Whenever one sees something that looks a bit unusual, especially in patients who are immunocompromised or taking any medication that might impair the immune system, one should think “fungi,” said Dr. Rosen.
Novel “biologics” and anti-TNF drugs can leave patients susceptible to opportunistic fungi such as Sporothrix. Clinical conditions such as alcoholism, diabetes, and some forms of cancer can also leave patients vulnerable to odd fungi, he said.