Yeast

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Yeast

  1. 1. Yeasts Round to oval, single cells which reproduce by budding www.freelivedoctor.com
  2. 2. Yeasts <ul><li>SELECTED GENERA </li></ul><ul><li>Candida </li></ul><ul><li>Cryptococcus </li></ul>www.freelivedoctor.com
  3. 3. Candidiasis <ul><li>Candida albicans </li></ul><ul><li>Non-albicans species </li></ul>www.freelivedoctor.com
  4. 4. Ecological Niche Candida albicans Endogenous (mouth, gut, vagina) www.freelivedoctor.com
  5. 5. Infections with Candida usually occur when there is some alteration in: <ul><li>Cellular immunity </li></ul><ul><li>(Immunocompromised) </li></ul><ul><li>Normal Flora </li></ul><ul><li>(Prolonged antibiotics) </li></ul><ul><li>Physiology </li></ul><ul><li>(Cardiac surgery, catheter) </li></ul>www.freelivedoctor.com
  6. 6. CANDIDIASIS <ul><li>Skin </li></ul><ul><li>Vaginitis </li></ul><ul><li>Urinary tract </li></ul><ul><li>Mucous membranes </li></ul><ul><li>Septicemia </li></ul><ul><li>Endocarditis </li></ul><ul><li>Pneumonia </li></ul>www.freelivedoctor.com
  7. 7. www.freelivedoctor.com
  8. 8. CANDIDIASIS The fourth most common nosocomial bloodstream infection. www.freelivedoctor.com
  9. 9. GEOGRAPHIC OCCURENCE WORLDWIDE www.freelivedoctor.com
  10. 10. Clinical Specimens Candida <ul><li>Sputum </li></ul><ul><li>Scrapings from lesions </li></ul><ul><li>Blood smears </li></ul><ul><li>Vaginal discharge </li></ul><ul><li>Urine </li></ul><ul><li>Feces </li></ul><ul><li>Nail clippings </li></ul>www.freelivedoctor.com
  11. 11. SEROLOGY <ul><li>There have been several antibody detection test, but none are significant. </li></ul><ul><li>Beta-Glucan measurement is now showing promise </li></ul>www.freelivedoctor.com
  12. 12. Therapy <ul><li>Nystatin </li></ul><ul><ul><li>Vaginitis </li></ul></ul><ul><ul><li>Cutaneous </li></ul></ul><ul><li>Fluconazole * </li></ul><ul><li>Itraconazole </li></ul>www.freelivedoctor.com
  13. 13. Cryptococcosis Cryptococcus neoformans www.freelivedoctor.com
  14. 14. Cryptococcosis <ul><li>A sub-acute or chronic infection which may affect the lungs or skin but most commonly manifests as a meningitis </li></ul>www.freelivedoctor.com
  15. 15. Typical clinical course <ul><li>Inhalation </li></ul><ul><li>Mild pneumonia </li></ul><ul><li>Vision, lethargy, headache </li></ul><ul><li>Delirium, nuchal rigidity, coma </li></ul><ul><li>Over a period of months </li></ul><ul><li>Death if not treated </li></ul>www.freelivedoctor.com
  16. 16. Cryptococcus neoformans <ul><li>Spherical </li></ul><ul><li>5-10 microns </li></ul><ul><li>Narrow- base </li></ul><ul><li>Surrounded by polysaccharide capsule </li></ul>www.freelivedoctor.com
  17. 17. www.freelivedoctor.com
  18. 18. www.freelivedoctor.com
  19. 19. Cryptococcus neoformans <ul><li>Virulence factors </li></ul><ul><li>Anti-phagocytic polysaccharide capsule </li></ul><ul><li>Antioxidant melanin </li></ul><ul><li>Ability to grow at 37 C </li></ul>www.freelivedoctor.com
  20. 20. Ecological Niche Cryptococcus neoformans <ul><li>Pigeon droppings </li></ul><ul><li>Chicken droppings </li></ul>www.freelivedoctor.com
  21. 21. Isolation of Cryptococcus neoformans from environmental sites in South Carolina www.freelivedoctor.com Number Examined Number Positive Percent Positive SITES 79 51 65 SAMPLES 299 137 45
  22. 22. Cryptococcus portal of entry <ul><li>Inhalation </li></ul><ul><li>inoculation </li></ul>www.freelivedoctor.com
  23. 23. www.freelivedoctor.com
  24. 24. www.freelivedoctor.com
  25. 25. Specimen of choice Cerebrospinal fluid www.freelivedoctor.com
  26. 26. Clinical Specimens Cryptococcosis <ul><li>CSF </li></ul><ul><li>Sputum </li></ul><ul><li>Pus </li></ul><ul><li>Biopsy material </li></ul><ul><li>urine </li></ul>www.freelivedoctor.com
  27. 27. www.freelivedoctor.com
  28. 28. www.freelivedoctor.com
  29. 29. www.freelivedoctor.com
  30. 30. Serological Tests Cryptococcosis <ul><li>Indirect fluorescent antibody </li></ul><ul><li>Tube Agglutination </li></ul><ul><li>Latex Agglutination </li></ul><ul><li>(measures antigen) </li></ul>www.freelivedoctor.com
  31. 31. www.freelivedoctor.com
  32. 32. Drugs of Choice Cryptococcosis <ul><li>Amphotericin B plus 5-Flucytosine </li></ul><ul><li>OR </li></ul><ul><li>Amphotericin B plus Fluconazole </li></ul>www.freelivedoctor.com

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