The other black fungi: exploring the opportunists in the order Pleosporales
Sarah A. Ahmed 1,2,3#, Ervin M. Alcanzo 4, Qirui Li 5,6, Nadir Abuzeid 7, Xin Zhou 1,8, Peiying Feng 8, Dea Garcia-Hermoso 9, Sybren de Hoog 1,2
1Radboudumc-CWZ Centre of Expertise for Mycology, Nijmegen, The Netherlands; 2Foundation Atlas of Clinical Fungi, Hilversum, The Netherlands; 3Department of Microbiology, Faculty of Medicine, Kuwait University, Kuwait; 4Radboud University, Nijmegen, The Netherlands; 5High Efficacy Application of Natural Medicinal Resources Engineering Center of Guizhou Province (The Key Laboratory of Optimal Utilization of Natural Medicine Resources), School of Pharmaceutical Sciences, Guizhou Medical University, University Town, Guian New District, Guizhou, P.R. China; 6State Key Laboratory of Discovery and Utilization of Functional Components in Traditional Chinese Medicine & School of Pharmaceutical Sciences, Guizhou Medical University, Guian New District, Guizhou, China; 7Department of Medical Microbiology, Faculty of Medical Laboratory Sciences, Omdurman Islamic University, Khartoum, Sudan; 8Department of Dermatology and Allergy, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, P.R. China; 9Institut Pasteur, Université Paris Cité, National Reference Centre for Invasive Mycoses and Antifungals, Translational Mycology Research Group, Mycology Department, Paris, France
Abstract
Species within the order Pleosporales are associated with diseases in humans, animals, and plants. Historically, human infections caused by these fungi have been underrecognized, largely due to their opportunistic nature and infrequency in clinical settings. Genera such as Alternaria, Bipolaris, and Phoma are recognized as causative agents of human and plant diseases. However, substantial revisions in their taxonomy have posed challenges for their accurate identification in routine diagnostic laboratories. The full spectrum of their pathogenic potential and diversity in human disease is yet to be elucidated. This study provides an overview of the clinical impact, pathogenic origins, taxonomy, and recent classifications of clinically relevant Pleosporales. Diseases caused by these fungi mostly manifest as allergic reactions, mild superficial infections, or localized subcutaneous infections, with invasive cases being rare. While some species produce toxins, there are no recent documented cases of mycotoxicosis in humans. Pleosporalean diseases are more frequently observed in immunocompetent individuals, though transplant recipients, diabetic patients, and oncology patients are at increased risk. Additionally, deep-seated infections generally exhibit a predilection for immunocompromised hosts, but cases with cerebral dissemination are more common in immunocompetent individuals. The role of Pleosporales in keratitis and infections of skin and soft tissues is considerable and warrants further attention. Members of the family Pleosporaceae are responsible for a large proportion of these infections; however, despite the developments in identification of these fungi with conventional and modern diagnostic techniques, substantial gaps persist in the effective diagnosis and treatment of diseases caused. Comprehensive guidelines for precise identification, antifungal susceptibility testing, and clinical management are needed.
Open Access
Cite this article:
Ahmed SA, Alcanzo EM, Li Q, Abuzeid N, Zhou X, Feng P, Garcia-Hermoso D, de Hoog S, 2025.
The other black fungi: exploring the opportunists in the order Pleosporales. One Health Mycology 2(1), 11-41
ISSN: 3050-4627
doi.org/10.63049/OHM.25.21.2
Keywords:
Pleosporales, Pleosporaceae, infection, mycosis, allergy, mycotoxin, skin and soft tissue infection, phaeohyphomycosis, eumycetoma, cerebritis, keratitis
Article highlights:
- Opportunistic fungi in Pleosporales cause a wide range of diseases including deep and (sub)cutaneous infections.
- Standardized guidelines for the diagnosis and management of the ≈140 clinically relevant species have yet to be established.
- Taxonomic dilemmas are numerous, such as the reclassification of clinical species of Bipolaris in Curvularia, and the polyphyletic nature of the ancient genus Phoma.
- Health effects also involve allergy and mycotoxin production.
#Correspondence: sara3707@gmail.com
Article info:
Received 19 January 2025
Revised 13 March 2025
Accepted 15 March 2025
Appeared online 25 March 2025
One Health Mycology 2(1): 11−41, 2025