Symptoms and Signs Mucocutaneous infections most often involve the face, especially at the nasal and oral mucocutaneous borders. Yeasts are usually abundantly present within pinpoint lesions throughout granular bases of slowly expanding ulcers. Regional lymph nodes enlarge, become necrotic, and discharge necrotic material through the skin. Lymphatic infections mainly involve painless enlargement of cervical, supraclavicular, or axillary nodes. Visceral infections are characterized by focal lesions causing enlargement mainly of the liver, spleen, and abdominal lymph nodes, sometimes with accompanying abdominal pain.
Mixed infections involve combinations of all three patterns.
Clinically apparent infections are generally chronic and progressive but not usually fatal. Azoles are highly effective. Oral itraconazole is generally considered the drug of choice. IV amphotericin B also can eliminate the infection and is often used in very severe cases. Sulfonamides, which are widely used in some countries because they are inexpensive, can suppress growth and improve lesions but are not curative.