Many pathogenic fungi are parasitic in humans and are known to cause diseases of humans and other animals. In humans, parasitic fungi most commonly enter the body through a wound in the epidermis (skin). Such wounds may be insect punctures or accidentally inflicted scratches, cuts, or bruises. One example of a fungus that causes disease in humans is Claviceps purpurea, the cause of ergotism (also known as St. Anthony’s fire), a disease that was prevalent in northern Europe in the Middle Ages, particularly in regions of high rye-bread consumption. The wind carries the fungal spores of ergot to the flowers of the rye, where the spores germinate, infect and destroy the ovaries of the plant, and replace them with masses of microscopic threads cemented together into a hard fungal structure shaped like a rye kernel but considerably larger and darker. This structure, called an ergot, contains a number of poisonous organic compounds called alkaloids. A mature head of rye may carry several ergots in addition to noninfected kernels. When the grain is harvested, much of the ergot falls to the ground, but some remains on the plants and is mixed with the grain. Although modern grain-cleaning and milling methods have practically eliminated the disease, the contaminated flour may end up in bread and other food products if the ergot is not removed before milling. In addition, the ergot that falls to the ground may be consumed by cattle turned out to graze in rye fields after harvest. Cattle that consume enough ergot may suffer abortion of fetuses or death. In the spring, when the rye is in bloom, the ergot remaining on the ground produces tiny, black, mushroom-shaped bodies that expel large numbers of spores, thus starting a new series of infections.
Other human diseases caused by fungi include athlete’s foot, ringworm, aspergillosis, histoplasmosis, and coccidioidomycosis. The yeast Candida albicans, a normal inhabitant of the human mouth, throat, colon, and reproductive organs, does not cause disease when it is in ecological balance with other microbes of the digestive system. However, disease, age, and hormonal changes can cause C. albicans to grow in a manner that cannot be controlled by the body’s defense systems, resulting in candidiasis (called thrush when affecting the mouth). Candidiasis is characterized by symptoms ranging from irritating inflamed patches on the skin or raised white patches on the tongue to life-threatening invasive infection that damages the lining of the heart or brain. Improved diagnosis and increased international travel, the latter of which has facilitated the spread of tropical pathogenic fungi, have resulted in an increased incidence of fungal disease in humans. In addition, drug therapies used to manage the immune system in transplant and cancer patients weaken the body’s defenses against fungal pathogens. Patients infected with human immunodeficiency virus (HIV), the causative agent of acquired immunodeficiency syndrome (AIDS), have similarly weakened immune defenses against fungi, and many AIDS-related deaths are caused by fungal infections (especially infection with Aspergillus fumigatus).