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Molecular identification: ITS and D1/D2 sequencing may be used for accurate species identification (Halliday
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et al., 2015).
Comment: Myrmecridium 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 visible in lactic acid mounts with bright-field microscopy (Arzanlou et al., 2007).
Antifungal susceptibility: (Table 62.1).
Table 62.1. Myrmecridium schulzeri very limited data (Australian national data); MIC μg/mL.
Antifungal No. ≤0.016 0.03 0.06 0.125 0.25 0.5 1 2 4 8 16 32 ≥64
AmB 1 1
VORI 1 1
POSA 1 1
ITRA 1 1
References: de Hoog (1977); Rippon et al. (1985); Arzanlou et al. (2007); de Hoog et al. (2015).
DOI: 10.1079/9781800622340.0062
Descriptions of Medical Fungi 176
X.Z. Liu et al.
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Synonymy: Cryptococcus albidus (Saito) Skinner; Cryptococcus diffluens (Zach) Lodder & Kreger-van Rij.
A phylogenetic review by Liu et al. (2015) reclassified Cryptococcus albidus as Naganishia albida. N.
albida has variable growth at 37
common risk factor with HIV infection and low CD4 counts a common comorbidity (Morales-Lopez and
Garcia-Effron, 2021).
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 formation: Negative.
Physiological tests: (+ Positive, - Negative, v Variable, w Weak, s Slow, n not done).
Fermentation: Absent.
Growth reactions:
Glucose + L-Sorbose v myo-Inositol +
Sucrose + L-Rhamnose v DL-Lactate +
Raffinose + D-Xylose + D-Gluconate +
Melibiose – L-Arabinose + 2-Keto-D-gluconate n
Galactose v D-Arabinose v D-Glucosamine –
Lactose v D-Ribose + N-Acetyl-D-glucosamine n
Trehalose + Glycerol v D-Glucuronate +
Maltose + Erythritol – Nitrate +
Melezitose + Ribitol v Urease +
Methyl-α-D-glucoside v Galactitol v 0.1% Cycloheximide –
Soluble starch + D-Mannitol + Growth at 35oC v
Cellobiose + D-Glucitol + Growth at 37oC v
o
C and infections in humans are rare. Impaired cellular immunity is the most
RG-1 organism
Molecular identification: ITS and D1/D2 sequencing may be used for accurate species identification.
MALDI-ToF MS: Able to accurately identify this species (Fraser et al., 2016).
© CAB International 2023. Descriptions of Medical Fungi (eds S. Kidd, C.Halliday and D. Ellis)
177
Antifungal susceptibility: (Table 63.1).
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Table 63.1. Naganishia albida very limited data (Australian national data); MIC μg/mL.
Antifungal No. ≤0.03 0.06 0.125 0.25 0.5 1 2 4 8 16 32 ≥64
AmB 1 1
FLU 1 1
VORI 1 1
POSA 1 1
ITRA 1
5FC 1 1
References: Barnett et al. (1983); Fonseca et al. (2011); de Hoog et al. (2020).
DOI: 10.1079/9781800622340.0063
Descriptions of Medical Fungi 178
Based on a recent multilocus phylogenetic study the taxonomy of the dermatophytes has been reviewed
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(de Hoog et al., 2017). The genus Nannizzia now consists of 13 species (Dukik et al., 2019). Nannizzia fulva,
N. gypsea, N. incurvata, N. nana and N. persicolor were previously included in the genus Microsporum.
64.1. Nannizzia fulva (Uribura) 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 that caused by Nannizzia 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 (Fig. 64.1). 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 (Fig. 64.1). Numerous spiral hyphae, which are often branched are seen. Numerous
pyriform to clavate microconidia are also produced but these are not diagnostic.
Fig. 64.1. Nannizzia fulva culture and macroconidia.
© CAB International 2023. Descriptions of Medical Fungi (eds S. Kidd, C.Halliday and D. Ellis)
20 ˜m
179
Key features: Macroconidia morphology and culture characteristics.
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Molecular identification: ITS sequencing is recommended with comparison to Type strains.
References: Rebell and Taplin (1970); Rippon (1988); Graser et al. (2008); Cafarchia et al. (2013); de Hoog
et al. (2015, 2017).
64.2. 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 ani-
mals 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.
RG-1 organism
Morphological description: Colonies are usually flat, spreading, suede-like to granular, with a deep cream to
tawny-buff to pale cinnamon coloured surface (Fig. 64.2). 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 reddish-brown 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 (Fig.
64.2). 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.
References: Rebell and Taplin (1970); Rippon (1988); Graser et al. (2008); Cafarchia et al. (2013); de Hoog
et al. (2015, 2017).
Descriptions of Medical Fungi 180
20 ˜m
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Fig. 64.2. Nannizzia gypsea culture and macroconidia. Note: Some pyriform to clavate microconidia are also present.
64.3. Nannizzia nana (Fuentes) Gräser & de Hoog
Synonymy: Microsporum nanum Fuentes.
Nannizzia nana is a geophilic and zoophilic fungus frequently causing chronic non-inflammatory lesions
in pigs and a rare cause of tinea in humans. Also present in soil of pig-yards. Infections in man are usually
through direct contract with 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 suede-like to powdery surface
texture. Young colonies have a brownish-orange pigment which deepens into a dark reddish-brown with age
(Fig. 64.3). 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 (Fig. 64.3). Occasional clavate microconidia are
present, which distinguishes N. nana from some species of Chrysosporium.
Descriptions of Medical Fungi 181
Fig. 64.3. Nannizzia nana culture and macroconidia.
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Key features: Distinctive macroconidia and culture characteristics.
Molecular identification: ITS sequencing is recommended.
20 ˜m
Descriptions of Medical Fungi 182
64.4. Nannizzia persicolor (Sabouraud) Stockdale
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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 (Fig. 64.4). 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 (Fig. 64.4).
Key features: Microscopic morphology and culture characteristics.
Molecular identification: ITS sequencing is recommended.
20 ˜m
Fig. 64.4. Nannizzia persicolor culture and microconidia.
References: Rebell and Taplin (1970); Rippon (1988); Graser et al. (2008); Cafarchia et al. (2013); de Hoog
et al. (2015, 2017).
DOI: 10.1079/9781800622340.0064
Descriptions of Medical Fungi 183
(Penzig) Crous & Slippers
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Synonymy: Hendersonula toruloidea Nattras; Scytalidium dimidiatum (Penz.) Sutton & Dyko; Scytalidium
hyalinum Campbell & Mulder.
Neoscytalidium dimidiatum is a recognised agent of onychomycosis and superficial skin infections, espe-
cially 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 Scytalidium 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 Scytalidium dimidiatum, is now
considered a distinct species, and has been placed in the genus Neofusicoccum, based on the lack of an
arthroconidial anamorph (Crous et al., 2006; Machouart et al., 2012).
RG-2 organism
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 (Fig. 65.1). 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.
Molecular identification: ITS and D1/D2 sequencing may be used for accurate species identification (Halliday
et al., 2015).
MALDI-ToF MS: Alshawa et al. (2012) developed a spectral database for 12 different species of dermato-
phytes which also included Neoscytalidium dimidiatum and N. dimidiatum var. hyalinum. Correct identifica-
tion of the species was obtained for 18/21 Neoscytalidium isolates (85.7%).
© CAB International 2023. Descriptions of Medical Fungi (eds S. Kidd, C.Halliday and D. Ellis) 184
20 ˜m
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Fig. 65.1. Neoscytalidium dimidiatum arthroconidia.
Antifungal susceptibility: (Table 65.1).
Table 65.1. Neoscytalidium dimidiatum limited data (Australian national data); MIC μg/mL.
Antifungal No. ≤0.016 0.03 0.06 0.125 0.25 0.5 1 2 4 8 16 32 ≥64
AmB 9 1 1 2 3 2
VORI 9 2 1 2 1 3
POSA 9 1 1 1 1 5
ITRA 9 1 1 7
References: McGinnis (1980); Moore (1986); Rippon (1988); Frankel and Rippon (1989); Sutton and Dyko
(1989); de Hoog et al. (2015).
DOI: 10.1079/9781800622340.0065
Descriptions of Medical Fungi 185
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