Mycoses systémiques du sujet apparemment immunocompétent

Systemic mycoses are rare among immunocompetent patients and display a different pattern than in immunocompetent hosts. An atypical presentation may result in an incorrect diagnosis and thus impairs the prognosis which depends on the delay before treatment. The main invasive mycoses of the immunocompetent host are described here: infections due to filamentous fungi, yeasts, dimorphic fungi and subcutaneous infections. Some fungi are true pathogens and do not seem to require predisposing factors. In specific cases, a local anatomic defect may allow the infection to develop without a systemic immune deficit. In other cases no predisposing factor can be detected. This may be due to the lack of adequate means to explore immune defenses or to a transcient immunodepression. Because of these circumstances a fungal infection should not be ruled out a priori in non-immunocompromised hosts.