary 

chlamydospores. When present, macroconidia may resemble those of M. canis but 

are usually longer, smoother and more irregularly fusiform in shape; microconidia, 

when present, are pyriform to clavate in shape and are similar to those seen in other 

species of Microsporum, Lophophyton and Nannizzia. Pectinate (comb-like) hyphae 

and racquet hyphae (a series of hyphal segments swollen at one end) may also be 

present. 

a 

b 

10 µm 

Microsporum audouinii (a) Culture and (b) a thick-walled intercalary 

chlamydospore. Note: Macroconidia and microconidia are only rarely produced. 

Confirmatory Tests: 

Growth on Rice Grains: Very poor or absent, usually being visible only as a brown 

discolouration. This is one of the features which distinguish M. audouinii from M. canis. 

Reverse Pigment on Potato Dextrose Agar: Salmon to pinkish-brown (M. canis is 

bright yellow). 

BCP Milk Solids Glucose Agar: Both M. canis and M. audounii demonstrate profuse 

growth, but only M. audouinii shows a rapid pH change to alkaline (purple colour). 

Vitamin Free Agar (Trichophyton Agar No.1): Good growth indicating no special 

nutritional requirements. Cultures are flat, white, suede-like to downy, with a yellowbrown 

reverse. Note: Growth of some strains of M. audouinii is enhanced by the 

presence of thiamine (Trichophyton agar No.4). 

Hair Perforation Test: Negative after 28 days. 

Key Features: Absence of conidia, poor or no growth on polished rice grains, inability 

to perforate hair in vitro, and culture characteristics.

126 


Microsporum canis is a zoophilic dermatophyte of worldwide distribution and is a 

frequent cause of ringworm in humans, especially children. Invades hair, skin and 

rarely nails. Cats and dogs are the main sources of infection. Invaded hairs show 

an ectothrix infection and fluoresce a bright greenish-yellow under Wood’s ultra-violet 

light. 


Morphological Description: Colonies are flat, spreading, white to cream-coloured, with 

a dense cottony surface which may show some radial grooves. Colonies usually have 

a bright golden yellow to brownish yellow reverse pigment, but non-pigmented strains 

may also occur. Macroconidia are typically spindle-shaped with 5-15 cells, verrucose, 

thick-walled and often have a terminal knob, 35-110 x 12-25 µm. A few pyriform to 

clavate microconidia are also present. Macroconidia and/or microconidia are often not 

produced on primary isolation media and it is recommended that subcultures be made 

onto lactritmel agar and/or boiled polished rice grains to stimulate sporulation. 


Microsporum canis Bodin 

Growth on Rice Grains: good growth of white aerial mycelium with production of 

yellow pigment. Microscopy reveals numerous macroconidia and microconidia similar 

to those described above. 

Reverse Pigment on Potato Dextrose Agar: Bright yellow (both M. audouinii and M. 

canis var. equinum are salmon to pinkish-brown). 


nutritional requirements. Cultures are flat, white, suede-like to downy, with a yellow to 

pale yellow-brown reverse. 

Hair Perforation Test: Positive at 14 days. 

Key Features: Distinctive macroconidia and culture characteristics. Abundant growth 

and sporulation on polished rice grains and in vitro perforation of hair. 

Microsporum canis culture showing a bright golden yellow reverse pigment



20 µm 

Microsporum canis typical spindle-shaped macroconidia. 

Microsporum canis dysgonic strains are rare but may also occur. These dysgonic strains 

typically have a heaped and folded, yellow-brown thallus and macroconidia are usually 

absent. However, typical colonies and macroconidia of M. canis are usually produced 

by this variant when subcultured onto polished rice grains. Note: The dysgonic type 

colony of M. canis is similar to that of Microsporum ferrugineum.

128 



Supplementary description for Microsporum canis var. distortum, a dysgonic variant of 

M. canis with distinctive distorted macroconidia. Abundant growth and sporulation on 

rice grains. 

Microsporum canis var. distortum is a zoophilic fungus known to cause infections 

in cats, dogs and other animals. It is a rare cause of tinea capitis in New Zealand, 

Australia and North America. Clinical disease is similar to M. canis. Invaded hairs show 

an ectothrix infection and fluoresce a bright greenish-yellow under Wood’s ultra-violet 

light. 

a 

b 

10 μm 

Microsporum canis var. distortum (a) culture and (b) distorted macroconidia. 

Microsporum canis var. equinum is now considered to be a genotypic synonym of 

Microsporum canis (de Hoog et al. 2000). This variant of M. canis is a rare cause of 

ringworm of horses. Invaded hairs show an ectothrix infection and fluoresce a bright 

greenish-yellow under Wood’s ultra-violet light. Rarely infects man or other animal 

species. Reported from Australia, Europe and North America. 

a 

b 

10 μm 

Microsporum canis var. equinum (a) colonies are pale buff to pale salmon with, a buff 

to pinkish-buff to yellow-brown reverse. (b) Macroconidia are small, broad, irregular, 

spindle-shaped, 18-60 x 5-15 µm with rough thick walls and few septa. Microconidia 

are pyriform to clavate in shape, 3-9 x 1.5-3.5 µm, but are rarely produced.


Microsporum ferrugineum Ota 

Microsporum ferrugineum is an anthropophilic fungus causing epidemic juvenile tinea 

capitis in humans. The clinical features are similar to those of infections caused by M. 

audouinii. Invaded hairs show an ectothrix infection and fluoresce a greenish-yellow 

under Wood’s ultra-violet light. Reported from Asia (including China and Japan), 

Russia, Eastern Europe and Africa. 


Morphological Description: Colonies are slow growing, forming a waxy, glabrous, 

convoluted thallus with a cream to buff-coloured surface and no reverse pigment. 

Note: Surface pigmentation may vary from cream to yellow to deep red and a flatter 

white form sometimes occurs. Cultures rapidly become downy and pleomorphic. 

Microscopic morphology is negative, microconidia or macroconidia are not produced. 

However, irregular branching hyphae with prominent cross walls (“bamboo hyphae”) 

and chlamydospores are seen. “Bamboo hyphae” are a characteristic of this species. 

Key Features: Clinical history, culture characteristics and distinctive “bamboo hyphae”. 

a 

b 

20 µm 

Microsporum ferrugineum (a) culture and (b) “bamboo hyphae”.

130 


Mortierella wolfii Mehrotra & Baijal 

The genus Mortierella has now been placed in a separate order, the Mortierellales 

(Cavalier-Smith 1998). The genus contains about 90 recognised species, however 

Mortierella wolfii is probably the only pathogenic species being an important causal 

agent of bovine mycotic abortion, pneumonia and systemic mycosis in New Zealand, 

Australia, Europe and USA. RG-2 organism. 

Morphological Description: Cultures are fast growing, white to greyish-white, downy, 

often with a broadly zonate or lobed (rosette-like) surface appearance and no reverse 

pigment. Sporangiophores are typically erect, delicate, 80-250 µm in height, 6-20 µm 

wide at the base, arising from rhizoids or bulbous swellings on the substrate hyphae 

and terminating with a compact cluster of short acrotonous (terminal) branches. 

Sporangia are usually 15-48 µm in diameter, with transparent walls and a conspicuous 

collarette is usually present following dehiscence of the sporangiospores. Columellae 

are generally lacking and sporangiospores are single-celled, short-cylindrical, 6-10 x 

3-5 µm, with a double membrane. Chlamydospores with or without blunt appendages 

(amoeba-like) may be present, zygospores have not been observed. Temperature: 

grows well at 40-42 O C; maximum 48 O C. 

Key Features: Mucorales, rapid growth at 40 O C (thermotolerant), and characteristic 

delicate acrotonous branching sporangia without columellae. 

References: Domsch et al. (1980), McGinnis (1980), Rippon (1988), de Hoog et al. 

(2000, 2015). 

a 

b 

20 µm 

b 

20 µm 

Mortierella wolfii (a) culture showing a broadly zonate or lobed rosette-like surface 

appearance, and (b) sporangium, showing a sporangiophore, wide at the base, arising 

from rhizoids, and acrotonous (terminal) branches, collarettes and sporangiospores.


Mucor Micheli ex Staint-Amans 

The genus Mucor contains about 50 recognised taxa, many of which have widespread 

occurrence and are of considerable economic importance (Zycha et al. 1969, Schipper 

1978, Domsch et al. 1980). However, only a few thermotolerant species are of medical 

importance and human infections are only rarely reported. Most infections reported 

list M. circinelloides and similar species such as M. indicus, M. ramosissimus, M. 

irregularis and M. amphibiorum as the causative agents. However, M. hiemalis and 

M. racemosus have also been reported as infectious agents, although their inability to 

grow at temperatures above 32 O C raises doubt as to their validity as human pathogens 

and their pathogenic role may be limited to cutaneous infections (Scholer et al. 1983, 

Goodman and Rinaldi 1991, Kwon-Chung and Bennett 1992, de Hoog et al. 2000, 

2015). 

Maximum temperature for growth of the reported pathogenic species of Mucor. 

Species Max temp. ( O C) Pathogenicity 

M. amphibiorum 36 Animals, principally amphibians 

M. circinelloides 37 Animals, occasionally humans 

M. hiemalis 30 Questionable cutaneous infections only 

M. indicus 42 Humans and animals 

M. irregularis 38 Humans 

M. racemosus 32 Questionable 

M. ramosissimus 36 Humans and animals 

Morphological Description: Colonies are very fast growing, cottony to fluffy, white to 

yellow, becoming dark-grey, with the development of sporangia. Sporangiophores are 

erect, simple or branched, forming large (60-300 µm in diameter), terminal, globose 

to spherical, multispored sporangia, without apophyses and with well-developed 

subtending columellae. A conspicuous collarette (remnants of the sporangial 

wall) is usually visible at the base of the columella after sporangiospore dispersal. 

Sporangiospores are hyaline, grey or brownish, globose to ellipsoidal, and smoothwalled 

or finely ornamented. Chlamydospores and zygospores may also be present. 

Key Features: Mucorales, large, spherical, non-apophysate sporangia with 

pronounced columellae and conspicuous collarette at the base of the columella 

following sporangiospore dispersal. 

Molecular Identification: ITS sequencing recommended (Walther et al. 2012). 

References: Schipper (1978), Domsch et al. (1980), McGinnis (1980), Onions et al. 

(1981), Scholer et al. (1983), Rippon (1988), Goodman and Rinaldi (1991), Samson 

et al. (1995), de Hoog et al. (2000, 2015), Schipper and Stalpers (2003), Ellis (2005b).

132 


Mucor Micheli ex Staint-Amans 

20 µm 20 µm 

Mucor spp. showing sporangia, columella with inconspicuous 

collarette (arrow) and sporangiospores. 


Mucor amphibiorum Schipper 

Morphological Description: Colonies are greyish-brown, slightly aromatic and 

do not grow at 37 O C (maximum temperature for growth is 36 O C). Sporangiophores 

are hyaline, erect and mostly unbranched, rarely sympodially branched. Sporangia 

are dark-brown, up to 75 µm in diameter, and are slightly flattened with a diffluent 

membrane. Columellae are subglobose to ellipsoidal or pyriform, up to 60 x 50 µm, 

with small collarettes. Sporangiospores are smooth-walled, spherical, and 3.5-5.5 µm 

in diameter. Zygospores, when formed by compatible mating types, are spherical to 

slightly compressed, up to 70 x 60 µm in diameter, with stellate projections. 

Comment: Mucor amphibiorum is distinguished by poor branching of the 

sporangiophores and by globose sporangiospores. Ethanol and nitrates are not 

assimilated (Schipper 1978, Scholer et al. 1983, Hoog et al. 2000, 2015). 

Antifungal Susceptibility: M. amphibiorum very limited data (Australian National 


No. 16 

AmB 1 1 

POSA 1 1 

ITRA 1 1


M. circinelloides is a common and variable species that includes four formae: 

circinelloides, lusitanicus, griseocyanus and janssenii (Schipper 1978, Scholer et al. 

1983). 


Mucor circinelloides v. Tiegh 

Morphological Description: Colonies are floccose, pale greyish-brown and grow 

poorly at 37 O C (maximum growth temperature 37 O C). Sporangiophores are hyaline and 

mostly sympodially branched with long branches erect and shorter branches becoming 

circinate (coiled). Sporangia are spherical, varying from 20-80 µm in diameter, with 

small sporangia often having a persistent sporangial wall. Columellae are spherical 

to ellipsoidal and are up to 50 µm in diameter. Sporangiospores are hyaline, smoothwalled, 

ellipsoidal, and 4.5-7 x 3.5-5 µm in size. Chlamydospores are generally absent. 

Zygospores are only produced in crosses of compatible mating types and are reddishbrown 

to dark-brown, spherical with stellate spines, up to 100 µm in diameter and have 

equal to slightly unequal suspensor cells. 

Comment: M. circinelloides differs from other species of Mucor in its formation of 

short circinated, branched sporangiophores bearing brown sporangia and its ability 

to assimilate ethanol and nitrates (Schipper 1976, Scholer et al. 1983, Samson et al. 

1995, de Hoog et al. 2000, Schipper and Stalpers 2003). 

Antifungal Susceptibility: M. circinelloides (Espinel-Ingroff et al. 2015a, Australian 


No. 16 

AmB 123 1 4 14 42 44 18 

POSA 120 2 2 9 21 49 26 5 2 4 

ITRA 48 4 3 7 12 15 5 3 

Mucor circinelloides culture.

134 


Mucor circinelloides v. Tiegh 

20 µm 20 µm 

Mucor circinelloides sporangia showing circinate sporangiophores, also note 

the columella with inconspicuous collarette (arrow) and sporangiospores. 

Mucor indicus Lendner 

Morphological Description: Colonies are characteristically deep-yellow, aromatic 

and have a maximum growth temperature of 42 O C. Sporangiophores are hyaline to 

yellowish, erect or rarely circinate and repeatedly sympodially branched, with long 

branches. Sporangia are yellow to brown, up to 75 µm in diameter, with diffluent 

membranes. Columellae are subglobose to pyriform, often with truncate bases, up to 

40 µm high. Sporangiospores are smooth-walled, subglobose to ellipsoidal, and 4-5 

µm in diameter. Chlamydospores are produced in abundance, especially in the light. 

Zygospores are black, spherical up to 100 µm in diameter, with stellate spines and 

unequal suspensor cells. RG-1 organism. 

Comment: Mucor indicus differs from other species of Mucor by its characteristic 

deep-yellow colony colour, growth at over 40 O C, assimilating ethanol, but not nitrate, 

and thiamine dependence (Schipper 1978, de Hoog et al. 2000, Schipper and Stalpers 

2003). 

Antifungal Susceptibility: M. indicus (Espinel-Ingroff et al. 2015a, Australian 


No. 16 

AmB 10 1 3 4 1 1 

POSA 10 2 3 3 1 1


Synonymy: Rhizomucor variabilis Zheng & Chen. 


Morphological Description: Colonies are whitish to ochraceous, with buff-ochre 

reverse. Sporangiophores arising from hyphae or from stolons; rhizoids abundant. 

Sporangiophores are hyaline, up to 2 mm long, 9-23 μm wide, simple or once branched, 

with branches terminating at a higher level than the main stems; branches all ending in 

a sporangium. Sporangia subspherical to spherical, up to 100 μm diameter. Columella 

spherical, ellipsoidal to cylindrical, about 40 μm wide, sometimes lobed, with or without 

an apophysis. Sporangiospores are hyaline, smooth-walled, very variable, mostly 

subspherical to ellipsoidal, 3-11 × 2-7 μm. Chlamydospores are abundant. Maximum 

growth temperature 38 O C. 

Comment: Mucor irregularis differs from other species of Mucor by having abundant 

rhizoids of different sizes and sporangiospores of highly variable shape, mostly 

subspherical to ellipsoidal (Lu et al. 2009, 2013). This species is closely related to 

Mucor hiemalis (Voigt et al. 1999). 


Mucor irregularis Stchigel et al. 

Mucor ramosissimus Samutsevich 

Morphological Description: Colonial growth is restricted, greyish and does not 

grow at 37 O C (maximum temperature for growth is 36 O C). Sporangiophores are 

hyaline, slightly roughened, tapering towards the apex and are erect with repeated 

sympodial branching. Sporangia are grey to black, globose or somewhat flattened, 

up to 80 µm in diameter and have very persistent sporangial walls. Columellae are 

applanate (flattened), up to 40-50 µm in size and are often absent in smaller sporangia. 

Sporangiospores are faintly brown, smooth-walled, subglobose to broadly ellipsoidal, 

5-8 x 4.5-6 µm in size. Oidia may be present in the substrate hyphae, chlamydospores 

and zygospores are absent. Assimilation of ethanol is negative and that of nitrate is 

positive. 

Comment: Mucor ramosissimus differs from other species of Mucor by its low, restricted 

growth on any medium, extremely persistent sporangial walls, columellae that are 

applanate or absent in smaller sporangia (often resembling Mortierella species), short 

sporangiophores that repeatedly branch sympodially as many as 12 times, and the 

occurrence of racket-shaped enlargements in the sporangiophores (Hesseltine and 

Ellis 1964b, Schipper 1976, Scholer et al. 1983, de Hoog et al. 2000, Schipper and 

Stalpers 2003). 

Antifungal Susceptibility: M. ramosissimus (Espinel-Ingroff et al. 2015a, Australian 


No. 16 

AmB 19 2 4 3 6 1 1 

POSA 13 4 4 2 2 1

136 


Myrmecridium schulzeri (Sacc.) Arzanlou et al. 

Synonymy: Ramichloridium schulzeri Stahel ex de Hoog. 

Ramichloridium schulzeri was placed in a new genus, Myrmecridium by Arzanlou et al. 

(2007). M. schulzeri is an uncommon soil saprophyte of worldwide distribution. It has 

also been isolated from plant detritus and as a contaminant of bronchoscopy fluid. It 

is the causative agent of “Golden Tongue” syndrome reported by Rippon et al. (1985). 


Morphological Description: Colonies growing moderately rapidly, consisting of a 

rather compact, flat, submerged mycelium, pale orange, locally with some powdery, 

brownish aerial mycelium; reverse pink to orange. Conidiophores are erect, straight, 

unbranched, thick-walled, reddish-brown, up to 250 µm high, gradually becoming paler 

towards the apex, of variable length, elongating sympodially during conidiogenesis, with 

scattered, pimple-shaped conidium bearing denticles which have unpigmented scars. 

Conidia are subhyaline, smooth-walled or slightly rough-walled, ellipsoidal, obovoidal 

or fusiform, 6.5-10 x 3-4 µm, usually with an acuminate base and unpigmented scars. 


species identification (Halliday et al. 2015). 

Note: Myrmecridium species can be distinguished from other Ramichloridium-like fungi 

by having entirely hyaline vegetative hyphae, and widely scattered, pimple-shaped 

denticles on the long hyaline rachis. The conidial sheath is also visible in lactic acid 

mounts with bright field microscopy Arzanlou et al. (2007). 

References: de Hoog (1977), Rippon et al. (1985), de Hoog et al. (2000, 2015), 

Arzanlou et al. (2007). 

10 µm 

20 µm 

Myrmecridium schulzeri conidiophores showing sympodial development of conidia.


Nannizzia fulva (Uriburu) Stockdale 

Synonymy: Microsporum fulvum Uriburu. 

Nannizzia fulva is a geophilic fungus of worldwide distribution which may cause 

occasional infections in humans and animals. Clinical disease is similar to N. gypsea 

but less common. Invaded hairs show a sparse ectothrix infection but do not fluoresce 

under Wood’s ultra-violet light. RG-1 organism. 

Morphological Description: Colonies are fast growing, flat, suede-like, tawny-buff 

to pinkish-buff in colour and frequently have a fluffy white advancing edge. A dark red 

under surface is occasionally seen, otherwise it is colourless to yellow brown. Abundant 

thin-walled, elongate, ellipsoidal macroconidia are formed which closely resemble 

those of N. gypsea, except they are longer and more bullet-shaped (clavate) with three 

to six septa. Numerous spiral hyphae, which are often branched are seen. Numerous 

pyriform to clavate microconidia are also produced but these are not diagnostic. 

Key Features: Macroconidial morphology and culture characteristics. 




a 

b 

20 µm 

Nannizzia fulva (a) culture and (b) macroconidia.

138 


Nannizzia gypsea (Nannizzi) Stockdale 

Synonymy: Microsporum gypseum (Bodin) Guiart & Grigorakis. 

Nannizzia gypsea is a geophilic fungus with a worldwide distribution which may cause 

infections in animals and humans, particularly children and rural workers during warm 

humid weather. Usually produces a single inflammatory skin or scalp lesion. Invaded 

hairs show an ectothrix infection but do not fluoresce under Wood’s ultra-violet light. 


Morphological Description: Colonies are usually flat, spreading, suede-like to 

granular, with a deep cream to tawny-buff to pale cinnamon-coloured surface. Many 

cultures develop a central white downy umbo (dome) or a fluffy white tuft of mycelium 

and some also have a narrow white peripheral border. A yellow-brown pigment, often 

with a central darker brown spot, is usually produced on the reverse, however a reddishbrown 

reverse pigment may be present in some strains. Cultures produce abundant, 

symmetrical, ellipsoidal, thin-walled, verrucose, four to six-celled macroconidia. The 

terminal or distal ends of most macroconidia are slightly rounded, while the proximal 

ends (point of attachment to hyphae) are truncate. Numerous clavate-shaped 

microconidia are also present, but these are not diagnostic. 

Key Features: Distinctive macroconidia and culture characteristics. 

Molecular Identification: ITS sequencing is recommended, especially for the 

separation of N. gypsea and N. incurvata which are morphologically similar. 



a 

b 

20 µm 

Nannizzia gypsea (a) culture and (b) macroconidia.


Nannizzia nana (Fuentes) Gräser & de Hoog 

Synonymy: Microsporum nanum Fuentes 

Nannizzia nana is a geophilic and zoophilic fungus frequently causing chronic noninflammatory 

lesions in pigs and a rare cause of tinea in humans. Also present in soil of 

pig-yards. Infections in man are usually contracted directly from pigs or fomites. Invaded 

hairs may show a sparse ectothrix or endothrix infection but do not fluoresce under 

Wood’s ultra-violet light. The geographical distribution is worldwide. RG-2 organism. 

Morphological Description: Colonies are flat, cream to buff in colour with a suedelike 

to powdery surface texture. Young colonies have a brownish-orange pigment which 

deepens into a dark reddish-brown with age. Cultures produce numerous small ovoid 

to pyriform macroconidia with one to three (mostly two) cells, with relatively thin, finely 

echinulate (rough) walls, and broad truncate bases. Many macroconidia are borne on 

conidiophores (stalks) which do not stain readily. Occasional clavate microconidia are 

present, which distinguishes N. nana from some species of Chrysosporium. 

Key Features: Distinctive macroconidia and culture characteristics. 




a 

b 

20 µm 

Nannizzia nana (a) culture and (b) macroconidia.

140 


Nannizzia persicolor (Sabouraud) Stockdale 

Synonymy: Microsporum persicolor (Sabouraud) Guiart & Grigorakis 

Nannizzia persicolor is a zoophilic fungus often occurring as a saprophyte on voles 

and bats. A rare cause of tinea corporis in humans. Not known to invade hair in vivo, 

but produces hair perforations in vitro. Distribution: Africa, Australia, Europe and North 

America. RG-2 organism. 

Morphological Description: Colonies are generally flat, white to pinkish in colour, with 

a suede-like to granular texture and peripheral fringe. Reverse pigmentation is orange 

to red. Macroconidia are thin-walled, cigar-shaped, four to seven-celled, 40-60 x 6-8 

µm but are only rarely produced. Microconidia are abundant, spherical to pyriform. 

Key Features: Microscopic morphology and culture characteristics. 




a 

b 

Nannizzia persicolor (a) culture and (b) microconidia. 

20 µm


Synonymy: Hendersonula toruloidea Nattras. 

Scytalidium dimidiatum (Penzig) Sutton & Dyko. 

Scytalidium hyalinum Campbell & Mulder. 

Neoscytalidium dimidiatum is a coelomycete and recognised agent of onychomycosis 

and superficial skin infections, especially in tropical regions. The primary isolation 

of this fungus from clinical specimens may be difficult as isolates are sensitive to 

cycloheximide (actidione), which is commonly added to primary isolation media used 

for culturing skin scrapings. 

The taxonomy of this species has been very confusing; the conidial state of S. 

dimidiatum was originally described under the name Hendersonula toruloidea. 

However it is phylogenetically remote from Scytalidium and has now been placed 

into Neoscytalidium (Crous et al. 2006, Machouart et al. 2012). Colourless mutants 

(previously known as Scytalidium hyalinum) often occur and have now been listed as 

variety N. dimidiatum var. hyalinum (Madrid et al. 2009). 

Note: Nattrassia mangiferae, previously considered the teleomorph form of S. 

dimidiatum, is now considered a distinct species, and has been placed in the genus 

Neofusicoccum, based on the lack of an arthoconidial anamorph (Crous et al. 2006, 

Machouart et al. 2012). 


Neoscytalidium dimidiatum (Penzig) Crous & Slippers 

Morphological Description: Cultures are effuse, hairy, dark grey to blackish-brown, or 

white to greyish, with a cream-coloured to deep ochraceous-yellow reverse. Colourless 

mutants often occur. Arthroconidia are typically present in chains of one to two-cells, 

darkly pigmented, 3.5-5 x 6.5-12 µm, produced by the holothallic fragmentation of 

undifferentiated hyphae. Pycnidia, only occasionally formed in older cultures are black, 

ostiolate and contain numerous hyaline, flask-shaped phialides. Phialoconidia are at 

first one-celled and hyaline, later becoming three-celled, brown, with the centre cell 

darker than the end cells and are ovoid to ellipsoidal in shape. 



MALDI-TOF MS: Alshawa et al. (2012) developed a spectral database for 12 different 

species of dermatophytes which also included Neoscytalidium dimidiatum and N. 

dimidiatum var. hyalinum. Correct identification of the species was obtained for 18/21 

Neoscytalidium isolates (85.7%). 

References: McGinnis (1980), Moore (1986), Rippon (1988), Frankel and Rippon 

(1989), Sutton and Dyko (1989) Madrid et al. (2009), de Hoog et al. (2000, 2015), 

Crous et al. (2006), Machouart et al. (2012), Alshawa et al. (2012).

142 


Neoscytalidium dimidiatum (Penzig) Crous & Slippers 

20 µm 

Neoscytalidium dimidiatum showing chains of one to two 

celled, darkly pigmented arthroconidia. 

Antifungal Susceptibility: Neoscytalidium dimidiatum limited data (Australian 


No. 64 

AmB 3 1 1 1 

VORI 3 1 1 1 

POSA 3 1 1 1 

ITRA 3 1 1 1 

N. dimidiatum data from 24 isolates (Madrid et al. 2009); MIC µg/mL. 

AmB Range 0.125-0.5; Geometric mean = 0.32 

VORI Range 0.06-4; Geometric mean = 1.37 

POSA Range 0.06-32; Geometric mean = 6.15 

N. dimidiatum data from 10 isolates (Espinel-Ingroff et al. 2001); MIC µg/mL. 

ITRA Range 0.03-32; Geometric mean = 0.65


Ochroconis de Hoog and Arx 

Recently, the genus Ochroconis has undergone taxonomic revision, and the most 

relevant species, Ochroconis gallopava, was transferred to the new genus Verruconis 

(Samerpitak et al. 2014). Ochroconis species are mesophilic saprobes, with an 

optimum growth temperature between 15 and 30 O C and an inability to grow at 37 O C. 

Nevertheless, some species have been isolated from clinical specimens; such as 

Ochroconis tshawytschae, O. mirabilis, O. cordanae, O. olivacea and O. ramosa 

(Samerpitak et al. 2014, Seyedmousavi et al. 2014, Giraldo et al. 2014). Note: Species 

described in the literature from clinical cases as O. constricta or O. humicola are 

probably O. musae (Samerpitak et al. 2014). 

Giraldo et al. (2014) reported on the occurrence of Ochroconis and Verruconis species in 

clinical specimens from the United States. V. gallopava was the most common species 

(69%), followed by O. mirabilis (22%). Other species isolated were O. cordanae, O. 

olivacea and O. ramosa. The most common anatomical site of isolation was the lower 

respiratory tract (59%), followed by superficial (22%) and deep tissues (20%) (Giraldo 

et al. 2014). 


Morphological Description: Colonies restricted, velvety to funiculose, brown to 

olivaceous, often with rust-brown reverse. Hyphae smooth- or somewhat rough-walled, 

pale olivaceous. Conidiophores slightly or conspicuously differentiated, cylindrical, 

often flexuose, producing conidia on scattered, cylindrical to conical denticles. After 

detachment an inconspicuous frill often remains both on the denticle and on the 

conidium base. Conidia one to four-celled, pale olivaceous brown, smooth- or roughwalled, 

ellipsoidal, cylindrical, clavate or cuneiform. Maximum growth temperature 

around 33 O C. 

Molecular Identification: Giraldo et al. (2014) used sequence analyses of the 18S, 

ITS, D1/2, actin, and β-tubulin genes, while Seyedmousavi et al. (2014), used ITS 

sequence analyses to identify species. 

References: de Hoog et al. (2015), Samerpitak et al. (2014), Seyedmousavi et al. 

(2014), Giraldo et al. (2014). 

Antifungal Susceptibility: Ochroconis mirabilis variable data for posaconazole, 

caspofungin and anidulafungin from Seyedmousavi et al. (2014) 1 and Giraldo et al 

(2014) 2 ; MIC µg/mL. 



0.06-0.25 

AmB 1-32 32 POSA 

1 - 

0.5-32 2 32 

ITRA 0.25-32 32 VORI 2-32 32 

CAS 

0.5-1 1 

1-32 2 - 

4 

ANID 

0.03-0.125 1 

0.015-32 2 - 

4 

MICA 0.06-0.50 0.25 TERB 0.015-0.125 0.02

144 


Onychocola canadensis Sigler 

Onychocola canadensis is an uncommon cause of distal and lateral subungual or white 

superficial onychomycosis. However, it may sometimes be present in an abnormalappearing 

nail as an insignificant finding, not acting as a pathogen. 


Morphologial Description: Colonies grow slowly and are velvety to lanose, white to 

yellowish, with a brownish reverse. Arthroconidia are cylindrical to broadly ellipsoidal, 

one to two-celled, hyaline to subhyaline, 4-16 x 2-5 µm in size, forming long chains. 

Older cultures may show broad, brown, rough-walled hyphae. 

Key Features: Slow growing, white, arthroconidial mould isolated from nails. 

References: Sigler and Congly (1990), Sigler et al. (1994), Gupta et al. (1998), de 

Hoog et al. (2000, 2015). 

a 

b 

10 µm 

Onychocola canadensis (a) culture and (b) arthroconidia.


Paecilomyces Bain 

The genus Paecilomyces may be distinguished from the closely related genus Penicillium 

by having long slender divergent phialides and colonies that are never typically 

green. Paecilomyces species are common environmental moulds and are seldom 

associated with human infection. However, the species, P. variotii and P. marquandii 

are emerging as causative agents of mycotic keratitis and of hyalohyphomycosis in the 

immunocompromised patient. Note: Paecilomyces lilacinus has been transferred to 

Purpureocillium lilacinum (Luangsa-ard et al. 2011). 

Morphological Description: Colonies are fast growing, powdery or suede-like, gold, 

green-gold, yellow-brown, lilac or tan, but never green or blue-green as in Penicillium. 

Phialides are swollen at their bases, gradually tapering into a rather long and slender 

neck, and occur solitarily, in pairs, as verticils, and in penicillate heads. Long, dry chains 

of single-celled, hyaline to dark, smooth or rough, ovoid to fusoid conidia are produced 

in basipetal succession from the phialides. 

Molecular Identification: Molecular phylogeny based on 18S rDNA sequences was 

done by Luangsa-ard et al. (2004); the genus is polyphyletic. 

Key Features: Long slender divergent phialides and culture pigmentation. 

References: Samson (1974), Domsch et al. (1980), McGinnis (1980), Onions et al. 

(1981), Rippon (1988), de Hoog et al. (2000, 2015). 

a 

b 

Cultures of (a) Paecilomyces marquandii and (b) Paecilomyces variotii 

showing colony pigmentation.

146 


Paecilomyces marquandii (Massee) Hughes 

Paecilomyces marquandii is a soil fungus of worldwide distribution from temperate to 

tropical regions. 


Morphological Description: Colonies are fast growing, suede-like to floccose, pale 

vinaceous to violet-coloured, with a yellow to orange yellow reverse. Conidiophores are 

erect, arising from submerged hyphae, 50-300 µm in length, bearing loose whorls of 

branches and phialides. Conidiophore stipes are 2.5-3.0 µm wide, hyaline and smoothwalled. 

Phialides are swollen at their bases, tapering into a thin, distinct neck. Conidia 

are ellipsoidal to fusiform, smooth-walled to slightly roughened, hyaline to purple in 

mass, 2.5-3.0 x 2-2.2 µm. Spherical to ellipsoidal chlamydospores, 3-5 µm diameter 

are present. No growth at 37 O C. 

Key Features: Colony pigmentation with yellow reverse pigment, phialides with swollen 

bases, smooth conidiophore stipes, presence of chlamydospores, and no growth at 

37 O C. Note: Purpureocillium lilacinum has no yellow reverse pigment, rough-walled 

conidiophore stipes, absence of chlamydospores and growth at 37 O C. 

References: Samson (1974), Domsch et al. (1980, 2007), de Hoog et al. (2000, 2015). 

20 µm 

Paecilomyces marquandii conidiophores, phialides and conidia. 

Antifungal Susceptibility: P. marquandii (Australian National data); MIC µg/mL. 

No. 64 

AmB 7 1 1 1 1 3 

VORI 4 1 2 1 

POSA 2 1 1 

ITRA 7 1 2 2 1 1


Paecilomyces variotii is a common environmental mould that is widespread in composts, 

soils and food products. It is known from substrates including food, indoor air, wood, 

soil and carpet dust. 


Paecilomyces variotii Bain 

Morphological Description: Colonies are fast growing, powdery to suede-like, 

funiculose or tufted, and yellow-brown or sand-coloured. Conidiophores bearing 

dense, verticillately arranged branches bearing phialides. Phialides are cylindrical or 

ellipsoidal, tapering abruptly into a long and cylindrical neck. Conidia are subspherical, 

ellipsoidal to fusiform, hyaline to yellow, smooth-walled, 3-5 x 2-4 µm and are produced 

in long divergent chains. Chlamydospores are usually present, singly or in short chains, 

brown, subspherical to pyriform, 4-8 µm in diameter, thick-walled to slightly verrucose. 

Key Features: Yellow-brown colony pigmentation, cylindrical phialides, and presence 

of chlamydospores. 

a 

10 µm b 5 µm c 10 µm 

Paecilomyces variotii (a) conidiophores, phialides, (b) conidia 

and (c) terminal chlamydospores. 

Antifungal Susceptibility: P. variotii (Australian National data); MIC µg/mL. 

No. 64 

AmB 17 7 3 4 2 1 

VORI 17 1 2 1 12 1 

POSA 17 5 3 2 5 2 

ITRA 17 4 5 5 3

148 


Paracoccidioides brasiliensis/lutzii Complex 

WARNING: RG-3 organism. Cultures of Paracoccidioides brasiliensis/lutzii represent 

a biohazard to laboratory personnel and should be handled with extreme caution in a 

Class II Biological Safety Cabinet (BSCII). 

Recently P. brasiliensis has been recognised as two species: P. brasiliensis and P. 

lutzii (Teixeira et al. 2014, Theodoro et al. 2012). P. brasiliensis/lutzii is geographically 

restricted to areas of South and Central America. The two species are morphologically 

very similar; conidia of P. lutzii are elongated whereas those from P. brasiliensis are 

pyriform. Molecular confirmation is recommended. 

Molecular Identification: ITS sequencing is recommended (Imai et al. 2000) 

Morphological Description: Colonies grown at 25 O C are slow growing and variable 

in morphology. Colonies may be flat, wrinkled and folded, glabrous, suede-like or 

downy in texture, white to brownish with a tan or brown reverse. Microscopically, a 

variety of conidia may be seen, including pyriform microconidia, chlamydospores and 

arthroconidia. However, none of these are characteristic of the species, and most 

strains may grow for long periods of time without the production of conidia. 

On blood agar at 37 O C, the mycelium converts to the yeast phase and colonies are white 

to tan, moist and glabrous and become wrinkled, folded and heaped. Microscopically, 

numerous large, 20-60 μm, round, narrow base budding yeast cells are present. Single 

and multiple budding occurs, the latter are thick-walled cells that form the classical 

“steering wheel” or “mickey mouse” structures that are diagnostic for this fungus, 

especially in methenamine silver stained tissue sections. 

Key Features: Clinical history, tissue pathology, culture identification with conversion 

to yeast phase at 37 O C, however molecular identification is now recommended. 


(2000, 2015). 

20 µm 

20 µm 

Paracoccidioides brasiliensis/lutzii showing multiple, 

narrow base budding yeast cells “steering wheels”. 

Antifungal Susceptibility: P. brasiliensis very limited data (McGinnis et al. 1997). 

Antifungal MIC Range µg/mL Antifungal MIC Range µg/mL 

AmB 0.03-4 ITRA


Synonymy: Microsporum cookei Ajello; Microsporum racemosum Borelli. 

Lophophyton cookei is a geophilic fungus which has been isolated from the hair of 

small mammals showing no clinical lesions. Infection has been reported in rodents, 

dogs and rarely in humans. It is not known to invade hair in vivo, but produces hair 

perforations in vitro. RG-1 organism. 

Morphological Description: Colonies are flat, spreading, buff to pale brown, powdery 

to suede-like, with a slightly raised and folded centre and some radial grooves. Reverse 

pigment dark reddish-brown. Numerous large, very thick-walled, echinulate (rough) 

elliptical macroconidia with predominantly five to six septa but may be from two to eight 

septa. Occasional spiral hyphae may be seen. Moderate numbers of mainly slender 

clavate with some pyriform microconidia are present. 

Key Features: The macroconidia of L. cookei are quite characteristic and diagnostic; 

the thick walls and usually larger size of the macroconidia distinguish it from N. gypsea. 


Paraphyton cookei (Ajello) Gräser & de Hoog 


nutritional requirements, pinkish-buff-coloured, suede-like colony with a deep magenta 

red reverse. 

Hair Perforation Test: Positive. 

Key Features: Distinctive macroconidial morphology and culture characteristics. 




a 

b 

20 µm 

Lophophyton cookei (a) culture and (b) macroconidia.

150 


Penicillium is a very large and ubiquitous genus which currently contains 354 accepted 

species (Visagie et al. 2014). Many species are common contaminants on various 

substrates and are known as potential mycotoxin producers. Correct identification is 

therefore important when studying possible Penicillium contamination of food. Human 

pathogenic species are rare, however opportunistic infections leading to mycotic 

keratitis, otomycosis and endocarditis (following insertion of valve prosthesis) have 

been reported (Lyratzopoulos et al. 2002). Note: Penicillium marneffei and other 

subgenus Biverticillium species have been transferred to the genus Talaromyces 

(Samson et al. 2011b). 


Penicillium Link: Fries 

Morphological Description: Colonies are usually fast growing, in shades of green, 

sometimes white, mostly consisting of a dense felt of conidiophores. Microscopically, 

chains of single-celled conidia are produced in basipetal succession from a specialised 

conidiogenous cell called a phialide. The term basocatenate is often used to describe 

such chains of conidia where the youngest conidium is at the basal or proximal end of 

the chain. In Penicillium, phialides may be produced singly, in groups or from branched 

metulae, giving a brush-like appearance (a penicillus). The penicillus may contain both 

branches and metulae (penultimate branches which bear a whorl of phialides). All cells 

between the metulae and the stipes of the conidiophores are referred to as branches. 

The branching pattern may be either simple (non-branched or monoverticillate), 

one-stage branched (biverticillate-symmetrical), two-stage branched (biverticillateasymmetrical) 

or three- to more-staged branched. Conidiophores are hyaline, smooth 

or rough-walled. Phialides are usually flask-shaped, consisting of a cylindrical basal 

part and a distinct neck, or lanceolate (with a narrow basal part tapering to a somewhat 

pointed apex). Conidia are in long dry chains, divergent or in columns, are globose, 

ellipsoidal, cylindrical or fusiform, hyaline or greenish, smooth or rough-walled. Sclerotia 

are produced by some species. 

phialides 

metulae 

branches 

a b c d 

Morphological structures and types of conidiophore branching in Penicillium. 

(a) Monoverticillate; (b) Biverticillate; (c) Terverticillate; (d) Quaterverticillate 

(see Visagie et al. 2014).


Penicillium Link:Fries 

For identification, isolates are usually inoculated at three points on Czapek Dox agar 

and 2% Malt extract agar and incubated at 25 O C. Most species sporulate within 7 days. 

Microscopic mounts are best made using a cellotape flag or a slide culture preparation 

mounted in lactophenol cotton blue. A drop of alcohol is usually needed to remove 

bubbles and excess conidia (Samson et al. 1995). 

Molecular Identification: ITS and/or β-tubulin loci are recommended for identification 

of Penicillium species (Visagie et al. 2014, Yilmaz et al. 2014). 

Key Features: Hyphomycete, flask-shaped phialides arranged in groups from branched 

metulae forming a penicillus. 

References: Raper and Thom (1949), Pitt (1979), Domsch et al. (1980), McGinnis 

(1980), Onions et al. (1981), Ramirez (1982), Samson et al. (1995, 2011b), de Hoog et 

al. (2000, 2015), Visagie et al. (2014). 

a 

20 µm b 

20 µm 

(a) P. verrucosum var. cyclopium conidiophores showing two-stage branching. 

(b) P. cheresanum simple conidiophore showing chains of single-celled conidia. 

Antifungal Susceptibility: Penicillium sp. (Australian National data); MIC µg/mL. 

No. 64 

AmB 28 2 3 5 12 5 1 

VORI 26 2 4 6 3 2 8 1 

POSA 26 1 3 4 5 3 6 4 

ITRA 27 3 4 1 6 8 1 4

152 


Phaeoacremonium parasiticum (Ajello et al.) W. Gams et al. 

Synonymy: Phialophora parasiticum Ajello, Gerog & Wang. 

The genus Phaeoacremonium initially accommodated isolates with features similar to 

those seen in both Acremonium and Phialophora. It differs from the former by having 

pigmented hyphae and conidiophores and from the latter by having indistinct collarettes 

and warty conidiogenous cells (Revankar and Sutton, 2010). 

Phaeoacremonium currently consists of 46 species with P. parasiticum and P. krajdenii 

recognised as the predominant species associated with human infections (Mostert 

et al. 2005). Other species have also been isolated from clinical cases i.e. P. alvesii, 

P. amstelodamense, P. griseorubrum, P. minimum, P. rubrigenum, P. tardicrescens, 

and P. venezuelense. Infections caused by P. parasiticum include subcutaneous 

abscesses, thorn-induced arthritis, and disseminated infection (Revankar and Sutton, 

2010, Gramaje et al. 2015). 


Morphological Description: Cultures usually slow growing, suede-like with radial 

furrows, initially whitish-grey becoming olivaceous-grey with age. Hyphae hyaline, later 

becoming brown and some becoming rough-walled. Phialides are brown, thick-walled, 

slender, acular to cylindrical slightly tapering towards the tip, 15-50 μm long, often 

proliferating, with small, funnel-shaped collarettes. Conidia, often in balls, are hyaline, 

thin-walled, cylindrical to sausage-shaped, 3-6 x 1-2 μm, later inflating. Maximum 

growth temperature 40°C. 

Molecular Identification: ITS and β-tubulin sequencing (Mostert et al. 2006, Gramaje 

et al. 2015). 

Key Features: The identification of the different Phaeoacremonium species can be 

done by combining cultural, morphological and sequence data (Mostert et al. 2006, 

Gramaje et al. 2015). 

References: de Hoog et al. (2000, 2015), Revankar and Sutton (2010), Mostert et al. 

(2005, 2006), Gramaje et al. (2015), Badali et al. (2015). 

10 µm 

a 

b 

Phaeoacremonium parasiticum (a) colony and (b) a phialide 

with a small, funnel-shaped collarette.


Phaeoacremonium parasiticum (Ajello et al.) W. Gams et al. 

20 µm 

Phaeoacremonium parasiticum phialides and conidia. 

Antifungal Susceptibility: Phaeoacremonium parasiticum (Badali et al. 2015, 


No. 64 

AmB 56 1 7 13 17 13 5 

VORI 56 2 8 21 23 1 2 

POSA 53 1 5 17 23 6 1 

ITRA 56 1 3 3 1 1 47 

Antifungal Susceptibility: Phialophora verrucosa limited data (Australian National 


No. 64 

AmB 4 1 1 2 

VORI 4 1 3 

POSA 4 2 2 

ITRA 4 1 3 1 

P. verrucosa data from 25 isolates (McGinnis and Pasarell 1998a); MIC µg/mL. 

AmB Range 0.03-4; Geometric mean = 0.36 

VORI Range 0.03-0.5; Geometric mean = 0.12 

ITRA Range 0.03-0.5; Geometric mean = 0.07

154 


The genus Phialophora contains more than 40 species, most are saprophytes 

commonly found in soil or on decaying wood. Some human pathogens with phialidic 

conidiogenesis previously assigned to Phialophora have been moved to other genera, 

namely, Phaeoacremonium and Pleurostomophora. P. verrucosa, P. americana, P. 

bubakii, P. europaea and P. reptans remain of medical interest (Revankar and Sutton 

2010). Both P. verrucosa and P. americana produce their conidia from phialides with 

conspicuous darkened collarettes, however sequencing has demonstrated a close 

relatedness, suggesting that these species may be synonymous (de Hoog et al. 1999). 

P. verrucosa is primarily an agent of chromoblastomycosis although other reported 

infections include endocarditis, keratitis, and osteomyelitis. 


Phialophora verrucosa Medlar 

Morphological Description: Colonies (SDA) are slow growing, initially dome-shaped, 

later becoming flat, suede-like and olivaceous to black in colour. Phialides are flaskshaped 

or elliptical with distinctive funnel-shaped, darkly pigmented collarettes. Conidia 

are ellipsoidal, smooth-walled, hyaline, mostly 3.0-5.0 x 1.5-3.0 μm, and aggregate in 

slimy heads at the apices of the phialide. 

Key Features: Characteristic flask-shaped phialides with distinctive funnel-shaped, 

darkly pigmented collarettes. 

Molecular Identification: ITS sequencing recommended (de Hoog et al. 1999). 

References: Ellis (1971), McGinnis (1978a, 1980), Domsch et al. (1980), de Hoog et 

al. (1999, 2000, 2015), Revankar and Sutton (2010). 

20 µm 

20 µm 

Phialophora verrucosa phialides and conidia.


Members of the genus Phoma have a worldwide distribution and are ubiquitous in 

nature, with over 200 species having been described from soil, as saprophytes on 

various plants, and as pathogens to plants and humans. 


Phoma Saccardo 

Morphological Description: Colonies are spreading, greyish-brown, powdery or 

suede-like and produce large, globose, membranous to leathery, darkly pigmented, 

ostiolate pycnidia. Conidia are produced in abundance within the pycnidia on narrow 

thread-like phialides, which are hardly differentiated from the inner pycnidial wall cells. 

Conidia are globose to cylindrical, one-celled, hyaline, and are usually extruded in 

slimy masses from the apical ostiole. 

Molecular Identification: ITS, D1/D2, β-tubulin and 18S sequencing has been used 

to identify Phoma species (de Gruyter et al. 2009, Aveskamp et al. 2010). Note: Public 

sequence databases, particularly GenBank, contain many sequences from incorrectly 

identified species, making identifications of coelomycetous fungi very difficult, without 

confirmatory morphological studies. 

Key Features: Coelomycete, ostiolate pycnidia producing masses of slimy, hyaline, 

single-celled conidia. 

References: Punithalingam (1979), McGinnis (1980), Sutton (1980), Rippon (1988), 

Montel et al. (1991), Samson et al. (1995), de Hoog et al. (2000, 2015). 

20 µm 

Phoma spp. pycnidia with apical ostiole.

156 


Pichia kudriavzevii Boidin et al. 

Synonymy: Candida krusei (Castellani) Berkhout. 

Issatchenkia orientalis Kudryavtesev. 

Pichia kudriavzevii is regularly associated with some forms of infant diarrhoea 

and occasionally with systemic disease. It has also been reported to colonise the 

gastrointestinal, respiratory and urinary tracts of patients with granulocytopenia. 

Environmental isolations have been made from beer, milk products, skin, faeces of 

animals and birds. RG-2 organism. 


Microscopy: Predominantly small, elongated to ovoid blastoconidia, 2-5 x 4-5 µm. 


Dalmau Plate Culture: Abundant long, wavy, branched pseudohyphae with elongated 

to ovoid blastoconidia, budding off in verticillate branches. 






Glucose + Maltose - D-Ribose - D-Gluconate - 







Glucose + Soluble Starch - Galactitol - 0.1% Cycloheximide v 


Key Features: Germ tube negative yeast and sugar assimilation pattern. Colonies 

pale pink on Candida CHROMagar. 

Antifungal Susceptibility: P. kudriavzevii (Australian National data); MIC µg/mL. 


Note: P. kudriavzevii is intrinsically resistant to fluconazole (No CLSI breakpoints). 

No. 64 

AmB 152 1 2 25 41 61 18 4 

FLU 152 1 9 45 77 

VORI 135 5 16 62 40 7 3 2 

POSA 115 1 8 18 49 30 6 1 2 

ITRA 152 1 3 16 73 47 10 2 

ANID 86 5 35 26 19 1 

MICA 86 1 0 32 34 19 

CAS 115 1 15 55 29 13 1 1 

5FC 152 3 2 5 15 92 33 2


Synonymy: Candida norvegensis Dietrichson ex van Uden & Buckley. 

Pichia norvegensis is a very rare clinical isolate that has been reported as a causative 

agent of peritonitis and disseminated candidiasis in a patient on CAPD. 


Pichia norvegensis Leask & Yarrow 


Microscopy: Ovoid to ellipsoid, budding blastoconidia, 2.0-4 x 3-10 µm. 


Dalmau Plate Culture: Spherical to ovoid budding yeast cells only. Abundant 

pseudohyphae produced. 






Glucose s Maltose - D-Ribose - D-Gluconate - 

Galactose - Cellobiose + L-Rhamnose - DL-Lactate w 









Antifungal Susceptibility: P. norvegensis very limited data (Guitard et al. 2013, 


No. 64 

AmB 8 1 6 1 

FLU 8 1 2 1 4 

VORI 5 2 1 2 

POSA 5 2 3 

ITRA 7 1 4 1 1 

ANID 1 1 

MICA 1 1 

CAS 4 2 2 

5FC 5 1 1 1 1 1

158 


The genus Pithomyces contains about 50 species commonly isolated from a wide range 

of plant material, also from air, soil, hay, sawn timber and ceiling plaster. Pithomyces 

chartarum has long been reported as causing facial eczema in sheep. However, recent 

molecular studies have identified at least two additional species P. sacchari and P. 

maydicus (de Cunha et al. 2014). Most human isolates are recovered from skin, nail, 

respiratory and sinus specimens. 


Pithomyces chartarum (Berk. & M.A. Curtis) M.B. Ellis 

Morphological Description: Colonies are fast growing, suede-like to downy 

and black. Conidiophores are pale olive, smooth or verrucose, 2.5-10 x 2-3.5 µm. 

Conidiogenous cells integrated, intercalary or terminal, indeterminate, with one to two 

loci of similar width in the conidiogenous cells. Conidia are muriform, medium to dark 

brown, echinulate to verrucose, three-(some up to five)-euseptate, slightly constricted 

at the septa, with one or both median cells divided by longitudinal septa, thick-walled, 

broadly ellipsoidal, apex obtuse, base truncate and characteristically with part of the 

conidiogenous cell remaining attached as a small pedicel, 18-29 x 10-17 µm. 

Key Features: Dematiaceous hyphomycete with multicelled conidia produced on 

small peg-like branches of the vegetative hyphae. 

Molecular Identification: ITS and D1/D2 sequencing recommended (de Cunha et al. 

2014). 

References: Ellis (1971, 1976), Domsch et al. (1980), Rippon (1988), de Hoog et al. 

(2000, 2015), de Cunha et al. (2014). 

15 µm 

Pithomyces chartarum conidiophores and conidia.


Pleurostomophora richardsiae (Nannf.) Mostert et al. 

Synonymy: Phialophora richardsiae (Nannf.) Conant. 

Vijaykrishna et al. (2004) separated Pleurostomophora richardsiae from Phialophora 

based on molecular data. P. richardsiae is a soft rot fungus of wood and is an 

uncommon cause of human infection, usually through traumatic implantation causing 

subcutaneous phaeohyphomycosis. RG-2 organism. 

Morphological Description: Colonies grow rapidly, and are powdery to woolly or 

tufted, greyish-brown with a grey-brown to olivaceous-black reverse. Two conidial 

types are produced: (1) hyaline conidia which are allantoid or cylindrical, 3-6 x 1.5-2.5 

μm in size, formed on inconspicuous, peg-like phialides on thin-walled hyphae; and 

(2) brown, thick-walled conidia which are spherical to subspherical, 2.5-3.5 x 2-3 μm, 

formed on dark brown, slender, tapering phialides with flaring collarettes. 

Key Features: P. richardsiae is characterised microscopically by phialides with 

prominent flaring collarettes bearing globose, brown conidia while phialides with 

indistinct collarettes bear pale allantoid to cylindrical conidia. 

Molecular Identification: ITS sequencing is recommended (Vijaykrishna et al. 2004). 

References: Ellis (1971), McGinnis (1978a, 1980), Domsch et al. (1980), de Hoog et 

al. (2000, 2015), Vijaykrishna et al. (2004), Revankar and Sutton (2010). 

2 

10 µm 

1 

10 µm 

Pleurostomophora richardsiae phialides producing two types of conidia. 

(1) hyaline conidia, and (2) brown, thick-walled conidia (arrows). 

Antifungal Susceptibility: Pleurostomophora richardsiae limited data (Australian 


No. 64 

AmB 7 1 1 4 1 

VORI 7 3 4 

POSA 5 1 2 2 

ITRA 7 2 3 2 1 

P. richardsiae data from 11 isolates (McGinnis and Pasarell 1998a); MIC µg/mL. 

AmB Range 0.125-1; Geometric mean = 0.73 

VORI Range 0.25-2; Geometric mean = 0.64 

ITRA Range 0.03-2; Geometric mean = 0.44

160 


Prototheca species are achlorophyllous algae with phylogenetic affinities to the genus 

Chlorella. To date only P. wickerhamii and P. zopfii have been involved in human or 

animal infections (Lass-Florl and Mayr 2007). 


Prototheca Kruger 

Morphological Description: Colonies are smooth, moist, white to cream and yeastlike. 

Cultures are sensitive to cycloheximide (actidione) and optimal growth occurs 

at 25-30 O C. Mycelium and conidia are absent. Vegetative cells are globose to ovoid, 

hyaline, varying in size from approximately 3-30 µm, and have a relatively thick and 

highly refractile wall. No budding cells are present; reproduction is by the development 

of large sporangia (theca) which contain from 2-20 or more small sporangiospores 

(endospores or autospores) which are asexually produced by nuclear division and 

cleavage of the cytoplasm. 

Molecular Identification: ITS and D1/D2 sequencing is recommended (Wang et al. 

2014). 

Key Features: Achlorophyllous algae reproducing by sporangia (theca) and 

sporangiospores (autospores). Prototheca species which can be differentiated by 

assimilation tests and morphological criteria as outlined below. The API 20C yeast 

identification strip may be used for species identification. 

References: Kaplan (1977), McGinnis (1980), Rippon (1988), Pore (1985), Ueno et al. 

(2005), Lass-Florl and Mayr (2007), Wang et al. (2014). 

Colony morphology 

P. wickerhamii P. zopfii P. stagnora 

Hemispheric, with 

smooth margin 

Flat, rough, 

corrugated margin 

Flat, with smooth 

margin 

Cell diameter μm 3-10 7-30 7-14 

Growth at 37 O C + + - 

Glucose + + + 

Trehalose + - - 

L-propanol - + +/- 

Acetate (pH 5) - + +/- 

Galactose + - + 

Capsule - - + 

5 µm 

Prototheca wickerhamii thecae and autospores.


Prototheca Kruger 

Antifungal Susceptibility: P. wickerhamii (Australian National data); MIC µg/mL. 

No. 64 

AmB 9 3 3 2 1 

VORI 7 2 4 1 

POSA 7 1 2 4 

ITRA 9 2 5 2 

Purpureocillium lilacinum (Thom) Luangsa-ard et al. 

Synonymy: Paecilomyces lilacinus (Thom) Samson. 

Purpureocillium lilacinum is commonly isolated from soil, decaying vegetation, insects, 

nematodes and as a laboratory contaminant. It is also a causative agent of infection in 

human and other vertebrates (Luangsa-ard et al. 2011). 


Morphological Description: Colonies are fast growing, suede-like to floccose, 

vinaceous to violet-coloured. Conidiophores are erect 400-600 µm in length, bearing 

branches with densely clustered phialides. Conidiophore stipes are 3-4 µm wide, yellow 

to purple and rough-walled. Phialides are swollen at their bases, gradually tapering into 

a slender neck. Conidia are ellipsoidal to fusiform, smooth-walled to slightly roughened, 

hyaline to purple in mass, 2.5-3.0 x 2-2.2 µm, and are produced in divergent chains. 

Chlamydospores are absent. Growth at 38 O C. 

Molecular Identification: ITS sequencing is recommended (Atkins et al. 2005, 

Luangsa-ard et al. 2011). 

Key Features: Colony pigmentation, phialides with swollen bases, pigmented and 

rough-walled conidiophore stipes, absence of chlamydospores and growth at 37 O C. 

Note: Paecilomyces marquandii differs by having a yellow reverse pigment, smooth 

conidiophore stipes, presence of chlamydospores, and no growth at 37 O C. 

References: Samson (1974), Domsch et al. (1980), McGinnis (1980), Onions et al. 

(1981), Rippon (1988), de Hoog et al. (2000, 2015), Perdomo et al. (2013). 

Antifungal Susceptibility: P. lilacinum (Australian National data); MIC µg/mL. 

No. 16 

AmB 52 1 1 6 6 24 14 

VORI 50 8 30 9 1 2 

POSA 37 2 7 4 23 1 

ITRA 53 5 13 18 2 7 2 6

162 


Purpureocillium lilacinum (Thom) Luangsa-ard et al. 

a 

b 

10 µm b 

10 µm 

Purpureocillium lilacinum (a) culture and (b) conidiophores, 

phialides and conidia. Note: Rough-walled conidiophore (arrow).


Quambalaria cyanescens 

Synonymy: Sporothrix cyanescens de Hoog & de Vries. 

Cerinosterus cyanescens (de Hoog & de Vries) R.T. Moore 

The genus Quambalaria contains five species, including Q. cyanescens, Q. pitereka, 

Q. eucalypti, Q. coyrecup and Q. simpsonii. Q. cyanescens is a hyaline basidiomycete 

isolated from a broad range of ecological niches, including air, soil, and insect larvae as 

well as in association with diverse plant sources, including Corymbia and Eucalyptus 

species from Australia. Q. cyanescens appears to be an emerging opportunistic 

pathogen in immunocompromised or debilitated individuals. It has been isolated from 

human skin and subcutaneous infections, blood, nosocomial infections in patients with 

pneumonia, peritonitis and invasive pulmonary infection (Jackson et al. 1990, Tambini 

et al. 1996, Schmidt et al. 2000, Kuan et al. 2015). 


Morphological Description: Colonies are restricted, farinose or velvety, often compact 

and somewhat cerebriform, snow-white, and later often exuding a pH-dependent, deep 

blue/violet pigment into the agar. Conidiogenous cells are undifferentiated, cylindrical, 

of variable size (1.5-3.0 µm wide), apically with a cluster of small denticles, the cluster 

often repeatedly proliferating and forming similar clusters. Conidia are hyaline, smoothwalled 

or finely verrucose, obovoidal, 3-4 µm long, somewhat larger (3.5-6.5 µm long) 

when bearing secondary conidia. 

Molecular Identification: ITS and D1/D2 sequencing recommended. 

Key Features: Q. cyanescens is similar to Sporothrix, but the conidial scars are 

very small and cultures are thin and fragile. In fresh cultures the diffusible pigment 

is characteristic. Sporothrix schenckii forms tough colonies, which finally become 

blackish-brown. 

References: de Hoog and de Vries (1973), de Beer et al. (2006), Simpson (2000), de 


b 

b 

a 

b 

10 µm 

b 

c 

Quambalaria cyanescens (a) culture, (b) conidiogenous cells with small 

denticles and conidia, and (c) mature conidium bearing secondary conidia.

164 


Rhinocladiella Nannfeldt 

Rhinocladiella contains six to eight species, with five species of medical interest; 

R. aquaspersa, R. atrovirens, R. basitona, R. mackenziei (formerly Ramichloridium 

mackenziei) and R. similis. R. mackenziei is a frequently fatal neurotropic organism 

and appears to be restricted to individuals residing in, or immigrating from, Middle 

Eastern countries (Revankar and Sutton 2010). 


Rhinocladiella atrovirens Nannfeldt 

Morphological Description: Colonies are restricted, velvety or lanose, olivaceous, 

often slightly mucoid at the centre; reverse dark olivaceous green to blackish. 

Conidiophores are short, brown, thick-walled. Conidiogenous cells are cylindrical, 

intercalary or free, 9-19 x 1.6-2.2 µm; denticulate rachis up to 15 µm long, with 

crowded, flat or butt-shaped, unpigmented conidial denticles. Conidia are hyaline, thinand 

smooth-walled, short-cylindrical, with truncate basal scars, 3.7-5.5 x 1.2-1.8 µm. 

Budding cells, if present, are hyaline, thin-walled, broadly ellipsoidal, 3.0-4.3 x 1.7-2.5 

µm. Germinating cells are inflated, spherical to subspherical, 4.5-6.0 µm. An annellidic 

Exophiala synanamorph may be present. 


identification (Taj-Aldeen et al. 2010). 

References: de Hoog (1977, 1983), Schell et al. (1983), de Hoog et al. (2000, 2015). 

a 

c 

10 µm 10 µm b b 10 µm 

Rhinocladiella atrovirens (a) culture, (b) conidiophores showing a terminal 

denticulate rachis with conidia, and (c) budding yeast cells.


Rhinocladiella Nannfeldt 

Antifungal Susceptibility: Rhinocladiella atrovirens very limited data (McGinnis 

and Pasarell 1998a); MIC µg/mL. 

Antifungal Range Antifungal Range Antifungal Range 

AmB 0.03-0.25 ITRA 0.03-0.06 VORI 0.03-0.5 

Rhinocladiella mackenziei (Campbell & Al-Hedaithy) Arzanlou & Crous 

WARNING: RG-3 organism. Cultures of R. mackenziei represent a potential biohazard 

to laboratory personnel and must be handled with extreme caution in a Class II Biological 

Safety Cabinet (BSCII). 

R. mackenziei is an extremely rare, neurotropic organism that causes fatal brain 

lesions, mostly in patients who are immunocompromised or suffered from underlying 

metabolic diseases. The species is typically restricted to the Middle East, in an arid 

zone between Israel and Pakistan (Kanj et al. 2001, Khan et al. 2002, Taj-Aldeen et al. 

2010), with a single autochtonous case in India (Badali et al. 2010). Cases in the USA 

and Europe invariably were found in patients originating from the Middle East (Sutton 

et al. 1998, Revankar and Sutton 2010, de Hoog et al. 2015). 

Morphological Description: Colonies growing moderately rapidly, velvety, olivaceousbrown. 

Conidiophores arising at right angles from creeping hyphae, stout, thick-walled, 

brown, 3.0-4.5 µm wide, 10-25 µm long, apically with short-cylindrical denticles. Conidia 

brown, ellipsoidal, 8.5-12.0 × 4-5 µm, with a prominent, wide basal scar. 

Molecular Identification: ITS and D1/D2 sequencing is recommended for accurate 

species identification (Taj-Aldeen et al. 2010). 

References: de Hoog (1977, 1983), Schell et al. (1983), de Hoog et al. (2000, 2015), 

Taj-Aldeen et al. (2010), Revankar and Sutton (2010). 

Antifungal Susceptibility: R. mackenziei very limited data compiled from six case 

reports (Taj-Aldeen et al. 2010); MIC µg/mL. 

No. 32 

AmB 7 1 3 2 1 

VORI 3 1 1 1 

POSA 5 2 2 1 

ITRA 7 5 1 1

166 


The genus Rhizomucor is distinguished from Mucor by the presence of stolons and 

poorly developed rhizoids at the base of the sporangiophores and by the thermophilic 

nature of its two species: R. miehei and R. pusillus. Both of these species are potential 

human and animal pathogens and were originally classified in the genus Mucor. 

Rhizomucor pusillus is cosmopolitan and both R. miehei and R. pusillus have been 

reported as pathogens to humans and animals, the latter to a greater extent. 

References: Cooney and Emerson (1964), Schipper (1978), Domsch et al. (1980), 

McGinnis (1980), Ellis and Keane (1981), Scholer et al. (1983), de Hoog et al. (2000, 

2015), Schipper and Stalpers (2003) and Ellis (2005b). 

Identification of most Mucorales is based primarily on the morphology of the sporangia; 

i.e. arrangement and number of sporangiospores, shape, colour, presence or absence 

of columellae and apophyses, as well as the arrangement of the sporangiophores and 

the presence or absence of rhizoids. Growth temperature tests can also be especially 

helpful in identifying and differentiating members of the genera Rhizomucor, Rhizopus 

and Lichtheimia. 

Rhizomucor miehei (Cooney and Emerson) Schipper 

Synonymy: Mucor miehei Lindt. 

This species has been reported as a rare cause of bovine mastitis (Scholer et al. 1983) 

and is similar in many respects to R. pusillus. 


Rhizomucor Lucet & Costantin 

Morphological Description: All strains are homothallic forming numerous zygospores, 

which are reddish-brown to blackish-brown, globose to slightly compressed, up to 50 

µm in diameter, with stellate warts and equal suspensor cells. Colony colour is a dirty 

grey rather than brown, and sporangia have spiny walls, are up to 50-60 µm in diameter, 

with columellae rarely larger than 30 µm in diameter. Growth is stimulated by thiamine, 

with no assimilation of sucrose and maximum growth temperature is 54-58 O C. 

Key Features: Growth at 45 O C, the formation of numerous zygospores, a dirty grey 

culture colour and a partial growth requirement for thiamine. 

Synonymy: Mucor pusillus Lindt. 

Rhizomucor pusillus (Lindt) Schipper 

This species is a rare human pathogen. It has been reported from cases of pulmonary, 

disseminated and cutaneous types of infection. It is more often associated with animal 

disease, especially bovine abortion. Rhizomucor pusillus has a worldwide distribution 

and is commonly associated with compost heaps.



Rhizomucor pusillus (Lindt) Schipper 

Morphological Description: Cultures are characterised by compact, low growing 

(2-3 mm high), grey to greyish brown-coloured mycelium and by the development of 

typical sympodially branched, hyaline to yellow-brown sporangiophores (8-15 μm in 

diameter), always with a septum below the sporangium. Sporangia are globose (40-60 

µm in diameter), each possessing an oval or pear-shaped columella (20-30 µm), often 

with a collarette. Sporangiospores are hyaline, smooth-walled, globose to subglobose, 

occasionally oval (3-5 µm), and are often mixed with crystalline remnants of the 

sporangial wall. Chlamydospores are absent. Zygospores are rough-walled, reddish 

brown to black, 45-65 µm in diameter and may be produced throughout the aerial 

hyphae in matings between compatible isolates. Temperature growth range: minimum 

20-27 O C; optimum 35-55 O C; maximum 55 O C. There is positive assimilation of sucrose 

and no thiamine dependence. 

Key Features: Mucorales, growth at 45 O C (thermophilic), poorly developed stolons 

and rhizoids, branching sporangiophores with a septum below the sporangium, darkcoloured 

sporangia without apophyses and smooth-walled globose to subglobose 

sporangiospores. 

20 µm 

b 

a 

15 µm 

Rhizomucor pusillus (a) sporangiophores, collumellae and (b) primitive rhizoids. 

Antifungal Susceptibility: R. pusillus (Espinel-Ingroff et al. 2015a, Australian 


No. 32 

AmB 36 3 8 9 12 1 2 1 

POSA 36 1 5 11 11 7 1 

ITRA 18 3 6 4 3 1 1

168 


Rhizopus Ehrenberg ex Corda. 

A molecular phylogenetic study of the genus Rhizopus by Abe et al. (2010) recognised 

eight species; R. caespitosus, R. delemar, R. homothallicus, R. microsporus, R. arrhizus 

(R. oryzae), R. reflexus, R. schipperae and R. stolonifer. Based on these results and 

confirmed by Dolatabadi et al. (2014) the previous varieties of Rhizopus microsporus 

(R. microsporus var. oligosporus and R. microsporus var. rhizopodiformis) have been 

reduced to synonyms. In addition, R. azygosporus has been reduced to a synonym of 

R. microsporus. Finally, the controversy surrounding which species name to use for 

R. oryzae - R. arrhizus has been resolved in favour of the latter (Ellis 1985, de Hoog 

et al. 2015). Thus the important medical pathogens have now been reduced to just 

R. arrhizus and R. microsporus. These two species are the most common causative 

agents of mucormycosis, accounting for some 60% of the reported cases. 

Morphological Description: The genus Rhizopus is characterised by the presence of 

stolons and pigmented rhizoids, the formation of sporangiophores, singly or in groups 

from nodes directly above the rhizoids, and apophysate, columellate, multispored, 

generally globose sporangia. After spore release the apophyses and columella often 

collapse to form an umbrella-like structure. Sporangiospores are globose to ovoid, 

one-celled, hyaline to brown and striate in many species. Colonies are fast growing 

and cover an agar surface with a dense cottony growth that is at first white becoming 

grey or yellowish brown with sporulation. 

Molecular Identification: ITS sequencing is recommended but sequences must be 

compared to those of quality controlled reference strains with updated species names. 

(Alvarez et al. 2009 and Abe et al. 2010). 

References: Domsch et al. (1980), McGinnis (1980), Onions et al. (1981), Scholer 

et al. (1983), Schipper (1984), Schipper and Stalpers (1984, 2003), Yuan and Jong 

(1984), Ellis (1985, 1986), Rippon (1988), Kwon-Chung and Bennett (1992), Samson 

et al. (1995), Schipper et al. (1996), de Hoog et al. (2000, 2015), Ellis (2005b), Alvarez 

et al. (2009), Abe et al. (2010), Dolatabadi et al. (2014). 

Antifungal Susceptibility: R. arrhizus (Espinel-Ingroff et al. 2015a, Australian 


No. 32 

AmB 280 1 7 21 30 67 112 39 3 

POSA 370 1 5 14 84 161 65 29 4 4 2 

ITRA 238 5 9 42 93 41 34 2 4 9 

Antifungal Susceptibility: R. microsporus (Espinel-Ingroff et al. 2015a, Australian 


No. 32 

AmB 189 2 23 22 95 72 22 5 

POSA 180 3 12 34 60 21 4 1 2 

ITRA 117 1 1 8 27 39 24 3 1 13


Synonymy: Rhizopus oryzae Went & Prinsen Geerligs. 


Rhizopus arrhizus Fischer 

Morphological Description: Colonies are very fast growing, about 5-8 mm high, 

with some tendency to collapse, white cottony at first becoming brownish grey to 

blackish-grey depending on the amount of sporulation. Sporangiophores up to 1500 

µm in length and 18 µm in width, smooth-walled, non-septate, simple or branched, 

arising from stolons opposite rhizoids usually in groups of three or more. Sporangia are 

globose, often with a flattened base, greyish black, powdery in appearance, up to 175 

µm in diameter and many spored. Columellae and apophysis together are globose, 

subglobose or oval, up to 130 µm in height collapsing to an umbrella-like form after 

spore release. Sporangiospores are angular, subglobose to ellipsoidal, with striations 

on the surface, and up to 8 µm in length. No growth at 45 O C; good growth at 40 O C. 

a 

b 

20 µm 

c 

100 µm 

Rhizopus arrhizus (a) culture, (b) columellae and (c) sporangia 

showing sporangiospores, sporangiophores and rhizoids.

170 


Rhizopus microsporus v. Tiegh 

Synonymy: Rhizopus azygosporus Yuan & Jong. 

Rhizopus microsporus var. microsporus Tiegh. 

Rhizopus microsporus var. oligosporus (Saito) Schipper & Stalpers. 

Rhizopus microsporus var. rhizopodiformis (Cohn) Schipper & Stalpes. 

Rhizopus microsporus var. chinensis (Saito) Schipper & Stalpers. 


Morphological Description: Colonies are dark greyish-brown, up to 10 mm high 

producing simple rhizoids. Sporangiophores are brownish, up to 400 µm high and 10 

µm wide, and may be produced in groups of one to four, usually in pairs. Sporangia 

are greyish-black, spherical, up to 100 µm in diameter. Columellae are subglobose to 

globose to conical comprising 80% of the sporangium. Sporangiospores are angular 

to broadly ellipsoidal or subglobose, up to 5-9 µm in length and are distinctly striate. 

Chlamydospores may be present. Zygospores are dark red–brown, spherical, up 

to 100 µm in diameter, with stellate projections and unequal suspensor cells. Some 

strains may be homothallic and produce azygospores. There is good growth at 45 O C, 

with a maximum of 50-52 O C. 

30 µm 

Rhizopus microsporus sporangia showing sporangiospores, 

columellae, sporangiophores and rhizoids.


Rhodotorula Harrison 

Rhodotorula species are common environmental basidiomycetous yeasts, which can 

be found in soil, ocean and lake water, fruit juice and milk, and on shower curtains 

and toothbrushes. Today, the genus contains 46 species of which three have been 

described as rare human pathogens: R. mucilaginosa (formerly known as R. rubra), R. 

glutinis and R. minuta (Arendrup et al. 2014). 

Rhodotorula mucilaginosa is a common airborne contaminant of skin, lungs, urine and 

faeces. R. mucilaginosa is a known cause of fungal peritonitis in patients on continuous 

ambulatory peritoneal dialysis (CAPD). This is usually due to saprophytic colonisation 

of catheters or dialysis machinery and removal of the source of contamination usually 

leads to clearing of the symptoms. This species accounts for the majority of the 

infections (74–79%) followed by R. glutinis (7.7%) (Tuon and Costa 2008, Arendrup et 

al. 2014). 

Molecular Identification: In many clinical cases species identification requires ITS 

and/or D1/D2 sequencing (Duboc de Almeida et al. 2008, Tuon and Costa 2008, 

Arendrup et al. 2014). 

MALDI-TOF MS: reliably identifies clinically relevant Rhodotorula spp. 

References: McGinnis (1980), Barnett et al. (1983), Kreger-Van Rij (1984), Rippon 

(1988), Kurtzman and Fell (1988), de Hoog et al. (2000, 2015), Spiliopoulou et al. 

(2012), Duboc de Almeida et al. (2008), Tuon and Costa (2008), Arendrup et al. (2014). 

Rhodotorula mucilaginosa culture.

172 



Rhodotorula glutinis (Fresenius) Harrison 

Morphological Description: Colonies are coral red to salmon-coloured or slightly 

orange, smooth to wrinkled, highly glossy to semi-glossy. Mucoid to pasty to slightly 

tough, yeast-like colonies. Ovoidal to globose or more elongate budding yeast-like 

cells or blastoconidia, 2.3-5.0 x 4.0-10 µm. 

India Ink Preparation: Small capsules present. 

Molecular Identification: Requires sequencing of the ITS and/or D1/D2 regions. 

Key Features: Germ tube negative yeast and sugar assimilation pattern. Common 

saprophyte however cases of fungaemia have been reported. 

Physiological Tests: + Positive, - Negative, v Variable, w Weak, s Slow, nd No data 


Fermentation Sucrose + D-Arabinose v α-M-D-glucoside 


Galactose - Cellobiose v L-Rhamnose v DL-Lactate v 


Maltose - Lactose - N-A-D-glucosamine - 2-K-D-gluconate nd 

Lactose - Melibiose - Glycerol v D-Glucuronate nd 

Trehalose - Raffinose v Erythritol - Nitrate - 


Glucose + Soluble Starch - Galactitol v 0.1% Cycloheximide v 

Galactose v D-Xylose v D-Mannitol v Growth at 37 O C v 

Antifungal Susceptibility: R. glutinis (Diekema et al. 2005, Australian National 

data); MIC µg/mL. Note: Rhodotorula species are intrinsically resistant to azoles 

and echinocandins (Arendrup et al. 2014). 

No. 64 

AmB 38 1 2 4 3 28 

FLU 38 38 

VORI 36 1 1 12 12 9 1 

POSA 34 2 9 18 4 1 

ITRA 38 1 1 3 9 11 2 3 8 

5FC 38 17 12 8 1


Rhodotorula mucilaginosa (Jorgensen) Harrison 

Synonymy: Rhodotorula rubra (Demme) Lodder. 


Morphological Description: Colonies are coral pink, usually smooth, sometimes 

reticulate, rugose or corrugated, moist to mucoid, yeast-like colonies. Spherical to 

elongate budding yeast-like cells or blastoconidia, 2.5-6.5 x 6.5-14.0 µm. 

India Ink Preparation: Small capsules present. 

Molecular Identification: Requires sequencing of the ITS and/or D1/D2 regions. 

Key Features: Germ tube negative yeast and sugar assimilation pattern. Common 

saprophyte however cases of peritonitis and fungaemia have been reported. 



Fermentation Sucrose + D-Arabinose v α-M-D-glucoside 

Glucose - Maltose v D-Ribose v D-Gluconate + 

Galactose - Cellobiose v L-Rhamnose v DL-Lactate v 

Sucrose - Trehalose + D-Glucosamine v myo-Inositol - 

Maltose - Lactose - N-A-D-glucosamine - 2-K-D-gluconate nd 

Lactose - Melibiose - Glycerol v D-Glucuronate nd 

Trehalose - Raffinose + Erythritol v Nitrate - 

Assimilation Melezitose v Ribitol v Urease + 

Glucose + Soluble Starch - Galactitol v 0.1% Cycloheximide - 

Galactose v D-Xylose + D-Mannitol v Growth at 40 O C + 

Antifungal Susceptibility: R. mucilaginosa (Diekema et al. 2005, Australian 

National data); MIC µg/mL. Note: Rhodotorula species are intrinsically resistant to 

azoles and echinocandins (Arendrup et al. 2014). 

No. 64 

AmB 39 4 4 5 25 1 

FLU 39 39 

VORI 37 2 3 6 11 10 4 1 

POSA 37 1 3 8 17 2 2 4 

ITRA 39 3 8 15 4 1 2 6 

5FC 39 1 14 12 11 1

174 


Saccharomyces cerevisiae Meyen ex Hansen 

Synonomy: Candida robusta Diddens & Lodder 

Saccharomyces cerevisiae, commonly known as Baker’s yeast, may be found as a 

harmless and transient digestive commensal and coloniser of mucosal surfaces of 

normal individuals. The anamorphic state of S. cerevisiae is sometimes referred to as 

Candida robusta. This species is phylogenetically closely related to Candida glabrata 

and shares many clinical and microbiological characteristics to this species (Arendrup 

et al. 2014). S. cerevisiae may be involved in mucosal infections like vaginitis, 

and in bloodstream infections, particularly in fluconazole-exposed patients. Note: 

Saccharomyces boulardii, a genetically similar subtype that is used as a probiotic 

for prevention and treatment of various sorts of diarrhoea and recurrent Clostridium 

difficile-associated diarrhoea should be avoided in immunocompromised hosts 

(Enache-Angoulvant and Hennequin 2005, Arendrup et al. 2014). RG-1 organism. 

Morphological Description: Colonies are white to cream, smooth, glabrous and 

yeast-like. Large globose to ellipsoidal budding yeast-like cells or blastoconidia, 3.0- 

10.0 x 4.5-21.0 µm. No capsules present on India Ink preparation. 

Physiological Tests: + Positive, - Negative, v Variable, w Weak, s Slow, nd No data 


Fermentation Sucrose + D-Arabinose - M-D-glucoside 

Glucose + Maltose + D-Ribose - D-Gluconate - 

Galactose v Cellobiose - L-Rhamnose - DL-Lactate v 


Maltose v Lactose - N-A-D-glucosamine - 2-K-D-gluconate nd 

Lactose - Melibiose v Glycerol - D-Glucuronate nd 

Trehalose - Raffinose + Erythritol - Nitrate - 

Assimilation Melezitose v Ribitol - Urease - 


Galactose v D-Xylose - D-Mannitol - Growth at 37 O C v 

Molecular Identification: ITS and/or D1/D2 sequencing is recommended (McCullough 

et al. 1988). 

References: McGinnis (1980), Barnett et al. (1983), Kreger-Van Rij (1984), Rippon 

(1988), Kurtzman and Fell (1988), de Hoog et al. (2000, 2015). 

Antifungal Susceptibility: S. cerevisiae (Australian National data); MIC µg/mL. 

No. 64 

AmB 41 1 1 8 14 11 6 

FLU 42 3 2 4 6 5 12 10 

VORI 38 5 8 7 8 8 2 

POSA 35 1 2 4 10 11 5 2 

ITRA 42 2 6 9 10 10 1 1 3 

ANID 32 3 3 17 6 3 

MICA 32 1 21 9 1 

CAS 36 2 3 11 14 5 1 

5FC 42 7 32 1 1 1


Saksenaea vasiformis Complex 

The genus Saksenaea is characterised by the formation of flask-shaped sporangia with 

columellae and simple, darkly pigmented rhizoids. It is an emerging human pathogen 

(Holland, 1997) that is most often associated with cutaneous or subcutaneous lesions 

after trauma. Until recently, Saksenaea vasiformis was the only known species with a 

worldwide distribution in association with soil. However S. vasiformis has recently been 

split into three species; S. vasiformis, S erythrospora and S. oblongispora (Alvarez et 

al. 2010b). All three species have been isolated from clinical samples, but as yet no 

proven case reports have been published on the new species (de Hoog et al. 2015). 

Saksenaea vasiformis Saksena 

Morphological Description: Colonies are fast growing, downy, white with no reverse 

pigment, and made up of broad, non-septate hyphae typical of a mucormycetous 

fungus. Sporangia are typically flask-shaped with a distinct spherical venter and longneck, 

arising singly or in pairs from dichotomously branched, darkly pigmented rhizoids. 

Collumellae are prominent and dome-shaped. Sporangiospores are small, oblong, 1-2 

x 3-4 µm, and are discharged through the neck following the dissolution of an apical 

mucilaginous plug. RG-2 organism. 

Key Features: Mucorales, unique flask-shaped sporangia, failure to sporulate on 

primary isolation media. 

Molecular Identification: ITS sequencing is required for differentiation of species 

within the complex, and may be necessary to achieve identification in a timely manner 

(Alvarez et al. 2010b, Walther et al. 2012, Halliday et al. 2015). 

Comment: Laboratory identification of this fungus may be difficult or delayed because of 

the mould’s failure to sporulate on primary isolation media or on subsequent subculture 

onto potato dextrose agar. Sporulation may be stimulated by using the agar block 

method described by Ellis and Ajello (1982), Ellis and Kaminski (1985) and Padhye 

and Ajello (1988), although this may still take a period of days to weeks. Failure to 

sporulate prohibits antifungal susceptibility testing. 

The agar block method to induce sporulation 

of Saksenaea spp. and Apophysomyces 

spp. 

A small block of agar is cut from a well 

established culture grown on PDA and is 

placed in the centre of petri dish containing 

1% agar in distilled water. After 21 days 

at 26 O C sporangia might be formed at the 

periphery of the petri dish. 

Antifungal Susceptibility: S. vasiformis very limited data, due to poor sporulation 

(Sun et al. 2002 and Australian national data); MIC µg/mL. 



AmB 0.125-2 2 POSA 0.016-0.25 0.25 

ITRA 0.016-0.03 0.03 VORI 0.5-4 4

176 


Saksenaea vasiformis Saksena 

15 µm 

Saksenaea vasiformis showing a typically flask-shaped sporangium. 

References: Saksena (1953), Ellis and Hesseltine (1966), Ajello et al. (1976), Ellis and 

Ajello (1982), Ellis and Kaminski (1985), Pritchard et al. (1986), Padhye et al. (1988), 

Padhye and Ajello (1988), Goldschmied-Reouven et al. (1989), de Hoog et al. (2000) 

and Ellis (2005b).


Saprochaete clavata (de Hoog et al.) de Hoog & M.Th. Smith 

Synonmy: Geotrichum clavatum de Hoog, M.Th. Smith & Guého. 

Saprochaete clavata (formerly known as Geotrichum clavatum), which is also closely 

related to Magnusiomyces capitatus (formerly known as Geotrichum capitatum or 

Saprochaeta capitata), has only very infrequently been described as involved in invasive 

human infection. However, an outbreak of invasive infections caused by Saprochaete 

clavata in haematology patients has been reported (Vaux et al. 2013). 


Morphological Description: Colonies are moderately fast growing, flat, whitish and 

butyrous. True hyphae are abundant, soon breaking up into rectangular arthroconidia 

of variable size, 2.8-4 3 x 6-20 μm. Sympodial conidiogenesis is occasionally present. 

Terminal parts of hyphae may swell and become thick-walled. 

Note: Saprochaete clavata and Magnusiomyces capitatus are human pathogens that 

are closely related and are frequently mistaken for each other. 


identification. 

MALDI-TOF MS: reliably identifies S. clavata, M. capitatus and Geotrichum candidum 

to the species level (Desnos-Ollivier et al. 2014). 


Germ Tube - L-Sorbose + L-Arabinose - D-Glucitol - 

Fermentation Sucrose - D-Arabinose - M-D-glucoside - 


Galactose - Cellobiose + L-Rhamnose - DL-Lactate +,w 







Galactose + D-Xylose - D-Mannitol - Growth at 37 O C + 

Antifungal Susceptibility: Saprochaete clavata (Vaux et al. 2013); MIC µg/mL. 

Note: S. clavata is intrinsically resistant to echinocandins. 

Antifungal Range Median Antifungal Range Median 

AmB 0.125-1 0.5 POSA 0.125-1 0.5 

5FC

178 


Sarocladium W. Gams & D. Hawksw. 

Based on a recent molecular phylogenetic study the taxonomy of Acremonium was 

reviewed and some medically important species have been transferred to Sarocladium; 

i.e. S. kiliense (formerly A. kiliense) and S. strictum (formerly A. strictum). Although these 

genera are morphologically similar they are phylogenetically distant. Sarocladium can 

be morphologically differentiated from Acremonium by its elongated phialides rising 

solitary on vegetative hyphae or on conidiophores that are sparsely or repeatedly 

branched, the production of abundant adelophialides and elongated conidia. (Glenn et 

al. 1996, Summerbell et al. 2011, Giraldo et al. 2015). 

Sarocladium strictum (W. Gams) Summerbell 

Sarocladium strictum is commonly found in soil and plant debris. Cutaneous, CAPDrelated 

peritonitis and invasive infections in immunosuppressed patients have been 

reported. 


Morphological Description: Colonies growing rapidly, moist to slimy, pink or orange; 

reverse remaining colourless or turning pink to orange. Conidiophores simple, 

occasionally branched. Phialides slender, arising from submerged or slightly fasciculate 

aerial hyphae, 20-65 × 1.4-2.5 μm. Submerged sporulation frequent from reduced 

phialides. Conidia grouped in slimy heads, cylindrical or ellipsoidal, 3.3-5.5 × 0.9-1.8 

μm, hyaline. 

Molecular Identification: Summerbell et al. (2011) revised the genus and recommends 

using D1/D2 sequences for phylogenetic analysis and sequence-based identification. 

References: Glenn et al. (1996), Summerbell et al. (2011), Giraldo et al. (2015), de 


a 

b 

10 µm 

Sarocladium strictum (a) colony and (b) slender phialides with conidia in slimy heads. 

Antifungal Susceptibility: S. strictum very limited data (Australian National data); 

MIC µg/mL. 

No. 32 

AmB 5 1 2 2 

VORI 5 1 1 1 2 

POSA 5 1 2 1 1 

ITRA 5 1 1 3


Scedosporium Sacc. ex Castell. & Chalm. 

The taxonomy of this genus has been subject to change on the basis of sequence data; 

Scedosporium apiospermum and Scedosporium boydii (formerly Pseudallescheria 

boydii) are now recognised as separate species and along with S. aurantiacum are 

the principal human pathogens (Lackner et al. 2014a). The majority of infections 

are mycetomas, the remainder include infections of the eye, ear, central nervous 

system, internal organs and more commonly the lungs. Scedosporium dehoogii and 

S. minutispora are mainly isolated from environmental samples and have been rarely 

reported from clinical cases (Gilgado et al. 2005, Rainer and de Hoog 2006, Cortez et 

al. 2008, Kaltseis et al. 2009). 

Scedosporium prolificans has been transferred to the genus Lomentospora. L. prolificans 

is phylogenetically and morphologically distinct from the remaining Scedosporium 

species (Lennon et al. 1994, Lackner et al. 2014a). 

Morphological identification of Scedosporium species has become increasingly 

unreliable and molecular identification methods are now recommended. The conidial 

states of S. apiospermum and S. boydii are morphologically indistinguishable; although 

the latter is homothallic and produces ascocarps. S. aurantiacum also exhibits similar 

conidial morphology but most strains produce a pale to bright yellow diffusible pigment 

on potato dextrose agar. 

Molecular Identification: Recommended genetic markers are ITS and β-tubulin 

(Lackner et al. 2012a). 


accurate identification of Scedosporium and Lomentospora species (Lau et al. 2013, 

Sitterlé et al. 2014). 

References: McGinnis (1980), Domsch et al. (1980), McGinnis et al. (1982), Campbell 

and Smith (1982), Rippon (1988), de Hoog et al. (2000, 2015), Gilgado et al. (2005), 

Rainer and de Hoog (2006), Guarro et al. (2006), Lackner et al. (2014a). 

Scedosporium apiospermum (Saccardo) Castellani and Chalmers 

Synonymy: Pseudallescheria apiosperma Gilgado, Gené, Cano & Guarro 


Morphological Description: Colonies are fast growing, greyish-white, suede-like 

to downy with a greyish-black reverse. Numerous single-celled, pale-brown, broadly 

clavate to ovoid conidia, 4-9 x 6-10 µm, rounded above with truncate bases are 

observed. Conidia are borne singly or in small groups on elongate, simple or branched 

conidiophores or laterally on hyphae. Conidial development can be described as 

annellidic, although the annellations (ring-like scars left at the apex of an annellide after 

conidial secession) are extremely difficult to see. Erect synnemata may be present in 

some isolates. Optimum temperature for growth is 30-37 O C.

180 


Scedosporium apiospermum (Saccardo) Castellani and Chalmers 

a 

20 µm 

10 µm 

b 

c 

Scedosporium apiospermum (a) conidiophores and conidia, 

(b) culture and (c) synnemata. 

Antifungal Susceptibility: S. apiospermum (Australian National data); MIC µg/mL. 

No. 64 

AmB 167 2 2 10 45 51 40 17 

VORI 163 5 27 57 47 23 1 3 

POSA 112 2 6 22 49 27 3 1 2 

ITRA 167 2 5 21 86 38 7 8


Scedosporium aurantiacum Gilgado et al. 

Morphological Description: Most isolates produce a light yellow diffusible pigment 

on potato dextrose agar after a few days incubation. Conidiogenous cells and 

conidia are similar in shape and size to S. apiospermum, and the two can best be 

distinguished by genetic analysis. Conidiogenous cells arising from undifferentiated 

hyphae are cylindrical to slightly flask-shaped, producing slimy heads of one-celled 

, smooth-walled, subhyaline, obovoid or sub-cylindrical conidia. 5-14 x 2-5 um. Erect 

synnemata may be present in some isolates, but the teleomorph is unknown. Optimum 

temperature for growth 37-40 O C, max 45 O C. RG-2 organism. 

a 

b 

Culture reverse (PDA) of (a) S. apiospermum and (b) S. aurantiacum showing 

production of a light yellow diffusible pigment that is typical of S. aurantiacum. 

20 µm 

Scedosporium aurantiacum conidiophores (annellides) and conidia. 

Antifungal Susceptibility: S. aurantiacum (Australian National data); MIC µg/mL. 

No. 64 

AmB 11 1 7 3 

VORI 11 5 5 1 

POSA 11 4 4 2 1 

ITRA 11 4 4 3

182 


Synonymy: Pseudallescheria boydii (Shear) McGinnis, A.A. Padhye & Ajello. 


Scedosporium boydii (Shear) Gilgado et al. 

Morphological Description: Colonies are fast growing, greyish-white, suede-like 

to downy with a greyish-black reverse. Numerous single-celled, pale-brown, broadly 

clavate to ovoid conidia, 4-9 x 6-10 µm, rounded above with truncate bases are 

observed. Conidia are borne singly or in small groups on elongate, simple or branched 

conidiophores or laterally on hyphae. Cleistothecia (non-ostiolate ascocarps) are 

yellow-brown to black, spherical, 50-200 μm in diameter, and are mostly submerged 

in the agar and are composed of irregularly interwoven brown hyphae. When crushed 

cleistothecia release numerous, faintly brown, ellipsoidal ascospores, 4-5 x 7- 9 µm 

in size. Erect synnemata may be present in some isolates. Optimum temperature for 

growth is 30-37 O C. 

Note: S. boydii is homothallic and is recognised by smaller cleistothecia (50-200 μm) 

whereas S. apiospermum is heterothallic (requires mating of two strains) and has 

larger cleistothecia, 140-480 μm (Gilgado et al. 2010). 

a 

Scedosporium boydii (a) culture and a (b) cleistothecium. 

b 

20 µm 

Antifungal Susceptibility: S. boydii vs S. apiospermum (Lackner et al. 2014b). 

S. boydii S. apiospermum 

Antifungal (MIC µg/mL) 

Range MIC 90 

Range MIC 90 

AmB 0.5->16 >16 0.5->16 >16 

VORI 0.125-2 2 0.25->8 2 

POSA 0.125->16 >16 0.25->16 >16 

ITRA 0.125->16 >16 0.25->16 >16


Schizophyllum commune Fries 

Schizophyllum commune is a common basidiomycete bracket fungus found on rotten 

wood, and is an occasional human pathogen, principally associated with sinusitis, 

allergic bronchopulmonary mycosis and as a contaminant from respiratory specimens. 

However the introduction of DNA sequencing and/or MALDI-TOF MS identification in 

the clinical laboratory has seen many more cases of S. commune fungal rhinosinusitis 

identified (Michel et al. 2012, Chowdhary et al. 2013a, 2014a,b). 


Morphological Description: Colonies on 2% malt extract agar are spreading, woolly, 

whitish to pale greyish-brown, soon forming macroscopically visible fruiting bodies. 

Some isolates may take up to 12 weeks to form fruiting bodies. Fruit bodies are sessile, 

kidney-shaped, lobed with split gills on the lower side. Hyphae are hyaline, wide 

and have clamp connections. Basidia bear four basidiospores on erect sterigmata. 

Basidiospores hyaline, smooth-walled, elongate with lateral scar at lower end, 6-7 x 

2-3 µm. 

Note: Many clinical isolates of S. commune are monokaryotic and do not show clamp 

connections, therefore any white, rapidly growing, sterile isolate showing good growth 

at 37 O C with tolerance to benomyl, susceptibility to cycloheximide, and a pronounced 

odour should be suspected of being S. commune (Sigler et al. 1995). 

Molecular Identification: Sequencing of the ITS and D1/D2 regions is recommended 

(Buzina et al. 2001, Won et al. 2012, Chowdhary et al. 2013b, Michel et al. 2012), 

however the number of well identified nucleotide sequences of these fungi in the 

GenBank database remains limited. 

MALDI-TOF MS: Michel et al. (2012), Chowdhary et al. (2014b), Huguenin et al. (2015) 

provide identification procedures, however the number of mass spectral profiles to be 

found in MALDI-TOF libraries remains limited. 

References: McGinnis (1980), Rippon (1988), Sigler et al. (1995), de Hoog et al. 

(2015). 

Schizophyllum commune basidiocarps growing on malt extract agar. 

Antifungal Susceptibility: S. commune (Chowdhary et al. 2013b); MIC µg/mL. 



AmB 0.03-2 1 FLU 2-64 64 

ITRA 0.03-8 1 VORI 0.06-2 0.5

184 


Scopulariopsis Bain 

Most members of the genus Scopulariopsis are soil fungi, which are frequently isolated 

from food, paper and other materials. They also occur as laboratory contaminants. 

Several species have been reported as causative agents of onychomycosis and 

hyalohyphomycosis (Sandoval-Denis et al. 2013). The most common species seen in 

the clinical laboratory is S. brevicaulis, followed by S. gracilis S. brumptii, Microascus 

cinereus, S. candida complex, and M. cirrosus (Sandoval-Denis et al. 2013). 

Morphological Description: Colonies are fast growing, varying in colour from white, 

cream, grey, buff to brown and black, but are predominantly light brown. Microscopic 

morphology shows chains of single-celled conidia produced in basipetal succession 

from a specialised conidiogenous cell called an annellide. Once again, the term 

basocatenate can be used to describe such chains of conidia where the youngest 

conidium is at the basal end of the chain. In Scopulariopsis, annellides may be solitary, 

in groups, or organised into a distinct penicillus. Conidia are globose to pyriform, usually 

truncate, with a rounded distal portion, smooth to rough, and hyaline to brown in colour. 

RG-2 for species isolated from humans. 

Key Features: Hyphomycete, conidia often shaped like light globes, basocatenate 

arising from annellides. 

Molecular Identification: D1/D2 and EF-1α sequence analysis can be useful for the 

identification of the most common clinically relevant species (Sandoval-Denis et al. 

2013). 

References: Morton and Smith (1963), McGinnis (1980), Rippon (1988), Samson et 

al. (1995), Domsch et al. (2007), de Hoog et al. (2000, 2015). 

10 µm 

Scopulariopsis brevicaulis conidiophores (annellides) and conidia. 

Antifungal Susceptibility: S. brevicaulis (Skora et al. 2014); MIC µg/mL. 



AmB 4-16 >16 VORI 8->16 >16 

ITRA >16 >16 TERB 0.5-16 4


Sepedonium species are common soil fungi and parasites of fleshy fungi, however 

Yogo et al. (2014) reported an intra-abdominal infection in an immunosuppressed 

patient. Sepedonium species closely resemble Histoplasma capsulatum. Note: For 

laboratory safety, culture identification to exclude Histoplasma capsulatum should be 

performed by either exoantigen test or DNA sequencing. 


Sepedonium Link ex Greville 

Morphological Description: Colonies are moderately fast growing, usually white 

to golden yellow, suede-like to downy, becoming fluffy with age. Conidiophores are 

hyaline and non-specialised, resembling short branches of the vegetative hyphae. 

Conidia are terminal, solitary, or in clusters, one-celled, globose to ovoid, 7-17 µm, 

hyaline to amber, smooth to verrucose and usually with a thick wall. 

Key Features: Hyphomycete, producing large, thick-walled, one-celled, verrucose, 

globose, terminal conidia from non-specialised conidiophores, resembling the 

macroconidia seen in Histoplasma capsulatum. 



References: McGinnis (1980), Rippon (1988), Yogo et al. (2014). 

15 µm 

Sepedonium spp. showing large, globose, thick-walled, 

one-celled, verrucose, terminal conidia.

186 


Sporothrix schenckii complex 

It is now recognised that Sporothrix schenckii is a species complex of five distinct 

species: S. schenckii sensu strictu, S. brasiliensis, S. globosa, S. mexicana and S. 

luriei (Marimon et al. 2007, Romeo et al. 2011, Barros et al. 2011, Oliveira et al. 2014, 

Zhang et al. 2015b). RG-2 organism. 

Sporothrix schenckii complex is a dimorphic fungus and has a worldwide distribution, 

particularly in tropical and temperate regions. It is commonly found in soil and on decaying 

vegetation and is a well-known pathogen of humans and animals. Sporotrichosis is 

primarily a chronic mycotic infection of the cutaneous or subcutaneous tissues and 

adjacent lymphatics characterised by nodular lesions which may suppurate and 

ulcerate. Infections are caused by the traumatic implantation of the fungus into the 

skin, or very rarely, by inhalation into the lungs. Secondary spread to articular surfaces, 

bone and muscle is not infrequent, and the infection may also occasionally involve the 

central nervous system, lungs or genitourinary tract. 

Sporothrix schenckii Hektoen & Perkins 

Morphological Description: Colonies at 25 O C, are slow growing, moist and glabrous, 

with a wrinkled and folded surface. Some strains may produce short aerial hyphae 

and pigmentation may vary from white to cream to black. Conidiophores arise at right 

angles from thin septate hyphae and are usually solitary, erect and tapered toward the 

apex. Conidia are formed in clusters on tiny denticles by sympodial proliferation at the 

apex of the conidiophore, their arrangement often suggestive of a flower. As the culture 

ages, conidia are subsequently formed singly along the sides of both conidiophores 

and undifferentiated hyphae. Conidia are ovoid or elongated, 3-6 x 2-3 µm, hyaline, 

one-celled and smooth-walled. In some isolates, solitary, darkly-pigmented, thickwalled, 

one-celled, obovate to angular conidia may be observed along the hyphae. On 

brain heart infusion (BHI) agar containing blood at 37 O C, colonies are glabrous, white 

to greyish-yellow and yeast-like consisting of spherical or oval budding yeast cells. 

Molecular Identification: DNA sequencing using ITS, D1/D2, β-tubulin, calmodulin 

and chalcone synthase genes is recommended for species identification (Marimon 

et al. 2007, Romeo et al. 2011, Barros et al. 2011, Oliveira et al. 2014, Zhang et al. 

2015b). 

MALDI-TOF MS: Oliverira et al. (2015) established a MALDI-TOF protocol and 

reference database for the identification of Sporothrix species. 

Key Features: Hyphomycete characterised by thermal dimorphism and clusters of 

ovoid, denticulate conidia produced sympodially on short conidiophores. 

References: McGinnis (1980), Domsch et al. (1980), Rippon (1988), de Hoog et al. 

(1985, 2000, 2015). 

Antifungal Susceptibility: S. schenckii variable data for amphotericin B and azoles; 

testing of individual strains recommended (Alvarado-Ramirez and Torres-Rodriguez 

2007, Marimon et al. 2008, Silveira et al. 2009, Oliveira et al. 2011, Ottonelli Stopiglia 

et al. 2014, Rodrigues et al. 2014, Australian National data); MIC µg/mL. 



AmB 0.03->16 >16 POSA 0.03->16 8 

ITRA 0.03->16 >16 VORI 0.125->16 >16 

TERB 0.03-1 0.5


Sporothrix schenckii complex 

10 µm 

Sporothrix schenckii PAS stained tissue section showing budding yeast-like cells. 

a 

b 

10 µm 

Sporothrix schenckii (a) culture at 25 O C and (b) budding yeast cells in BHI at 37 O C. 

10 µm 

Sporothrix schenckii conidiophores and conidia at 25 O C.

188 


Most species of Stemphylium are plant pathogens with occasional isolates from soil, 

they are rarely seen in the clinical laboratory. 


Stemphylium Wallroth 

Morphological Description: Colonies are rapid growing, brown to olivaceous-black or 

greyish and suede-like to floccose. Microscopically, solitary, darkly pigmented, terminal, 

multicellular conidia (dictyoconidia) are formed on a distinctive conidiophore with a 

darker terminal swelling. Note: The conidiophore proliferates percurrently through the 

scar where the terminal conidium (poroconidium) was formed. Conidia are pale to 

mid-brown, oblong, rounded at the ends, ellipsoidal, obclavate or subspherical and 

are smooth or in part verrucose. Stemphylium should not be confused with Ulocladium 

which produces similar dictyoconidia from a sympodial conidiophore, not from a 

percurrent conidiogenous cell as in Stemphylium. 

Molecular Identification: ITS sequencing (Woudenberg et al. 2013). 

Key Features: Dematiaceous hyphomycete producing darkly pigmented, dictyoconidia 

from the swollen end of a percurrent conidiophore. 

References: Ellis (1971, 1976), Rippon (1988), de Hoog et al. (2000). 

20 µm 

Stemphylium spp. conidiophores and conidia.


Syncephalastrum racemosum Cohn 

The genus Syncephalastrum is characterised by the formation of cylindrical 

merosporangia on a terminal swelling of the sporangiophore. Sporangiospores are 

arranged in a single row within the merosporangia. Syncephalastrum racemosum is the 

type species of the genus and a potential human pathogen; however, well-documented 

cases are lacking. It is found mainly from soil and dung in tropical and subtropical 

regions. It can also be a laboratory aerial contaminant. The sporangiophore and 

merosporangia of Syncephalastrum species may also be mistaken for an Aspergillus 

species, if the isolate is not examined carefully. RG-2 organism. 

Morphological Description: Colonies are very fast growing, cottony to fluffy, white to 

light grey, becoming dark grey with the development of sporangia. Sporangiophores are 

erect, stolon-like, often producing adventitious rhizoids, and show sympodial branching 

(racemose branching) producing curved lateral branches. The main stalk and branches 

form terminal, globose to ovoid vesicles which bear finger-like merosporangia directly 

over their entire surface. At maturity, merosporangia are thin-walled, evanescent 

and contain five to ten (up to 18) globose to ovoid, smooth-walled sporangiospores 

(merospores). Maximum growth temperature 40 O C. 

Key Features: Mucorales, producing sympodially branching sporangiophores with 

terminal vesicles bearing merosporangia. 

References: Domsch et al. (1980), McGinnis (1980), Onions et al. (1981), Rippon 

(1988), Samson et al. (1995), de Hoog et al. (2000, 2015), Ellis (2005b). 

a 

30 µm 

b 

10 µm 

Syncephalastrum racemosum (a) merosporangia and (b) merospores. 

Antifungal Susceptibility: S. racemosum (Espinel-Ingroff et al. 2015a); MIC µg/mL. 

No. 16 

AmB 35 8 16 3 6 2 

POSA 36 1 2 4 10 11 5 1 2 

ITRA 26 4 3 5 7 4 1 2

190 


Talaromyces marneffei (Segretain et al.) Samson et al. 

Synonymy: Penicillium marneffei Segretain et al. 

WARNING: RG-3 organism. Cultures of Talaromyces marneffei may represent a 

biohazard to laboratory personnel and should be handled with caution in a class II 

Biological Safety Cabinet (BSCII). T. marneffei exhibits thermal dimorphism and is 

endemic in Southeast Asia and the southern region of China. 

Samson et al. (2011b) redefined Talaromyces by combining Penicillium subgenus 

Biverticillium into Talaromyces based upon phylogenetic analysis of the ITS and RPB1 

loci. The genus contains 88 species that were placed into seven sections based on a 

multigene phylogeny of the ITS, β-tubulin and RPB2 regions (Yilmaz et al. 2014). T. 

marneffei is the only known dimorphic species in the genus, producing filamentous 

growth at 25 O C and a yeast phase at 37 O C (Andrianopoulos 2002). 

Molecular Identification: ITS sequencing is recommended, as well as β-tubulin as a 

secondary molecular marker for identification (Yilmaz et al. 2014). 

Morphological Description: Colonies at 25 O C are fast growing, suede-like to downy, 

white with yellowish-green conidial heads. Colonies become greyish-pink to brown 

with age and produce a diffusible brownish-red to wine-red pigment. Conidiophores 

generally biverticillate and sometimes monoverticillate; hyaline, smooth-walled and 

bear terminal verticils of three to five metulae, each bearing three to seven phialides. 

Phialides are acerose to flask-shaped. Conidia are globose to subglobose, 2-3 µm in 

diameter, smooth-walled and are produced in basipetal succession from the phialides. 

On brain heart infusion (BHI) agar containing blood incubated at 37 O C, colonies are 

rough, glabrous, tan-coloured and yeast-like. Microscopically, yeast cells are spherical 

to ellipsoidal, 2-6 µm in diameter, and divide by fission rather than budding. Numerous 

short hyphal elements are also present. 

Histopathology: Tissue sections show small, oval to ellipsoidal yeast-like cells, 3 µm in 

diameter, either packed within histiocytes or scattered through the tissue. Occasional, 

large, elongated sausage-shaped cells, up to 8 µm long, with distinctive septa may be 

present. 

Key Features: Talaromyces marneffei is the only dimorphic species of Talaromyces, 

which grows as a yeast at 37 O C. It produces a red soluble pigment on general media 

and conidiophores have flask-shaped to acerose phialides. 

References: Pitt (1979), Ramirez (1982), de Hoog et al. (2000, 2015), Andrianopoulos 

(2002), Lyratzopoulos et al. (2002), Samson et al. (2011b), Visagie et al. (2014), Yilmaz 

et al. (2014).


Talaromyces marneffei (Segretain et al.) Samson et al. 

a 

b 

5 µm 

c 

15 µm 5 µm 

c 

Talaromyces marneffei (a) colony, (b) a giemsa stained touch smear showing 

typical septate yeast-like cells (arrow), (c) phialides and conidia. 

Antifungal Susceptibility: T. marneffei very limited data (Australian National data); 

MIC µg/mL. 

No. 8 

AmB 5 2 2 1 

VORI 5 3 2 

POSA 4 3 1 

ITRA 5 1 4

192 


Torulaspora delbrueckii (Lindner) Lindner 

Synonymy: Candida colliculosa (Hartmann) S.A. Meyer & Yarrow. 

Torulaspora delbrueckii is a rare cause of candidaemia. 



Microscopy: Spherical to ellipsoidal budding blastoconidia, 2-6 x 3-7 µm in size. 

Ascospores may be produced on 5% malt extract or cornmeal agar after 5-30 days at 

25 O C. 


Dalmau Plate Culture: Budding yeast cells only. No pseudohyphae or true hyphae 

produced. 




Germ Tube - L-Sorbose v L-Arabinose - D-Glucitol v 

Fermentation Sucrose v D-Arabinose - α-M-D-glucoside v 

Glucose + Maltose v D-Ribose - D-Gluconate v 

Galactose v Cellobiose - L-Rhamnose - DL-Lactate v 

Sucrose v Trehalose -,s D-Glucosamine - myo-Inositol - 

Maltose v Lactose - N-A-D-glucosamine - 2-K-D-gluconate + 

Lactose - Melibiose - Glycerol v D-Glucuronate v 

Trehalose v Raffinose v Erythritol - Nitrate - 



Galactose v D-Xylose v D-Mannitol + Growth at 37 O C v 

Key Features: asci containing one to four spheroidal ascospores, strong growth at 

37 O C and a variable sugar assimilation profile. 

Antifungal Susceptibility: T. delbrueckii very limited data (Australian National 


No. 64 

AmB 2 2 

FLU 2 2 

VORI 2 1 1 

POSA 2 1 1 

ITRA 2 2 

CAS 1 1 

5FC 2 2


Trichoderma Persoon ex Grey 

Trichoderma is a very common genus especially in soil and decaying wood. Gliocladium 

(with strongly convergent phialides) and Verticillium (with straight and moderately 

divergent phialides) are closely related genera. Trichoderma infections in humans 

have been associated mostly with peritoneal dialysis, organ transplantation, and 

haematologic disorders (Sandoval-Denis et al. 2014b). 

Morphological Description: Colonies are fast growing, at first white and downy, later 

developing yellowish-green to deep green compact tufts, often only in small areas 

or in concentric ring-like zones on the agar surface. Conidiophores are repeatedly 

branched, irregularly verticillate, bearing clusters of divergent, often irregularly bent, 

flask-shaped phialides. Conidia are mostly green, sometimes hyaline, with smooth or 

rough walls and are formed in slimy conidial heads (gloiospora) clustered at the tips of 

the phialides. RG-1 organism. 

Key Features: Hyphomycete with repeatedly branched conidiophores bearing clusters 

of divergent, flask-shaped phialides. 

Molecular Identification: Species identification is based on multilocus sequence data 

using ITS, EF-1α, Chi18-5, and actin genes (Sandoval-Denis et al. 2014b). 

References: Domsch et al. (1980), McGinnis (1980), Rippon (1988), Samson et al. 

(1995), de Hoog et al. (2000, 2015), Sandoval-Denis et al. (2014b). 

20 µm 

Trichoderma harzianum species complex phialides and conidia. 

Antifungal Susceptibility: Trichoderma spp.(Australian National data); MIC µg/mL. 

No. 64 

AmB 3 2 1 

VORI 3 1 1 1 

POSA 2 2 

ITRA 3 2 1 

Trichoderma spp. data from 73 isolates (Sandoval-Denis et al. 2014b); MIC µg/mL. 


= 2 VORI Range 0.125-32; MIC 90 

= 4 

ITRA Range 1-32; MIC 90 

= 32 POSA Range 1-32; MIC 90 

= 32

194 


Trichophyton Malmsten 

Rippon (1988) accepted 22 species and four varieties in the genus Trichophyton based 

on morphology. DNA sequences now play a prominent role in delineating phylogenetic 

relationships, and as such species concepts in Trichophyton have changed. Sixteen 

species are now recognised in the genus. The descriptions and species concepts 

provided in this publication are based upon a combination of traditional morphological 

criteria and the current (2016) recognised phylogenetic species (de Hoog et al. 2016). 

The genus Trichophyton is characterised morphologically by the development of both 

smooth-walled macro- and microconidia. Macroconidia are mostly borne laterally 

directly on the hyphae or on short pedicels, and are thin- or thick-walled, clavate to 

fusiform, and range from 4-8 x 8-50 µm in size. Macroconidia are few or absent in many 

species. Microconidia are spherical, pyriform to clavate or of irregular shape and range 

from 2-3 x 2-4 µm in size. The presence of microconidia differentiates this genus from 

Epidermophyton, and the smooth-walled, mostly sessile macroconidia differentiates it 

from Lophophyton, Microsporum and Nannizzia. 

In practice, two groups may be recognised on direct microscopy: 

1. Those species that usually produce microconidia; macroconidia may or may 

not be present i.e. T. rubrum, T. interdigitale, T. mentagrophytes, T. equinum, T. 

eriotrephon, T. tonsurans, and to a lesser extent T. verrucosum, which may produce 

conidia on some media. In these species the shape, size and arrangement of the 

microconidia is the most important character. Culture characteristics are also useful. 

2. Those species that usually do not produce conidia. Chlamydospores or other 

hyphal structures may be present, but microscopy is generally non-diagnostic; i.e. 

T. verrucosum, T. violaceum, T. concentricum, T. schoenleinii and T. soudanense. 

Culture characteristics and clinical information such as the site, appearance of the 

lesion, geographic location, travel history, animal contacts and even occupation are 

most important. 

Many laboratories have used growth on additional media and/or confirmatory tests to 

help differentiate between species of Trichophyton, especially isolates of T. rubrum, T. 

interdigitale, T. mentagrophytes and T. tonsurans. These include growth characteristics 

on media such as Littman oxgall agar, lactritmel agar, potato dextrose agar, Sabouraud’s 

agar with 5% Salt, 1% peptone agar, bromocresol purple-milk solids glucose agar 

(BCP), Trichophyton agars No. 1-5, hydrolysis of urea and hair perforation tests. 

Molecular Identification: ITS and EF-1α sequencing is recommended for accurate 

species identification (Gräser et al. 1998, 1999b, 2000a, 2008; Irinyi et al. 2015; 

Mirhendi et al. 2015). 

MALDI-TOF MS: Methods reported by Erhard et al. (2008), Nenoff et al. (2011), 

Cassange et al. (2011), l’Ollivier et al. (2013), Calderaro et al. (2014), Packeu et al. 

(2013, 2014). 

References: Rebell and Taplin (1970), Ajello (1972), Vanbreusegham et al. (1978), 

Rippon (1988), McGinnis (1980), Domsch et al. (1980), Kane et al. (1997), Chen et al. 

(2011), de Hoog et al. (2000, 2015, 2016).


Trichophyton concentricum is an anthropophilic fungus which causes chronic 

widespread non-inflammatory tinea corporis known as tinea imbricata because of the 

concentric rings of scaling it produces. It is not known to invade hair. Infections among 

Europeans are rare. Distribution is restricted to the Pacific Islands of Oceania, South 

East Asia and Central and South America. 


Morphological Description: Colonies are slow growing, raised and folded, glabrous 

becoming suede-like, mostly white to cream-coloured, but sometimes orange-brown 

coloured, often deeply folded into the agar which may produce splitting of the medium 

in some cultures. Reverse is buff to yellow-brown to brown in colour. Cultures consist 

of broad, much-branched, irregular, often segmented, septate hyphae which may 

have “antler” tips resembling T. schoenleinii. Chlamydospores are often present in 

older cultures. Microconidia and macroconidia are not usually produced, although 

some isolates will produce occasional clavate to pyriform microconidia. Note: Hyphal 

segments may artificially resemble macroconidia. 


Trichophyton concentricum Blanchard 

Hydrolysis of Urea: Negative after 7 days. 

Vitamin Free Agar (Trichophyton Agar No.1): Growth occurs on vitamin free agar 

(T1) but is usually slightly better on media containing thiamine i.e. T3 = T1 + thiamine 

and inositol, and T4 = T1 + thiamine. The slight enhancement of growth in the presence 

of thiamine helps to distinguish T. concentricum from T. schoenleinii, although this 

does not occur in all strains. 

Hair Perforation Test: Negative at 28 days. 

Key Features: Clinical disease, geographical distribution and culture characteristics. 

a 

b 

20 µm 

Trichophyton concentricum (a) culture showing a typical slow growing, heaped and 

folded, glabrous to suede like colony, and (b) the formation of typical “balloon-shaped” 

chlamydospores. Note: Microconidia and macroconidia are usually not produced.

196 


Trichophyton equinum (Matruchot & Dassonville) Gedoelst 

Synonomy: Trichophyton equinum var. autotrophicum J.M.B. Smith et al. 

Trichophyton equinum is a zoophilic fungus causing ringworm in horses and rare 

infections in humans. It has a worldwide distribution except for the autotrophicum strain 

which is restricted to Australia and New Zealand. Invaded hairs show an ectothrix 

infection but do not fluoresce under Wood’s ultra-violet light. 


Morphological Description: Colonies are usually flat, but some may develop gentle 

folds or radial grooves, white to buff in colour, suede-like to downy in texture, and are 

similar to T. mentagrophytes. Cultures usually have a deep-yellow submerged fringe 

and reverse which later becomes dark red in the centre. Microscopically: abundant 

microconidia which may be clavate to pyriform and sessile or spherical and stalked 

are formed laterally along the hyphae. Macroconidia are only rarely produced, but 

when present are clavate, smooth, thin-walled and of variable size. Occasional nodular 

organs may be present and the microconidia often undergo a transformation to produce 

abundant chlamydospores in old cultures. 


Lactritmel Agar: Flat spreading, white to cream-coloured, powdery to granular surface 

with a central downy papilla, and deep brownish-red reverse. Microscopic morphology 

as described above. 

Hydrolysis of Urea: Positive in 4-5 days. 

a 

b 

Nutritional Tests on Trichophyton Agars: (a) Most strains require nicotinic acid for 

growth except those from Australia and New Zealand, which are autotrophic (b). T1 = 

vitamin free agar, T5 = vitamin free + nicotinic acid agar. 

Hair Perforation Test: Negative; but positive for the autotrophicum strains. 

Molecular Diagnostics: Species identification supported by ITS sequencing (Gräser 

et al. 1999a; Chen et al. 2011). 

Key Features: Microscopic morphology, culture characteristics, nicotinic acid 

requirement and clinical lesions in horses. Most strains require nicotinic acid for growth 

except autotrophic strains.


Trichophyton equinum (Matruchot & Dassonville) Gedoelst 

a 

c 

b 

20 µm 

d 

Trichophyton equinum (a) culture, (b) microconidia, (c) macroconidia 

and (d) nodular organs.

198 


Trichophyton eriotrephon Papegaaij, Nederl. Tijdschr. Geneesk 

Synonymy: Trichophyton mentagrophytes var. erinacei J.M.B. Smith & Marples. 

Trichophyton erinacei (Smith & Marples) Quaife. 

Trichophyton eriotrephon is a zoophilic fungus associated with hedgehogs and the 

epidermal mites, harboured by hedgehogs. Human infections occur most frequently on 

the exposed parts of the body, but tinea of the scalp and nails can also occur. Invaded 

hairs show an ectothrix infection but do not fluoresce under Wood’s ultra-violet light. 

The distribution of this fungus is New Zealand and Europe. 


Morphological Description: Colonies are white, flat, powdery, sometimes downy 

to fluffy with a brilliant lemon-yellow reverse. Numerous large clavate microconidia 

are borne on the sides of hyphae. Macroconidia are smooth-walled, two to six-celled, 

clavate, variable in size, and may have terminal appendages. Macroconidia are much 

shorter than those seen in T. mentagrophytes. 


Lactritmel Agar: White suede-like to powdery colony with brilliant yellow reverse. 

Numerous large slender clavate microconidia. 

Hydrolysis of Urea: Negative at 7 days. 


nutritional requirements. Colonies are white suede-like to powdery with no reverse 

pigment. 


Key Features: Include microscopic morphology and culture characteristics; slender 

clavate microconidia and brilliant lemon-yellow reverse pigment on SDA; and negative 

hydrolysis of urea. 

Positive “in vitro” hair perforation test.


Trichophyton eriotrephon Papegaaij, Nederl. Tijdschr. Geneesk 

a 

c 

b 

20 µm 

Trichophyton eriotrephon (a) culture, (b) microconidia and (c) macroconidia. 

Trichophyton eriotrephon is generally distinguished from T. mentagrophytes by: (a) 

its microscopic morphology showing numerous large slender clavate microconidia 

borne on the sides of hyphae and its smooth, thin-walled clavate macroconidia; (b) 

its brilliant lemon yellow reverse pigment on SDA and lactritmel agar; (c) its lack of 

reverse pigment on Sabouraud’s salt agar; and (d) its negative hydrolysis of urea.

200 


Synonymy: T. mentagrophytes var. interdigitale (Priestley) Moraes, Anais Bras. 

Trichophyton interdigitale is an anthropophilic fungus which is a common cause of 

tinea pedis, particularly the vesicular type, tinea corporis, and sometimes superficial 

nail plate invasion in humans. It is not known to invade hair in vivo but produces hair 

perforations in vitro. Distribution is worldwide. This species may be regarded as a 

clonal offshoot of the zoophilic T. mentagrophytes (de Hoog et al. 2016). 


Morphological Description: Colonies are usually flat, white to cream in colour with 

a powdery to suede-like surface and yellowish to pinkish brown reverse pigment, 

often becoming a darker red-brown with age. Numerous subspherical to pyriform 

microconidia, occasional spiral hyphae and spherical chlamydospores are present, 

the latter being more abundant in older cultures. Occasional slender, clavate, smoothwalled, 

multiseptate macroconidia are also present in some cultures. 


Littman Oxgall Agar: Raised white downy colony with no reverse pigment. 

Lactritmel Agar: Macroscopic and microscopic features as described above. 

Sabouraud’s Dextrose Agar with 5% Salt: Heaped and folded, buff-coloured, suedelike 

surface with a dark reddish-brown submerged fringe and brown reverse. 

1% Peptone Agar: Flat, white to cream, suede-like surface with raised white downy 

centre. No reverse pigment. 


nutritional requirements, flat cream powdery surface with central downy tuft. Reverse 

pale pinkish-brown. 

Hydrolysis of Urea: Positive within 7 days (usually 3 to 5 days). 


Trichophyton interdigitale Priestley 

Key Features: Culture characteristics, microscopic morphology and in vitro perforation 

of human hair. 

Trichophyton interdigitale can be distinguished from T. rubrum and T. mentagrophytes 

by: (a) its culture characteristics and microscopic morphology on SDA and/or lactritmel 

agar; (b) its growth and colony morphology on Sabouraud’s salt agar (colonies of T. 

interdigitale and T. mentagrophytes unlike T. rubrum, grow very well on this medium 

and usually produce a distinctive dark reddish-brown reverse pigment); (c) a positive 

urease test (within 7 days), a positive hair perforation test and the production of a 

yellow-brown to pinkish-brown reverse pigment on pigment stimulation media like 

lactritmel and Trichophyton No.1 agars; (d) T. interdigitale demonstrates profuse growth 

and alkalinity on BCP milk solids agar; (e) on 1% peptone agar T. interdigitale has a 

suede-like to downy surface whereas T. mentagrophytes has a characteristic granular 

appearance.



Trichophyton interdigitale culture. 

a 

b 

20 µm 

A dysgonic variant of Trichophyton interdigitale (formerly var. nodulare); (a) culture 

showing distinctive bright yellow to apricot-coloured colonies with a suede-like to 

powdery surface and a bright yellow-brown to orange reverse; and (b) microscopically 

characteristic “nodular organs” are observed in the vegetative hyphae. Usually, no 

conidia are seen but some isolates, especially with subculture may produce subspherical 

to pyriform microconidia similar to those of T. interdigitale.

202 



20 µm 

Trichophyton interdigitale microconidia, macroconidia and spiral hyphae. 

20 µm 

Trichophyton interdigitale microconidia, chlamydospores and spiral hyphae.


Trichophyton mentagrophytes (Robin) Blanchard 

Synonymy: T. mentagrophytes var. mentagrophytes (Robin) Sabour. 

Trichophyton mentagrophytes is a zoophilic fungus with a worldwide distribution and 

a wide range of animal hosts including mice, guinea-pigs, kangaroos, cats, horses, 

sheep and rabbits. Produces inflammatory skin or scalp lesions in humans, particularly 

in rural workers. Kerion of the scalp and beard may occur. Invaded hairs show an 

ectothrix infection but do not fluoresce under Wood’s ultra-violet light. Distribution is 

worldwide. 


Morphological Description: Colonies are generally flat, white to cream in colour, 

with a powdery to granular surface. Some cultures show central folding or develop 

raised central tufts or pleomorphic suede-like to downy areas. Reverse pigmentation is 

usually a yellow-brown to reddish-brown colour. Numerous single-celled microconidia 

are formed, often in dense clusters. Microconidia are hyaline, smooth-walled, and 

are predominantly spherical to subspherical in shape, however occasional clavate 

to pyriform forms may occur. Varying numbers of spherical chlamydospores, spiral 

hyphae and smooth, thin-walled, clavate-shaped, multicelled macroconidia may also 

be present. 


Littman Oxgall Agar: Raised greyish-white, suede-like to downy colony. Some 

cultures may show a diffusible yellow to brown pigment. 

Lactritmel Agar: Cultures are flat, white to cream in colour, with a powdery to granular 

surface. Some cultures develop raised central tufts or pleomorphic downy areas. 

Reverse pigmentation is yellow-brown to pinkish-brown to red-brown. Microscopic 

morphology similar to that described above, with predominantly spherical microconidia, 

often formed in dense clusters, and varying numbers of spherical chlamydospores, 

spiral hyphae and smooth, thin-walled, clavate, multiseptate macroconidia. 

Sabouraud’s Dextrose Agar with 5% Salt: Cultures are heaped and folded, buff to 

brown in colour, with a suede-like surface texture and characteristically have a very 

dark reddish-brown submerged peripheral fringe and reverse pigmentation. 

1% Peptone Agar: Flat, cream-coloured, powdery to granular colony with no reverse 

pigment. 

Hydrolysis of Urea: Positive within 7 days (usually 3 to 5 days). 


nutritional requirements. Cultures are flat, cream-coloured, with a powdery to suedelike 

surface, and have a reddish-brown reverse pigmentation. 

Hair Perforation Test: Positive within 14 days. 

Key Features: Culture characteristics, microscopic morphology and clinical disease 

with known animal contacts. T. mentagrophytes can be distinguished from T. interdigitale 

by: (a) its granular appearance on the 1% Peptone agar; (b) its microscopic morphology 

of more spherical microconidia and generally greater numbers of macroconidia; and 

(c) a yellow to brown diffusible pigment is often seen on the Littman oxgall agar. Both 

T. interdigitale and T. mentagrophytes demonstrate profuse growth and alkalinity on 

BCP milk solids agar.

204 


Trichophyton mentagrophytes (Robin) Blanchard 

a 

a 

b 

20 µm 

c 

20 µm d 

20 µm 

Trichophyton mentagrophytes (a) cultures, (b) macroconidia, 

(c) microconidia and (d) hyphal spirals.


Trichophyton quinckeanum (Zopf) MacLeod & Münde 

Synonymy: T. mentagrophytes var. quinckeanum (Zopf) J.M.B. Smith & Austwick. 

Trichophyton quinckeanum causes “mouse favus” on mice, seen as thick, yellow, 

saucer-shaped crusted lesions up to 1 cm in diameter called scutula. Invaded hairs 

are rarely seen but they may show either ectothrix or endothrix infection. Infected 

human hairs do not fluoresce under Wood’s ultra-violet light, but very occasional hairs 

from experimental lesions in guinea pigs have shown a pale yellow fluorescence. The 

geographical distribution of this dermatophyte is difficult to establish, but is probably 

worldwide. It is often associated with mice plagues in the Australian Wheat Belt. 


Morphological Description: Colonies are generally flat, white to cream in colour, with 

a powdery to granular surface. Some cultures show central folding or develop raised 

central tufts or pleomorphic suede-like to downy areas. Reverse pigmentation is usually 

a yellow-brown to reddish-brown colour. Numerous microconidia are borne laterally 

along the sides of hyphae, and are predominantly slender clavate when young. With 

age the microconidia become broader and pyriform to spherical in shape. Occasional 

to moderate numbers of smooth, thin-walled, multiseptate, clavate to cigar-shaped 

macroconidia may be present. Varying numbers of spherical chlamydospores and 

spiral hyphae may also be present. 


Littman Oxgall Agar: Raised, dome-like bluish-grey, suede-like colony with a narrow 

flat, greyish-white, suede-like border. No diffusible or reverse pigment is present. 

Lactritmel Agar: Flat, white to cream, suede-like to powdery colony with either no 

reverse pigment or a pale yellow-brown to pinkish-brown reverse. Numerous slender 

clavate to pyriform (depending on age of subculture) microconidia and occasional to 

moderate numbers of smooth, thin-walled, clavate macroconidia are present. 

Sabouraud’s Dextrose Agar with 5% salt: Heaped and much folded white suede-like 

colony with very pale yellow-brown reverse. No submerged fringe. 

1% Peptone Agar: Raised white suede-like to downy colony with no reverse pigment. 

Hydrolysis of Urea: Positive within 7 days (usually very rapid 2-3 days). 

Vitamin Free Agar (Trichophyton Agar No.1): Flat, white to cream, suede-like colony 

with either no reverse pigment or a pale yellow-brown reverse, i.e. no special nutritional 

requirements. 

Hair Perforation Test: Positive in 7 to 10 days. 

Key Features: Culture characteristics, microscopic morphology, and rapid urease test.

206 


Trichophyton quinckeanum (Zopf) MacLeod & Münde 

Trichophyton quinckeanum may be distinguished from T. mentagrophytes by: (a) its 

characteristic culture appearance on Littman oxgall agar (i.e. raised, dome-like, bluishgrey 

suede-like colony with a narrow flat, greyish-white, suede-like border and no 

diffusible or reverse pigment) and on Sabouraud’s 5% salt agar (typically heaped and 

folded white suede-like colony, but with no distinctive dark reddish-brown submerged 

fringe and reverse pigment as seen on T. mentagrophytes); (b) microscopic morphology 

showing numerous slender clavate with some pyriform microconidia and moderate 

numbers of smooth thin-walled, clavate macroconidia; and (c) a rapid urease test, 

usually positive within 2 to 3 days. 

a 

b 

20 µm 

Trichophyton quinckeanum (a) culture and (b) microconidia and macroconidia.


Trichophyton rubrum (Castellani) Semon 

Synonymy: Trichophyton fischeri Kane. 

Trichophyton raubitschekii Kane, Salkin, Weitzman & Smitka. 

Trichophyton kanei Summerbell. 

all varieties of T. rubrum. 

Trichophyton rubrum is an anthropophilic fungus that has become the most widely 

distributed dermatophyte of humans. It frequently causes chronic infections of skin, 

nails and rarely scalp. Granulomatous lesions may sometimes occur. Infected hairs do 

not fluoresce under Wood’s ultraviolet light, and microscopically may show endothrix 

or ectothrix type of invasion. 

Morphologically T. rubrum exhibits a spectrum of overlapping characters; for example 

culture surface texture may vary from downy to suede-like; culture surface pigmentation 

may vary from white to cream to deep red; culture reverse pigmentation may vary 

from colourless to yellowish to yellow-brown to wine red; numbers of microconidia 

range from none to scanty to many; shape of microconidia vary from slender clavate to 

pyriform; numbers of macroconidia range from none to scanty to many and may or may 

not have terminal projections. This is why so many varieties or synonyms have been 

described in the past. However, molecular evidence by Gräser et al. (1999b) reveals 

little variation between strains of T. rubrum and determined that the species is largely 

clonal. 

The majority of isolates, especially those causing tinea pedis and onychomycosis, are 

characterised by the production of scanty to moderate numbers of slender clavate 

microconidia and no macroconidia (formerly the “downy strain”). Some isolates, 

usually from cases of tinea corporis, are characterised by the production of moderate 

to abundant numbers of clavate to pyriform microconidia and moderate to abundant 

numbers of thin-walled, cigar-shaped macroconidia (formerly the “granular strain”). 

It should be stressed that intermediate strains do occur as many culture and 

morphological characteristics overlap. 

a b c d 

Trichophyton rubrum culture morphology; (a) “downy strain” with typical wine-red 

reverse; (b) “Y variety” with both yellow and red pigmentation; (c) “var. flava” with 

yellow pigmentation; (d) “granular strain” with red surface and reverse pigmentation.

208 



Morphological Description: Colonies are mostly flat to slightly raised, white to cream, 

suede-like to downy, with either no reverse pigment or a yellow-brown to wine-red 

reverse. Most cultures show scanty to moderate numbers of slender clavate to pyriform 

microconidia. Macroconidia are usually absent, but when present are smooth, thinwalled 

multiseptate, slender and cylindrical to cigar-shaped. Older cultures may show 

numerous chlamydospores with a few clavate to pyriform microconidia. 

Note: On primary isolation some cultures may lack reverse pigmentation and fail to 

produce microconidia. These need to be subcultured onto media like lactritmel agar or 

potato dextrose agar, which stimulate pigmentation and sporulation. If sporulation still 

fails subculture the fungus onto Trichophyton agar No.1. 



Littman Oxgall Agar: Raised, greyish-white, suede-like to downy colony with no 

reverse pigment. Some cultures may show a greenish-yellow diffusible pigment. 

Lactritmel Agar: Flat, white to rose pink, downy to granular colonies with a deep winered 

reverse pigment. 

Sabouraud’s Dextrose Agar with 5% salt: Very stunted, white to cream, downy to 

glabrous colony with a pale yellow-brown reverse pigment. 

1% Peptone Agar: Flat, white to cream, downy to glabrous colony with no reverse 

pigment. 

BCP Agar: restricted colony growth and neutral (unchanged) pH. Colonies typically 

demonstrate red pigment on reverse 

Hydrolysis of Urea: Typically, negative at 7 days (some may be positive). 


vitamin requirements. Colonies are flat, white to cream, suede-like to downy with a 

deep wine-red reverse pigment. 

Hair Perforation Test: Negative at 28 days. 

Key Features: Include clinical history, culture characteristics, microscopic morphology 

and failure to perforate hair in vitro.



a 

b 

Note: Trichophyton rubrum produces both red and yellow pigments. Culture colours 

may range from none to dark red to dark yellow, with all combinations in between. The 

images above show the same strain (a) grown on lactritmel agar that promotes red 

pigmentation and (b) on mycobiotic agar that shows an underlying yellow pigmentation. 

20 µm 

20 µm 

Trichophyton rubrum showing typical slender clavate microconidia.

210 



20 µm 

20 µm 

Trichophyton rubrum showing slender clavate microconidia and 

cigar-shaped macroconidia, some with terminal appendages.


Trichophyton schoenleinii (Lebert) Langeron & Milochevitch 

Trichophyton schoenleinii is an anthropophilic fungus causing favus in humans. Favus 

is a chronic, scarring form of tinea capitis characterised by saucer-shaped crusted 

lesions or scutula and permanent hair loss. Invaded hairs remain intact and fluoresce 

a pale greenish-yellow under Wood’s ultra-violet light. Favus was once common in 

Eurasia and North Africa, however its incidence is now in decline. 


Morphological Description: Colonies are slow growing, waxy or suede-like with a 

deeply folded honey-comb-like thallus and some subsurface growth. The thallus is 

cream-coloured to yellow to orange brown. Cultures are difficult to maintain in their 

typical convoluted form, and rapidly become flat and downy. No reverse pigmentation is 

present. No macroconidia and microconidia are seen in routine cultures, and numerous 

chlamydospores may be present in older cultures. Characteristic antler “nail head” 

hyphae, also known as “favic chandeliers”, may be observed. A few distorted clavate 

microconidia may be formed by some isolates when grown on polished rice grains. 

Key Features: Clinical history, culture characteristics and microscopic morphology 

showing “favic chandeliers”. 

a 

b 

20 µm 

Trichophyton schoenleinii (a) culture and (b) “favic chandeliers”.

212 


Trichophyton soudanense Joyeux. 

Trichophyton soudanense is an anthropophilic fungus that is a frequent cause of 

tinea capitis in Africa. Invaded hairs show an endothrix infection but do not fluoresce 

under Wood’s ultra-violet light. Distribution is mainly in Africa with imported cases now 

reported from Europe, Brazil, Australia and USA. 


Morphological Description: Colonies are slow-growing with a flat to folded, suedelike 

surface. Often there is a broad fringe of submerged growth. Surface mycelium and 

reverse pigment are characteristically a deep apricot-orange in colour. Microscopically, 

the hyphae often show reflexive or right-angle branching. Pyriform microconidia may 

occasionally be present and numerous chlamydospores are often found in older 

cultures. 

Note: T. soudanense demonstrates profuse growth and alkalinity on BCP milk solids 

agar. A thin halo of clearing usually appears in the milk solids around the colony edge 

at 7-10 days. 

Key Features: clinical history, culture characteristics and microscopic morphology 

showing reflexive hyphal branching and endothrix invasion of hair. 

a 

b 

20 µm 

Trichophyton soudanense (a) culture and (b) “reflex” hyphal branching.


Trichophyton tonsurans is an anthropophilic fungus with a worldwide distribution which 

causes inflammatory or chronic non-inflammatory finely scaling lesions of skin, nails 

and scalp. It is a common cause of tinea capitis in Australian Aborigines and African 

Americans. Invaded hairs show an endothrix infection and do not fluoresce under 

Wood’s ultra-violet light. 


Morphological Description: Colonies show considerable variation in texture and 

colour. They may be suede-like to powdery, flat with a raised centre or folded, often 

with radial grooves. The colour may vary from pale-buff to yellow, (the sulfureum form 

which resembles Epidermophyton floccosum), to dark-brown. The reverse colour 

varies from yellow-brown to reddish-brown to deep mahogany. Hyphae are relatively 

broad, irregular, much branched with numerous septa. Numerous characteristic 

microconidia varying in size and shape from long clavate to broad pyriform, are borne 

at right angles to the hyphae, which often remain unstained by lactophenol cotton blue. 

Very occasional smooth, thin-walled, irregular, clavate macroconidia may be present 

on some cultures. Numerous swollen giant forms of microconidia and chlamydospores 

are produced in older cultures. 


Mycosel Agar: Chlamydospore-like structures produced by 5 days is characteristic of 

T. tonsurans (Mochizuki et al. 2013). 

Hydrolysis of Urea: positive at 5 days. 

Trichophyton tonsurans Malmsten 

T1 

T4 

a 

b 

Nutritional Tests on Trichophyton Agars: results demonstrate a partial requirement 

for (a) thiamine. T1 = vitamin free agar, (b) T4 = vitamin free + thiamine agar. 

Hair Perforation Test: Positive within 14 days. 

Key Features: microscopic morphology, culture characteristics, endothrix invasion of 

hairs and partial thiamine requirement. 

References: Rebell and Taplin (1970), Ajello (1972), Vanbreusegham et al. (1978), 

Rippon (1988), McGinnis (1980), Domsch et al. (1980), Kane et al. (1997) and de 

Hoog et al. (2000, 2015).

214 


Trichophyton tonsurans Malmsten 

Trichophyton tonsurans cultures show considerable variation in texture and colour. The 

colour may vary from pale-buff to yellow to dark-brown. The reverse colour varies from 

yellow-brown to reddish-brown to deep mahogany. 

b 

a 

20 µm 

Trichophyton tonsurans (a) hyphae, microconidia and (b) macroconidia.


Trichophyton verrucosum is a zoophilic fungus causing ringworm in cattle. Infections in 

humans result from direct contact with cattle or infected fomites and are usually highly 

inflammatory involving the scalp, beard or exposed areas of the body. Invaded hairs 

show an ectothrix infection and fluorescence under Wood’s ultra-violet light has been 

noted in cattle but not in humans. Distribution is worldwide. RG-2 organism. 

Morphological Description: Colonies are slow growing, small, button or disk-shaped, 

white to cream-coloured, with a suede-like to velvety surface, a raised centre, and 

flat periphery with some submerged growth. Reverse pigment may vary from nonpigmented 

to yellow. Broad, irregular hyphae with many terminal and intercalary 

chlamydospores. Chlamydospores are often in chains. The tips of some hyphae are 

broad and club-shaped, and occasionally divided, giving the so-called “antler” effect. 

When grown on thiamine-enriched media, occasional strains produce clavate to 

pyriform microconidia borne singly along the hyphae. Macroconidia are only rarely 

produced, but when present have a characteristic tail or string bean shape. 


Trichophyton verrucosum Bodin 

Growth at 37 O C: Unlike other dermatophytes, growth is enhanced at 37 O C. 

Nutritional Requirements: all strains require thiamine and approximately 80% require 

thiamine and inositol. There is no growth on casein vitamin free agar (T1), minimal 

submerged growth on T1 + inositol (T2), good growth on T1 + inositol and thiamine 

(T3) and good growth on T1 + thiamine only (T4). 

All strains produce typical chains of chlamydospores, often referred to as “chains of 

pearls”, especially when grown on BCP milk solids glucose agar at 37 O C. When grown 

at 25 O C on milk solids glucose agar a “halo”-like zone of peripheral clearing of milk 

solids occurs within 7 days. 

Microscopic examination of young colonies (4 to 5 day old), grown from a very small 

inoculum, on Sabouraud’s dextrose agar containing 0.5% yeast extract and incubated 

at 30 O C, show characteristic terminal vesicles (not chlamydospores) at the tips of 

hyphae. The number of vesicles produced is greater from primary inoculations of skin 

scrapings or hairs than from subcultures. 

Key Features: Culture characteristics and requirements for thiamine and inositol, large 

ectothrix invasion of hair, clinical lesions and history. 

a 

b 

Trichophyton verrucosum (a) young button-shaped colonies and (b) mature culture.

216 


Trichophyton verrucosum Bodin 

a 

20 µm 

b 

20 µm 

20 µm 

c 

30 µm 

d 

Trichophyton verrucosum showing (a) clavate to pyriform microconidia, (b) 

characteristic rat tail or string bean-shaped macroconidia, (c) terminal vesicles 

at the tips of hyphae in young colonies and (d) chains of chlamydospores.


Synonymy: Trichophyton yaoundei Cochet & Doby-Dubois. 

All varieties of T. violaceum. 

Trichophyton violaceum is an anthropophilic fungus causing inflammatory or chronic 

non-inflammatory finely scaling lesions of skin, nails, beard and scalp, producing the 

so-called “black dot” tinea capitis. Distribution is worldwide, particularly in the Near 

East, Eastern Europe, Russia and North Africa. Invaded hairs show an endothrix 

infection and do not fluoresce under Wood’s ultra-violet light. 


Trichophyton violaceum Sabouraud apud Bodin 

Morphological Description: Colonies are very slow growing, glabrous or waxy, heaped 

and folded and deep violet in colour. Cultures often become pleomorphic, forming 

white sectors. Occasional non-pigmented strains may occur. Hyphae are relatively 

broad, tortuous, much branched and distorted. Young hyphae usually stain well in 

lactophenol cotton blue, whereas older hyphae stain poorly and show small central fat 

globules and granules. Typically, no conidia are present, although occasional pyriform 

microconidia have been observed on enriched media. Numerous chlamydospores are 

usually present, especially in older cultures. 

Nutritional Requirements: T. violaceum has a partial nutrient requirement for thiamine. 

There is minimal growth on casein vitamin-free agar (T1), and slightly better growth on 

vitamin-free agar plus thiamine (T4). The partial requirement for thiamine separates 

this organism from T. rubrum, and other species that may produce purple pigmented 

colonies. 

Key Features: Culture characteristics, partial thiamine requirement and endothrix hair 

invasion. 

a 

b 

20 µm 

Trichophyton violaceum (a) culture and (b) chlamydospores.

218 


Trichosporon Behrend 

Trichosporon species are urease-positive, non-encapsulated basidiomycetous yeasts 

characterised by the development of hyaline, septate hyphae that fragment into oval or 

rectangular arthroconidia. Some blastoconidia are also seen. The colonies are usually 

raised and have a waxy appearance, which develop radial furrows and irregular folds. 

They are widely distributed in the environment and many have different habitats, usually 

occupying narrow ecological niches. Some are soil borne and others are associated 

with humans and animals (Colombo et al. 2011, Sugita 2011, Arendrup et al. 2014). 

The genus has undergone major taxonomic revision (Gueho et al. 1992, de Hoog et 

al. 2000, Rodriguez-Tudela et al. 2005). In particular, the name Trichosporon beigelii is 

now obsolete, and previously described infections reported in the literature under this 

name could in fact be due to any one of the species listed below. 

Six species are of clinical significance: T. asahii, T. asteroides, T. cutaneum, T. 

inkin, T. mucoides and T. ovoides. Other species reported from human and animal 

infections include T. dermatis, T. domesticum, T. faecale, T. jirovecii, T. loubieri and T. 

mycotoxinovorans (Rodriguez-Tudela et al. 2005, Chagas-Neto et al. 2008, Colombo 

et al. 2011). 

Trichosporon species are a minor component of normal skin flora, and are widely 

distributed in nature. They are regularly associated with the soft nodules of white piedra, 

and have been involved in a variety of opportunistic infections in the immunosuppressed 

patient. Disseminated infections are most frequently (75%) caused by T. asahii 

(Arendrup et al. 2014) and have been associated with leukaemia, organ transplantation, 

multiple myeloma, aplastic anaemia, lymphoma, solid tumours and AIDS. Disseminated 

infections are often fulminate and widespread, with lesions occurring in the liver, spleen, 

lungs and gastrointestinal tract. Infections in non-immunosuppressed patients include 

endophthalmitis after surgical extraction of cataracts, endocarditis usually following 

insertion of prosthetic cardiac valves, peritonitis in patients on continuous ambulatory 

peritoneal dialysis (CAPD), and intravenous drug abuse. 

Note: Genus identification is mandatory for clinical management and should be 

performed and provided in a timely manner. Species identification remains difficult and 

requires molecular analysis or MALDI-TOF MS (with an extensive database) (Arendrup 

et al. 2014). 

Molecular Identification: ITS and D1/D2 sequencing is required for accurate species 

identification (Arendrup et al. 2014). 

MALDI-TOF MS: A promising identification tool to accurately identify species (with an 

extensive database) (Kolecka et al. 2013). 

Comment: The API 20C yeast identification system is recommended for sugar 

assimilation tests. 

References: Kurtzman and Fell (1988), Gueho et al. (1992), de Hoog et al. (2000, 

2015), Rodriguez-Tudela et al. (2005), Chagas-Neto et al. (2008), Guo et al. (2011), 

Xiao et al. (2013).


Trichosporon Behrend 

Key to medically important species (de Hoog et al. 2000). 

1. Growth with melibiose 2 

No growth with melibiose 3 

2. Tolerant to cycloheximide T. mucoides 

Not tolerant to cycloheximide 

T. cutaneum 

3. Growth with myo-inositol, no growth with L-arabinose T. inkin 

No growth with myo-inositol, growth with L-arabinose 4 

4. Colony with very slow growth; thallus consisting of clumps 

of meristematic cells 

T. asteroides 

Colonies and microscopy otherwise 5 

5. Appressoria present in slide cultures T. ovoides 

Appressoria absent in slide cultures 6 

6. Arthroconidia barrel-shaped; thallus not meristematic T. asahii 

Arthroconidia elongate, or thallus meristematic 

T. asteroides 

Trichosporon asahii Akagi ex Sugita et al. 


Morphological Description: Colonies are white to cream-coloured, powdery, suedelike 

to farinose with radial furrows and irregular folds. Budding cells and lateral conidia 

are absent. Arthroconidia are barrel-shaped. Appressoria absent. This species 

assimilates L-arabinose but not melibiose. Growth at 37 O C. Most common species, 

especially from invasive infections. 

Assimilation Tests: + Positive, - Negative, v Variable, w Weak, s Slow 

Glucose + Melibiose - L-Rhamnose + D-Glucitol v 

Galactose + Raffinose - D-Glucosamine + α-M-D-glucoside + 

L-Sorbose v Melezitose v N-A-D-glucosamine + D-Gluconate + 

Sucrose v Soluble Starch v Glycerol v DL-Lactate v 

Maltose + D-Xylose v Erythritol + myo-Inositol v 

Cellobiose + L-Arabinose + Ribitol v Nitrate - 

Trehalose + D-Arabinose + Galactitol - 2-K-D-gluconate + 

Lactose + D-Ribose + D-Mannitol v D-Glucuronate +

220 


Trichosporon asahii Akagi ex Sugita et al. 

a 

b 

20 µm 

Trichosporon asahii (a) culture and (b) hyphae and arthroconidia. 

Antifungal Susceptibility: T. asahii (Australian National data); MIC µg/mL. 

No. 64 

AmB 22 4 4 6 4 3 1 

FLU 22 1 3 11 7 

VORI 20 1 1 7 10 1 

POSA 19 1 1 11 4 2 

ITRA 22 3 15 3 1 

Note: Non-T. asahii isolates appear to be more susceptible than T. asahii isolates to 

AmB, FLU, and ITRA, while the new triazoles are active against both T. asahii and 

non-T. asahii isolates (Rodriguez-Tudela et al. 2005). 

Trichosporon inkin. Colonies are 

restricted, white, finely cerebriform with 

a granular covering, without marginal 

zone, often cracking the media.


Trichosporon asteroides (Rischin) Ota 

Morphological Description: Colonies are restricted, dry, cream-coloured, cerebriform, 

with radial furrows and irregular folds. The meristematic form is punctiform, brownish 

and consists of hyphae which swell and become multiseptate which may fall apart 

into smaller packets. Budding cells and lateral conidia are absent. Arthroconidia are 

elongate and hyphae are often present. Appressoria absent. This species assimilates 

L-arabinose but not myo-inositol. Growth at 37 O C is variable. Uncommon species 

usually associated with superficial infections. RG-2 organism. 



Galactose + Raffinose - D-Glucosamine v α-M-D-glucoside + 

L-Sorbose v Melezitose + N-A-D-glucosamine + D-Gluconate + 

Sucrose + Soluble Starch + Glycerol + DL-Lactate + 

Maltose + D-Xylose + Erythritol + myo-Inositol - 

Cellobiose + L-Arabinose + Ribitol v Nitrate - 

Trehalose + D-Arabinose + Galactitol - 2-K-D-gluconate + 

Lactose + D-Ribose + D-Mannitol v D-Glucuronate + 

Trichosporon cutaneum (de Beurmann et al.) Ota 

Morphological Description: Colonies are cream-coloured, cerebriform, glabrous, with 

radial furrows and irregular folds. Budding cells abundant in primary cultures; hyphae 

developing in older cultures. Arthroconidia are cylindrical to ellipsoidal. Appressoria 

absent. This species assimilates melibiose; not tolerant to 0.1% (variable tolerance 

to 0.01%) cycloheximide. No growth at 37 O C. Uncommon species usually associated 

with superficial infections. RG-2 organism. 


Glucose + Melibiose + L-Rhamnose + D-Glucitol + 

Galactose + Raffinose + D-Glucosamine v α-M-D-glucoside + 



Maltose + D-Xylose + Erythritol + myo-Inositol + 

Cellobiose + L-Arabinose + Ribitol + Nitrate - 

Trehalose + D-Arabinose v Galactitol - 2-K-D-gluconate + 

Lactose + D-Ribose + D-Mannitol + D-Glucuronate + 

Trichosporon inkin (Oho ex Ota) do Carmo-Sousa & van Uden 

Morphological Description: Colonies are restricted, white, finely cerebriform with a 

granular covering, without marginal zone, often cracking the media. Budding cells and 

lateral conidia absent. Arthroconidia are long cylindrical. Appressoria present in slide 

cultures. Sarcinae present on media with high sugar-content. This species assimilates 

myo-inositol but not melibiose and is tolerant to 0.01% (variable tolerance to 0.1%) 

cycloheximide. Growth at 37 O C. Usually associated with white piedra on pubic hairs. 

RG-2 organism.

222 


Trichosporon inkin (Oho ex Ota) do Carmo-Sousa & van Uden 


Glucose + Melibiose - L-Rhamnose - D-Glucitol - 

Galactose v Raffinose - D-Glucosamine v α-M-D-glucoside + 


Sucrose + Soluble Starch + Glycerol v DL-Lactate + 


Cellobiose + L-Arabinose v Ribitol - Nitrate - 

Trehalose + D-Arabinose v Galactitol - 2-K-D-gluconate + 

Lactose + D-Ribose + D-Mannitol v D-Glucuronate + 

Trichosporon mucoides Gueho & M.Th. Smith 

Morphological Description: Colonies are moist and glabrous, white, cerebriform, 

heaped and folded. Budding cells present in primary cultures. Broadly clavate, terminal 

or lateral blastoconidia often present, becoming thick-walled with age. Arthroconidia 

are barrel-shaped. Appressoria absent. This species assimilates melibiose and is 

tolerant to 0.01% (variable tolerance to 0.1%) cycloheximide. Growth at 37 O C. Common 

species associated with superficial infections, white piedra and onychomycosis. 



Glucose + Melibiose + L-Rhamnose + D-Glucitol + 

Galactose + Raffinose + D-Glucosamine + α-M-D-glucoside + 

L-Sorbose + Melezitose + N-A-D-glucosamine + D-Gluconate + 



Cellobiose + L-Arabinose + Ribitol + Nitrate - 

Trehalose + D-Arabinose + Galactitol + 2-K-D-gluconate + 

Lactose + D-Ribose + D-Mannitol + D-Glucuronate + 

Trichosporon ovoides Behrend 

Morphological Description: Colonies are restricted, white, granular, folded at the 

centre, with a flat marginal zone. Budding cells and lateral conidia absent. Arthroconidia 

are cylindrical. Appressoria present in slide cultures. This species does not assimilate 

melibiose, but tolerates 0.01% cycloheximide. Growth at 37 O C is variable. Uncommon 

species usually associated with superficial infections, like white piedra. RG-2 organism. 



Galactose + Raffinose v D-Glucosamine v α-M-D-glucoside + 

L-Sorbose v Melezitose v N-A-D-glucosamine + D-Gluconate + 

Sucrose + Soluble Starch + Glycerol v DL-Lactate + 


Cellobiose + L-Arabinose v Ribitol - Nitrate - 

Trehalose v D-Arabinose v Galactitol - 2-K-D-gluconate + 

Lactose + D-Ribose + D-Mannitol + D-Glucuronate +


Trichothecium roseum has a worldwide distribution and is often isolated from decaying 

plant substrates, soil, seeds of corn, and food-stuffs (especially flour products). It is 

occasionally isolated as a saprophyte in the clinical laboratory. 


Trichothecium roseum (Persoon) Link 

Morphological Description: Colonies are moderately fast growing, flat, suede-like to 

powdery, initially white but becoming rosy, pink or orange with age. The conidiophores 

are indistinguishable from the vegetative hyphae until the first conidium is produced. 

They are erect, unbranched, often septate near the base, more or less roughwalled, 

bearing basipetal zig-zag (alternating) chains of conidia at the apex. Note: 

The conidiophore is progressively shortened with the formation of each conidium i.e. 

retrogressive conidial development. Conidia are two-celled ellipsoidal to pyriform, with 

an obliquely truncate basal scar, hyaline, smooth to delicately roughened and thickwalled. 

Comment: T. roseum should not be confused with Nannizzia nanum. Colonies of the 

latter may be pinkish-buff in colour and also produce ovoid to pear-shaped, mostly twocelled 

macroconidia with thin, verrucose walls. However, N. nanum usually produces 

a red-brown reverse pigment and the two-celled macroconidia are sessile and formed 

singly, they are not produced in basipetal chains as in T. roseum. 

Molecular Identification: Summerbell et al. (2011) revised the genus using D1/D2 

sequences for phylogenetic analysis and sequence based identification. 

Key Features: Hyphomycete, basipetal zig-zag chains of two-celled conidia showing 

retrogressive development where the conidiophore becomes progressively shorter. 

References: McGinnis (1980), Domsch et al. (2007), Rippon (1988), Samson et al. 

(1995), Summerbell et al. (2011). 

20 µm 

Trichothecium roseum conidiophores showing retrogressive conidial development.

224 


Species of Ulocladium should not be confused with other poroconidial genera such as 

Stemphylium, Alternaria, Bipolaris, Exserohilum, Dreschlera and Curvularia. A human 

case of keratitis has been reported (Badenoch et al. 2006). 


Ulocladium Preuss 

Morphological Description: Colonies are rapid growing, brown to olivaceousblack 

or greyish and suede-like to floccose. Microscopically, numerous, usually 

solitary, multicelled conidia (dictyoconidia) are formed through a pore (poroconidia) 

by a sympodially elongating geniculate conidiophore. Conidia are typically obovoid 

(narrowest at the base), dark brown and often rough-walled. Seven species have been 

described, all being saprophytes. 

Molecular Identification: ITS sequencing is sufficient for genus identification 

(Badenoch et al. 2006) and Woudenberg et al. 2013). 

References: Ellis (1970, 1976), Domsch et al. (1980), Rippon (1988), Samson et al. 

(1995), de Hoog et al. (2000). 

10 µm 

Ulocladium spp. conidiophores and conidia. 

Antifungal Susceptibility: Ulocladium sp. very limited data (Pujol et al. 2000, 


Antifungal Range Antifungal Range Antifungal Range 

AmB 1->16 VORI 0.25 ITRA 0.06->16


Veronaea botryosa Ciferri & Montemartini 

This genus is very similar to Rhinocladiella, however the conidia are typically twocelled. 

Occasional skin infections have been reported from humans (Revankar and 

Sutton 2010). 


Morphological Description: Colonies grow rapidly and are suede-like to downy, 

greyish-brown to blackish-brown. Conidiophores are erect, straight or flexuose, 

occasionally branched and are usually geniculate, due to the sympodial development of 

the conidia. They are smooth-walled, pale to medium olivaceous-brown, up to 250 µm 

long and 2-4 µm wide. Conidia are pale brown, two-celled, cylindrical with a truncated 

base, smooth-walled or slightly verrucose, 5-12 x 3-4 µm. 

Molecular Identification: Arzanlou et al. (2007) used D1/D2 and ITS sequence data 

in a phylogenetic revision. 

References: Ellis (1971), de Hoog et al. (2000, 2015), Revankar and Sutton (2010). 

10 µm 

Veronaea botryosa conidiophores and conidia. 

Antifungal Susceptibility: V. botryosa limited data (Badali et al. 2013); MIC µg/mL. 



AmB 8-16 16 POSA 0.03-0.25 0.25 

ITRA 0.25-1 1 VORI 1-8 4

226 


Verruconis gallopava (W.B. Cooke) Samerpitak & de Hoog 

Synonymy: Ochroconis gallopava (W.B. Cooke) de Hoog. 

Verruconis species are thermophilic, with Verruconis gallopava occurring in hot 

environments, such as thermal soils, broiler house litter, hot springs, and self-heated 

waste (Samerpitak et al. 2014). V. gallopava is neurotropic and is a recognised agent 

of human brain infections and is responsible for encephalitis in poultry and wild birds 

dogs and cats (Seyedmousavi et al. 2014). Occasional human pulmonary infections 

in immunocompetent hosts have also been reported (Samerpitak et al. 2014, 

Seyedmousavi et al. 2014, Giraldo et al. 2014). 


Morphological Description: Colonies are smooth to suede-like, dry, flat, tobaccobrown 

to brownish-black with a dark brown diffusible pigment. Hyphae are brown with 

relatively thick walls. Conidiophores are mostly cylindrical to acicular, sometimes poorly 

differentiated, bearing a few conidia at the tip. Conidia are two-celled, subhyaline to pale 

brown, smooth-walled to verrucose, cylindrical to clavate, constricted at the septum, 

11-18 x 2.5-4.5 µm in size, with the apical cell wider than the basal cell. A remnant of 

a denticle may also be seen at the conidial base. Optimum growth at 35 O C, tolerant to 

40 O C. 

Molecular Identification: ITS sequencing can identify species. Additional genes 

include β-tubulin, actin, and the D1/D2 region (Giraldo et al. 2014, Seyedmousavi et 

al. 2014). 

References: Domsch et al. (1980), McGinnis (1980), de Hoog et al. (2000, 2015), 

Samerpitak et al. (2014), Seyedmousavi et al. (2014) and Giraldo et al. (2014). 

Antifungal Susceptibility: V. gallopava limited data (Australian National data); MIC 

µg/mL. 

No. 64 

AmB 8 1 2 2 1 2 

VORI 8 1 3 3 1 

POSA 7 1 2 1 1 1 1 

ITRA 8 3 1 3 1 

V. gallopava data for 11 isolates (Seyedmousavi et al. 2014); MIC µg/mL. 


= 0.5 VORI Range 0.5-2; MIC 90 

= 2 


= 0.5 POSA Range


Verruconis gallopava (W.B. Cooke) Samerpitak & de Hoog 

a 

10 µm 

b 

10 µm 

Verruconis gallopava (a) culture and (b) hyphae, conidiophores and conidia.

228 


Members of this genus are often isolated from the environment. It has been reported 

as a rare agent of mycotic keratitis. 


Verticillium Nees ex Link 

Morphological Description: Colonies are fast growing, suede-like to downy, white to 

pale yellow in colour, becoming pinkish-brown, red, green or yellow with a colourless, 

yellow or reddish-brown reverse. Conidiophores are usually well differentiated and 

erect, verticillately branched over most of their length, bearing whorls of slender awlshaped 

divergent phialides. Conidia are hyaline or brightly-coloured, mostly one-celled, 

and are usually borne in slimy heads (glioconidia). 

Molecular Identification: ITS, actin, EF-1α, GPDH and tryptophan synthase genes 

have been used to identify all recognised Verticillium species (Inderbitzin et al. 2013). 

Key Features: Hyphomycete, verticillate branched conidiophores bearing whorls of 

awl-shaped, divergent phialides. 

References: Domsch et al. (1980), McGinnis (1980), Rippon (1988), Samson et al. 

(1995), de Hoog et al. (2000, 2015). 

20 µm 

Verticillium spp conidiophores, phialides and conidia.


Wickerhamomyces anomalus (E.C. Hansen) Kurtzman et al. 

Synonymy: Candida pelliculosa Redaelli. 

Wickerhamomyces anomalus has been reported from cases of candidaemia and 

catheter related infections in humans and has been isolated from soil, grains, fruit and 

warm-blooded animals. 



Microscopy: Spherical to ellipsoidal budding blastoconidia, 2-4 x 2-6 µm. Pseudohyphae 

may be present. Asci when present, containing one to four hat-shaped ascospores. 


Dalmau Plate Culture: Spherical to ellipsoidal budding yeast cells and abundant 

pseudohyphae in most strains. 




Germ Tube - L-Sorbose - L-Arabinose v D-Glucitol + 



Galactose v Cellobiose + L-Rhamnose - DL-Lactate + 


Maltose v Lactose - N-A-D-glucosamine - 2-K-D-gluconate - 


Trehalose - Raffinose + Erythritol + Nitrate + 

Assimilation Melezitose + Ribitol v Urease - 

Glucose + Soluble Starch + Galactitol - 0.1% Cycloheximide - 

Galactose v D-Xylose v D-Mannitol + Growth at 37 O C v 

Key Features: Germ tube negative yeast and sugar assimilation pattern 

Antifungal Susceptibility: W. anomalus (Diekema et al. 2009, Australian National 


No. 64 

AmB 42 1 5 14 21 2 

FLU 43 2 8 25 8 

VORI 42 1 2 1 22 13 3 

POSA 42 1 1 7 4 15 12 2 

ITRA 3 3 

ANID 16 2 10 3 1 

MICA 16 5 9 2 

CAS 39 1 16 17 4 1 

5FC 3 1 2

230 


Yarrowia lipolytica (Wickerham et al.) van der Walt & von Arx. 

Synonymy: Candida lipolytica (F.C. Harrison) Diddens & Lodder. 

Yarrowia lipolytica is a rare cause of candidaemia. 



Microscopy: Spherical, ellipsoidal to elongate budding blastoconidia, 3-5 x 3-15 µm. 


Dalmau Plate Culture: Pseudohyphae and true hyphae are produced. 






Glucose - Maltose - D-Ribose v D-Gluconate v 

Galactose - Cellobiose w,- L-Rhamnose - DL-Lactate + 




Trehalose - Raffinose - Erythritol + Nitrate - 



Galactose v D-Xylose - D-Mannitol + Growth at 37 O C v 


Antifungal Susceptibility: Y. lipolytica limited data (Diekema et al. 2009, Australian 


No. 64 

AmB 19 1 1 1 6 5 4 1 

FLU 19 1 1 8 6 2 1 

VORI 19 1 6 9 2 1 

POSA 19 2 2 9 5 1 

ITRA 3 1 1 1 

ANID 12 1 3 5 2 1 

MICA 12 7 3 2 

CAS 17 6 10 1 

5FC 3 1 1 1


KOH with Calcofluor White. 

MICROSCOPY STAINS & TECHNIQUES 

For the direct microscopic examination of skin scrapings, hairs, nails and other 

clinical specimens for fungal elements. This is a very sensitive method, however, a 

fluorescence microscope with ultraviolet filters is required (Hageage and Harrington, 

1984; Hollander et al. 1984; Monheit et al. 1984; Harrington and Hageage 2003). 

Solution A: Potassium hydroxide reagent 

Potassium hydroxide 

Glycerine 

Distilled water 

10 g 

10 mL 

80 mL 

Solution B: Calcofluor white reagent 

Calcofluor white 

0.5 g 

Evans blue 

0.02 g 


50 mL 

Mix one drop of each solution on the centre of a clean microscope slide. 

Place the specimen in the solution and cover with a coverslip. 

KOH with Chlorazol Black. 

For the direct microscopic examination of skin scrapings, hairs, nails and other clinical 

specimens for fungal elements. Note: Parker Quink ink is no longer available. 

Polysciences list this product as “Chlorazol black E” product number 02730-25. 

Potassium hydroxide 

10 g 

Chlorazol Black E (0.1%) 

10 mL 

Glycerol 

10 mL 


80 mL 

Using sterile technique, remove a small portion of the specimen with an 

inoculation needle and mount in a drop of KOH on a clean microscope 

slide. Cover with a coverslip, squash the preparation with the butt of the 

inoculation needle and then blot off the excess fluid. 

India Ink Mounts. 

For the direct microscopic examination of CSF for Cryptococcus species. Place a drop 

of India Ink on the specimen, mix well with a sterile loop, and cover with a coverslip. 

Best brands to use are “Pelikan” or “Talons” India Ink.

232 



Lactophenol Cotton Blue (LPCB) 

For the staining and microscopic identification of fungi. 

Cotton Blue (Aniline Blue) 

0.05 g 

Phenol Crystals 

20 g 

Glycerol 

40 mL 

Lactic acid 

20 mL 


20 mL 

This stain is prepared over two days. 

1. On the first day, dissolve the cotton blue in the distilled water. Leave 

overnight to eliminate insoluble dye. 

2. On the second day, wearing gloves, add the phenol crystals to the lactic 

acid in a glass beaker. Place on magnetic stirrer until the phenol is 

dissolved. 

3. Add the glycerol. 

4. Filter the cotton blue and distilled water solution into the phenol/glycerol/ 

lactic acid solution. Mix and store at room temperature. 

Direct Microscopic Mounts or Squash Preparations 

Using sterile technique, remove a small portion of the colony with an inoculation needle 

and mount in a drop of lactophenol cotton blue on a clean microscope slide. Cover with 

a coverslip, squash the preparation with the butt of the inoculation needle and then blot 

off the excess fluid. 

Cellotape Flag Preparations 

An excellent technique for the rapid mounting of sporulating fungi because it keeps 

more of the reproductive structures intact. 

1. Using clear 2 cm wide cellotape and a wooden applicator stick (orange 

stick) make a small cellotape flag (2 x 2 cm). 

2. Using sterile technique, gently press the sticky side of the flag onto the 

surface of the culture. 

3. Remove and apply a drop of 95% alcohol to the flag, this acts as a 

wetting agent and also dissolves the adhesive glue holding the flag to 

the applicator stick. 

4. Place the flag onto a small drop of lactophenol cotton blue on a clean 

glass slide, remove the applicator stick and discard, add another drop of 

stain, cover with a coverslip, gently press and mop up any excess stain.


Slide Culture Preparations 


In order to accurately identify many fungi it is essential to observe the precise 

arrangement of the conidiophores and the way in which spores are produced (conidial 

ontogeny). Riddel’s simple method of slide culturing (Mycologia 1950; 42:265-270) 

permits fungi to be studied virtually in situ with as little disturbance as possible. A 

simple modification of this method using a single agar plate is described below. 

One plate of nutrient agar; potato dextrose is recommended, however, 

some fastidious fungi may require harsher media to induce sporulation like 

cornmeal agar or Czapek Dox agar. 

1. Using a sterile blade cut out an agar block (7 x 7 mm) small enough to 

fit under a coverslip. 

2. Flip the block up onto the surface of the agar plate. 

3. Inoculate the four sides of the agar block with spores or mycelial 

fragments of the fungus to be grown. 

4. Place a flamed coverslip centrally upon the agar block. 

5. Incubate the plate at 26 O C until growth and sporulation have occurred. 

6. Remove the cover slip from the agar block. 

7. Apply a drop of 95% alcohol as a wetting agent. 

8. Gently lower the coverslip onto a small drop of lactophenol cotton blue 

on a clean glass slide. 

9. The slide can be left overnight to dry and later sealed with fingernail 

polish. 

10. When sealing with nail polish use a coat of clear polish followed by one 

coat of red-coloured polish. 

Simple agar block method, inoculated on four sides with cover slip 

on top. Make at least two slides per culture.

234 


Bird Seed Agar 

SPECIALISED CULTURE MEDIA 

For selective isolation of Cryptococcus neoformans and C. gattii. 

Guizotia abyssinica (niger seed) 50 g Glucose 1 g 

KH 2 

PO 4 

(potassium dihydrogen 1 g Creatinine 1 g 

orthophosphate) 

Bacto agar (BD 214010) 15 g Distilled water 1000 mL 

Penicillin G (20 units/mL) 1 mL Gentamicin (40 mg/mL) 1 mL 

1. Grind seeds of Guizotia abyssinica as finely as possible with an electric grinder 

and add to 1000 mL distilled water in a stainless steel jug. 

2. Boil for 30 minutes, then pass through filter paper and adjust volume to 1000 

mL. 

3. Add remaining ingredients (except Bacto agar) to filtrate and dissolve. 

If required: Cool to room temperature and adjust pH to 5.5. 

Dispense into 500 mL bottles. 

4. Add 7.5 g Bacto agar to each 500 mL bottle. 

5. Autoclave 121 O C for 20 minutes. 

6. Cool to 48 O C and add 0.5 mL Penicillin G and 0.5 mL Gentamicin to each 500 

mL bottle of bird seed agar. 

7. Mix gently and pour into 90 mm plastic petri dishes. 

Bromocresol Purple Milk Solids Glucose Agar (BCP) 

For the differentiation of Trichophyton species (Fischer and Kane 1971; Summerbell 

et al. 1988). 

Solution A: 


1000 mL 

Skim milk powder (Carnation Brand) 

80 g 

Bromcresol (or bromocresol) purple 

2 mL 

(1.6% solution in alcohol) 

Dissolve in 2 litre flask and autoclave 121 O C for 10 minutes. 

Solution B: 

Glucose 40 g Distilled water 200 mL 

Dissolve and autoclave at 121 O C for 10 minutes. 

Solution C: 

Bacto agar (BD 214010) 30 g Distilled water 800 mL 

Soak for 15 minutes in 3 litre flask; autoclave at 121 O C for 10 minutes. 

To make media add solution A and B to solution C. Adjust final pH to 6.6. 

Aseptically dispense for slopes (7 mL amounts into bottles).


Creatinine Dextrose Bromothymol Blue Thymine (CDBT) Agar 

For differentiation of C. neoformans var. neoformans and C. neoformans var. grubii 

(Irokanulo et al. 1994). 

Solution A: 

Creatinine 1 g Dextrose 0.5 g 

KH 2 

PO 4 

1 g MgSO 4 

.7H 2 

O 0.5 g 

Thymine 0.1 g Distilled water 980 mL 

1. Dissolve ingredients in small beaker and adjust pH to 5.6 

2. Store in refrigerator. 

Solution B (Aqueous Bromothymol Blue): 

Bromothymol Blue 0.4 g 0.01N NaOH 64 mL 


36 mL 

1. Dissolve the Bromothymol Blue in the NaOH 

2. Add to the water. 

To prepare medium (1 litre for plates): 


Solution A 980 mL Solution B 20 mL 

Bacto agar (BD 214010) 20 g 

Autoclave to 121 O C for 15 minutes, cool to 48 O C and dispense as plates. 

L-Canavanine Glycine Bromothymol Blue (CGB) Agar 

For differentiation of C. neoformans and C. gattii (Kwon-Chung et al. 1982). 

Solution A: 

Glycine Univar 10 g KH 2 

PO 4 

1 g 

MgSO 4 

1 g Thiamine HCl 1 mg 

L-canavanine sulphate 30 mg Distilled water 100 mL 

1. Dissolve ingredients in small beaker and adjust pH to 5.6 

2. Filter sterilise solution using 0.22 µm filter. 

3. Store in refrigerator. 

Solution B (Aqueous Bromothymol Blue): 

Bromothymol Blue 0.4 g 0.01N NaOH 64 mL 


36 mL 

1. Dissolve the Bromothymol Blue in the NaOH 

2. Add to the water. 

To prepare medium (1 litre for plates): 

Distilled water 880 mL Solution B 20 mL 

Bacto agar (BD 214010) 20 g 

1. Autoclave to 121 O C for 15 minutes, cool to 48 O C. 

2. For plates add 100 mL of the filtered solution A and mix. Dispense as 

plates.

236 



Cornmeal Agar 

For routine cultivation and identification of fungi. 

Cornmeal agar (Oxoid CM0103) 

8.5 g 


500 mL 

1. Mix dry ingredients into 100 mL water, boil remaining water. 

2. Add boiling water to mixture and bring to boil. 

3. Autoclave for 10 minutes at 121 O C, then slope on racks. 

Cornmeal Glucose Sucrose Yeast Extract Agar 

For mucormycete sporulation. 


17 g 

Dextrose (Glucose) 

2 g 

Sucrose 

3 g 

Yeast extract 

1 g 


1000 mL 

1. Soak dry ingredients in 100 mL water, then boil remaining water. 

2. Add boiling water to mixture and bring to boil. 

3. Dispense for slopes. 

4. Autoclave for 10 minutes at 121 O C, remove and then angle to form 

slopes on racks. 

Czapek Dox Agar 

For routine cultivation of fungi, especially Aspergillus, Penicillium, and non-sporulating 

moulds. 

Czapek Dox agar (Oxoid CM97) 

45.4 g 


1000 mL 

1. Soak the ingredients in small amount of water. 

2. Bring remaining water to boil, add to soaking ingredients and bring to 

the boil again, stirring continuously. 

3. Dispense for slopes as required. 

4. Autoclave at 121 O C for 10 minutes, remove and slope or pour for 

plates as required. 

Modified Dixon’s Agar 

For primary isolation and cultivation of Malassezia species. 

Malt extract (Oxoid L39) 9 g Bacto Tryptone 1.5 g 

Ox-bile Desiccated (Oxoid L50) 5 g Tween 40 2.5 mL 

Oleic acid 0.5 g Glycerol 0.5 mL 

Bacto agar 3 g Distilled water 250 mL 

1. Soak ingredients in a little of the water. 

2. Bring remaining water to boil, add to the soaking ingredients and bring 

to the boil again constantly stirring. 

3. Dispense for slopes (7 mL) into 30 mL bottles. 

4. Autoclave at 121 O C for 10 minutes and then angle to form slopes on 

racks.



Hair Perforation Test 

For the differentiation of Trichophyton species. 

Blonde pre-pubital hair cut into short pieces (1 cm) 10-20 hairs 


5 mL 

1. Autoclave hair at 121 O C for 10 minutes and store in sterile container. 

2. Place 10-20 short pieces of hair in 5 mL water in vial. 

3. Inoculate with small fragments of the test fungus. 

4. Incubate at room temperature. 

5. Individual hairs are removed at intervals up to 4 weeks and examined 

microscopically in lactophenol cotton blue. Isolates of T. mentagrophytes 

produce marked localised areas of pitting and marked erosion whereas 

those of T. rubrum do not. 

Lactritmel Agar 

For the production of pigment by Trichophyton species. 

Skimmed milk powder 

7 g 

(use only Dutch Jug skimmed milk powder) 

Honey 

10 g 


17 g 

Chloramphenicol 

0.05 g 


1000 mL 

1. Weigh skimmed milk into stainless steel jug. Slowly add some water, 

mixing milk into smooth paste. Continue adding small quantities of 

water until powder is dissolved (about 150 mL). 

2. Weigh other ingredients into skimmed milk and allow to soak. 

3. Boil remaining water, and with it wash out honey from beaker. 

4. Add to other ingredients and boil. 

5. Dispense for slopes (7 mL). 

6. Autoclave for 10 minutes at 121 O C. 

7. On removal from autoclave allow to stand 5 minutes then shake and 

then angle to form slopes on racks. 

Note: Do not filter or adjust pH. 

Littman Oxgall Agar 


Littman oxgall agar (US Biological L3025) 

27.5 g 


500 mL 

1. Soak agar in 100 mL of water. Boil remaining 400mL in a separate 

container. 

2. When water has boiled add to soaking agar and bring back to the boil, 

stirring constantly. 


4. Autoclave for 10 minutes at 121 O C, remove and then angle to form 

slopes on racks.

238 



Malt Extract Agar 


Oxoid Malt Extract (L39) 

20 g 

Bacto agar (BD 214010) 

20 g 


1000 mL 

1. Dissolve malt extract in a beaker and adjust the solution to pH 6.5 with 

NaOH. 

2. Soak agar in small quantity of solution. Bring malt extract solution to 

the boil, stirring constantly. 

3. Add to soaking agar. Bring to boil, stirring constantly. 


5. Autoclave at 121 O C for 10 minutes, remove and then angle to form 

slopes on racks or pour for plates as required. 

1% Peptone Agar 


Tryptone Peptone (BD 211705) 

5 g 


10 g 


500 mL 

1. Soak agar and peptone in about 50 mL of water. 

2. Boil remaining water, add to the soaking ingredients and bring back to 

the boil again. 

3. Dispense for slopes (7 mL). 

4. Autoclave for 10 minutes at 121 O C, then angle to form slopes. 

Potato Dextrose Agar. 


Potato dextrose agar (Oxoid CM139) 

39 g 


1000 mL 

1. Soak potato dextrose agar in 100 mL of the water. 

2. Boil remaining water, add to soaking potato dextrose agar, bring back 

to the boil, stirring constantly. 


4. Autoclave at 121 O C for 15 minutes. Remove and slope or pour for 

plates as required. 

Rice Grain Slopes. 

To induce sporulation and for differentiation of M. audouinii and M. canis. 

Polished rice grains 


1. Place ~ 0.5 teaspoon rice grains into wide neck 20 mL glass vials. 

2. Add 8 mL distilled water to each vial. 

3. Loosely cap the vials, then angle to form slopes on racks ensuring rice 

grains are evenly distributed. 

4. Autoclave racks at 121 O C for 15 minutes.



Sabouraud’s Dextrose Agar (SDA) with Cycloheximide (0.05%), 

Chloramphenicol and Gentamicin 

For the primary isolation and cultivation of dermatophytes. 

Sabouraud’s dextrose agar (Oxoid CM41) 

65 g 

Cycloheximide (Actidione) 

0.5 g 


0.05 g 

Gentamicin (40mg/mL) 

0.56 mL 

Yeast extract 

5 g 


1000 mL 

1. Soak all ingredients, except gentamicin, in 100 mL water. 

2. Boil remaining water, add to soaking ingredients, and bring to boil to 

dissolve, stirring well to prevent from burning. 

3. Add the gentamicin. Mix well. 


5. Autoclave at 121 O C for 10 minutes. Remove and slope, or pour for plates 

as required. 

Sabouraud’s Dextrose Agar with Chloramphenicol and Gentamicin. 

For primary isolation and routine culture of yeasts and moulds. 

Sabouraud’s dextrose agar (Oxoid CM41) 

65 g 


0.05 g 

Gentamicin (40mg/mL) 

0.56 mL 


1000 mL 

See above method for Sabouraud dextrose agar with cycloheximide, 

chloramphenicol and gentamicin. 

Sabouraud’s Dextrose Agar with 5% Salt. 


Sabouraud dextrose agar (Oxoid CM41) 

Sodium Chloride NaCl (Univar 465) 


1. Soak dry ingredients in approximately 100 mL water. 

2. Bring remaining water to boil, add to soaking ingredients. 

3. Dispense into McCartney bottles for slopes (7 mL). 

4. Autoclave at 121 O C for 10 minutes, then slope on racks. 

32.5 g 

25 g 

500 mL

240 


Tap Water Agar 

For the stimulation of sporulation in Apophysomyces and Saksenaea isolates. 


15 g 


1000 mL 

1. Add agar to water in stainless steel jug, allow to soak. 


3. Autoclave at 121 O C for 10 minutes, remove and slope. 

Urea Agar Slopes with 0.5% Glucose. 

For the differentiation of urease producing organisms. 

Urea glucose broth base: 

Urea, broth base (Oxoid CM71) 

0.9 g 

Glucose 

5 g 


450 mL 

1. Add the Urea broth base and glucose to the distilled water in a 500mL 

beaker. 

2. Dispense in 5 x 90 mL amounts. 

3. Autoclave at 121 O C for 20 mins. 

4. When cool, label and store in the fridge. 

Method to make slopes: 


40% Urea Solution (Oxoid SR 20) 10 mL 


3 g 


100 mL 

1. Add agar to 100 mL of distilled water in a 250 mL pyrex bottle. 

2. Autoclave at 121 O C for 15 minutes and place in 50 O C water bath. 

3. When cool add 90 mL of the Urea broth with glucose and the 10 mL 

of 40% urea solution to agar and dispense in 3 mL aliquots and angle 

bottles to form slopes on racks. 

Vitamin Free Agar (Trichophyton Agar No.1) 


Trichophyton agar No. 1 (BD 287710) 

11.8 g 


200 mL 

1. Add agar to water in stainless steel jug, allow to soak. 

2. Bring to boil to dissolve, stirring constantly. 

3. Once boiled remove immediately to avoid discolouration. 


5. Autoclave at 121 O C for 10 minutes, remove and slope.


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