RCP Medicine Podcast Episode 88: Mycology Unmasked: What Every Clinician Should Know
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Aug 1, 2025 
Neil Stone, a consultant in infectious diseases and microbiology at University College London, dives into the world of clinical mycology. He discusses the urgent issue of Candida auris, a multi-drug resistant fungus threatening healthcare. Challenges in diagnosing cryptococcal meningitis, especially in HIV patients, are explored, alongside the importance of proper diagnostics for effective treatment. Neil also highlights the rising significance of environmental health in relation to fungal diseases, pushing for a collaborative approach to patient care and management.
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Candida auris: The Fungal Superbug
- Candida auris is a newly emerged multi-drug resistant fungal pathogen causing outbreaks globally.
- It spreads in healthcare settings exogenously and is difficult to eradicate once established.
Cryptococcus and Its Diagnosis
- Cryptococcus is an environmental yeast causing meningitis predominantly in immunocompromised patients, especially with advanced HIV.
- The cryptococcal antigen test is highly sensitive and specific, enabling rapid diagnosis.
Challenges Diagnosing Invasive Aspergillosis
- Diagnosing invasive aspergillosis is complex due to poor sensitivity of blood cultures and non-specific imaging findings.
- Most cases require balancing risk and probability with limited diagnostic proof.