<i>Exophiala dermatitidis</i>: Key issues of an opportunistic fungal pathogen

The black yeast <i>Exophiala dermatitidis</i> is an opportunistic pathogen, causing phaeohyphomycosis in immunosuppressed patients, chromoblastomycosis and fatal infections of the central nervous system in otherwise healthy Asian patients. In addition, it is also regularly isolated from respiratory samples from cystic fibrosis patients, with rates varying between 1% and 19%.Melanin, as part of the cell wall of black yeasts, is one major factor known contributing to the pathogenicity of <i>E. dermatitidis</i> and increased resistance against host defense and anti-infective therapeutics. Further virulence factors, e.g. the capability to adhere to surfaces and to form biofilm were reported. A better understanding of the pathogenicity of <i>E. dermatitidis</i> is essential for the development of novel preventive and therapeutic strategies. In this review, the current knowledge of <i>E. dermatitidis</i> prevalence, clinical importance, diagnosis, microbiological characteristics, virulence attributes, susceptibility, and resistances as well as therapeutically strategies are discussed.