Mycoses

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Mycoses

Mycoses

  1. 1. MYCOSES MAJID MOHIUDDIN
  2. 2. SUPERFICIAL MYCOSES• 1. Pityriasis (Tinea) versicolor (Malassezia furfur)• 2. Tinea Nigra – Hortaea/Exophiala werneckii• 3. White Piedia – Trichosporon• 4. Black piedra – Piedraia
  3. 3. SUPERFICIAL CAUSITIVE CLINICAL DIAGNOSIS TREATMENTMYCOSES ORGANISMS SYNDROME(TYPE)1. TINEA Malassezia furfur Small hypo Skin Topical azolesVERSICOLOR (Yeast like fungus) (or) hyper scraping Selenium(PITYRIASIS represent pigmented Direct sulfide shampoo ImidazoleVERSICOLOR) phialoconidia macules observation ointments Chronic, mild, Exposure Miconazole & infection of of Wood’s clotrimazole stratum lamp. shampoo corneum Hot soak bath
  4. 4. SUPERFICIAL CAUSITIVE CLINICAL DIAGNOSIS TREATMENTMYCOSES ORGANISMS SYNDROME(TYPE)2. TINEA NIGRA Hortaea werneckii/ Irregular Microscopic Whitfield’s exophiala werneckii examination ointment, pigmentedSuperficial macules of skin miconazole Black fungus scraping nitrate in a creamPhaeophypho Cladosporium No scaling culture basemycosis (or) invasion of Imidazole & (branched, septate hyphae, arthroconidia hair follicles triazole & elongate budding Non Sulfur cells) contagious ointments Tincture of iodine terbinafine
  5. 5. SUPERFICIAL CAUSITIVE CLINICAL DIAGNOSIS TREATMENTMYCOSES ORGANISMS SYNDROME(TYPE)3. WHITE Trichosporon: Hairs of the Culture in Topical azolesPIEDRA T. inkin, T.asahii, groin & axillae mycological Improve T.beigelii, White to media hygiene Shaving of T.mucoides brown welling without cycloheximide. infected hairs along the air Dolipore septum strand. hyphae Or budding yeast like cells
  6. 6. SUPERFICIAL CAUSITIVE CLINICAL DIAGNOSIS TREATMENTMYCOSES ORGANISMS SYNDROME(TYPE)4. BLACK ASCOMYCETES – Small, dark Branch Hair cutPIEDRA Piedraia hortae or nodules – pigmented Proper and hortai surround the hyphae regular washing. hair shafts Culture scalp Begin as yeast like colony then hyphae
  7. 7. CUTANEOUS MYCOSESCUTANEOUS CAUSITIVE CLINICAL DIAGNOSIS TREATMENTMYCOSES ORGANISMS SYNDROMEDERMATO- TRICHOPHYTON Ectothrix Direct Tropical AzolesPHYTOSES EPIDERMOPHYTON Endothrix microscopic (micronazole, MICROSPORUM Favic Skin, hair clotrimazole, econazole, etc) patterns /nail sample Macro and micro Terbinafine and Culture on haloprogin conidia scrappings Whitfield Arthroconidia ointment (benzoic & salicyclic acids) optical agent.
  8. 8. DERMATOPHYTOS CAUSITIVE CLINICALIS ORGANISMS SYNDROMETINEA CAPITIS Trichophyton Small scalling(Scalp ringworm) Microsporium patches to entire scalp Scalp, eyebrows & eyelashesTINEA BARBAE BeardTINEA CORPORIS E. floccosum Annular rings(Ring worm) Trichophyton with scaly centers MicrosporiumTINEA CRURIS Epidermophyton Moist groin area(Jock itch) T. rubrumTINEA PEDIS T.rubrum/mentagrop Toes then nails(Athlete’s foot) hytes becomes yellow E.fluccosum and brittlesTINEA UNGUIUM T. rubrum Nails thickned,(Onychomycosis) discolored & brittle
  9. 9. SUBCUTANEOUS MYCOSES• Main Lymphocutaneous sporotrichosis Chromoblastomycosis Eumycotic mycetoma Subcutaneous zygomycosis Subcutaneous phaeohyphomycosis• Additional Lobomycosis Rhinosporidiosis
  10. 10. SUBCUTANEOUS CAUSITIVE CLINICAL DIAGNOSIS TREATMENTMYCOSES ORGANISMS SYNDROME1. Sporothrix Skin by truma Culture of  OralLYMPHOCUTANEOUS schenckii – Small nodule pus / tissue potassiumSPOROTRICHOSIS thermophilic – ulcerate Immunologi iodide dimorphic Then cally – Itraconazole, Mold – narrow, discharge pus exoantigen terbinafine hyaline, septate – test /potassium condiophores iodide Yeast – spherical, Fluconazole oval (or) elongated Local application of heat
  11. 11. SUBCUTANEOUS CAUSITIVE CLINICAL DIAGNOSIS TREATMENTMYCOSES ORGANISMS SYNDROME2. Pigmented Legs & arms/ Histopathol  antifungalCHROMOBLASTOMYC septated shoulds, neck, ogic findings theraphy OSIS (dematiaceous) truck, face, of chestnut Itraconazole &(Chromomycosis) fungi ears. brown, terbinafine Chronic, musiform Fonsecaea, pruritic, cells. Posaconazole Cladosporium, progressive, with Exophiala, resistant to flucytosine Cladophialophora treat. Rhinocladiella Verrucous Phialophora lesions to flat plagues Form muriform cells Cauliflower (Sclerotic bodies, Medlar bodies) like growth
  12. 12. SUBCUTANEOUS CAUSITIVE CLINICAL DIAGNOSIS TREATMENTMYCOSES ORGANISMS SYNDROME3. Phaeoacremonium Foot & Grains can Amphotericin B,EUMYCOTIC hand/back be mounted Kitoconazole, MYCETOMA Curvularia, shoulders & Microscopic itraconazole Fusarium chest wall also. Antifungal Madurella, Small, Theraphy Exophiala, painless, Pyrenochaeta, subcutaneous Leptosphaeria nodule/plague - Scedosporium spp. increase slowly & enlarge - Septate disfigured Chlamydoconidia
  13. 13. SUBCUTANEOUS CAUSITIVE CLINICAL DIAGNOSIS TREATMENTMYCOSES ORGANISMS SYNDROME4. a)Conidiobolus Chronic Require ItraconazoleSUBCUTANEOUS coronatus a)Rhinofacial biopsy for Oral ZYGOMYCOSIS b)Basidiobolus area - swelling diagnosis potassium(Entomophthoromyc ranarum of the upperlips Can culture iodide osis) Facial area in & face - alternatively adults painless Facial Proximal limbs in b)Disk, reconstruction children shaped, surgery in case respectively rubbary of C.coronatus movable Mucoraceaous masses – Zygomycetes, shoulders, sparse hyphae, pelvis, lips & fragmented, thighs. septae
  14. 14. SUBCUTANEOUS CAUSITIVE CLINICAL DIAGNOSIS TREATMENTMYCOSES ORGANISMS SYNDROME5. Numerous & Solitary Culture Itraconazole,SUBCUTANEOUS diverse inflammatory Identification with or PHAEOHYPHOMY Black molds in cyst. of pattern of without COSIS culture Feet & legs sporulation flucytosine(Superficial, Yeast like in tissue. although other Posaconazole subcutaneous or deeply invasive Branced septate – body sites Voriconazole or disseminated) budding yeast like Lessions Terbinafine grows slowly Exophiala jeanselmei, and expand Alternaria, Firm & Curvularia, painless Phaeoacremonium, Bipolaris spp.
  15. 15. SYSTEMIC MYCOSES DUE TO DIMORPHIC FUNGI• 1. Blastomycosis• 2. Histoplasmosis• 3. Coccidiodomycoses• 4. Paracoccidiodomycosis(Blastomyces dermatitidis, Coccidioides immitis & C.posadasii, Histoplasma capsulatum var. capsulatum & H. Capsulatum var duboisii, Paracoccidioides brasiliensis & Penicillium marneffei).Restricted geographically to specific area.
  16. 16. SYSTEMIC MYCOSES CAUSITIVE CLINICAL DIAGNOSIS TREATMENT ORGANISMS SYNDROME1. BLASTOMYCES BLASTOMYCOSIS Present as Suptum,pus Itraconazole DERMATITIDIS Molds in culture - pulmonary , exudates, Ketoconazole Branced septate disease (or) Urine & Serious cases Yeast like in tissue. extra biopsis from amphotericin – single budding pulmonary lessions. B. yeast like disseminated Microscopic disease examination Older culture may Asymptomati Culture produce c /present as a Seriologic chlamydospores mild flu like test illness.
  17. 17. SYSTEMIC MYCOSES CAUSITIVE CLINICAL DIAGNOSIS TREATMENT ORGANISMS SYNDROME2.COCCIDIOIDOMY Coccidioides Asymptomati Suptum, Itraconazole COSIS immitis & c pulmonary exudates Serious cases C.posadasii disease from amphotericin Molds hyphae – Vally cutaneous B. arthroconidia – fever/SanJoaqu lession, spinal Azoles, endosporulating in vally fluid, blood, fluconazole spherule in tissue. fever/desert Urine & rheumatism Tissue biopsis. Microscopic examination Culture Seriologic test
  18. 18. SYSTEMIC MYCOSES CAUSITIVE CLINICAL DIAGNOSIS TREATMENT ORGANISMS SYNDROME3.HISTOPLASMOSIS Histocapsulatum Conidia Suptum, Itraconazole var Capsulatum, H. develops into scrapings In capsulatum var yeast cells – from disseminated duboisii engulfed by superficial disease, Molds in culture - alvelor lesions, bone treatment with hyaline septate - macrophages marrow, amphotericin conidiophore Initial aspirates & B. Yeast like in tissue. inflammatory buffy coat – intracelluar reaction blood cells, budding yeast like because blood films & granulomatous biopsis from Mediastinal lessions. fibrosis Microscopic examination Culture Seriologic test
  19. 19. SYSTEMIC MYCOSES CAUSITIVE CLINICAL DIAGNOSIS TREATMENT ORGANISMS SYNDROME4.PARACOCCIDIOID Paracoccidioides Present as Suptum, Itraconazole OMYCOSIS brasiliensis pulmonary exudates & Ketoconazole Molds in culture - disease (or) biopsis from & Branced septate extra lessions. Trimethoprim- Yeast like in tissue. pulmonary Microscopic sulfamethoxaz – multiply budding disseminated examination ole yeast like disease. Culture Serious cases Seriologic amphotericin Older culture may test B. produce chlamydospores and conidia

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