This document provides information on various fungal infections. It begins by stating that most fungal infections are opportunistic, with Candida being the most common cause of skin and soft tissue infections. It then discusses specific fungal infections in more detail, including aspergillosis, zygomycosis, hyalohyphomycosis, and the endemic mycoses of coccidioidomycosis, histoplasmosis, blastomycosis, and paracoccidioidomycosis. For each, it provides information on causative organisms, geographic distribution, clinical presentation, laboratory identification, and treatment.
Staphylococcus aureus,a bunch of grapes
commonly found on the skin or in the nose of even healthy individuals
cause skin infections but can cause pneumonia, heart valve infections, and bone infections.
TaxonomyKingdom: Fungi
Division: Zygomycota
Class: Mucormycotina
Order: Mucorales
Family: Mucoraceae
Genus: Mucor
Morphology- →Common contaminant. →Colonies are fast-growing and resemble white-to-gray cotton candy. →Hyphae are wide, 6-15μ. →No rhizoids →Sporangiophores are long, branch, Large (50-300μ).
culture media
Life cycle - vegetative , asexual, sexual
epidemology,
Clinical feature,
Rhinocerebral-Opportunistic infection of sinuses , nasal passages , oral cavity.
→Rapid death.
→Grow rapidly and release air-borne spores.
→Enter through nose, oral mucosa and throat.
→Attack immunelow peoples
Pulmonary-Rare diseases occur in patients who have prolonged neutropaenia.
Treatment with deferoxamine
Indistinguishable from Invasive Pulmonary Aspegillosis.
Symptoms: fever , Cough , dyspnoea, Chest Pain, Pleural effusion.
Species: Mucormycotina
Spores -3 to 11 µm.
Disseminated- Rare, fatal complication disease.
Multiorgans manifestations.
Symptoms: mental status changes.
Occur who are already sick from medical condition.
Leads to coma.
Gastrointestinal- Transmission: Inhalation of spores.
Common in children.
Affects Immuno-comprised patients.
Symptoms varies depend upon the part of the body.
Common Symptoms: abdominal pain, Bowel Obstruction, Vomiting , Bloody diarrhea,Dyspepsia.
Prognosis is very poor.
cutaneous- Reddish and swollen skin, skin trauma, ulcer.
*mainly painful patches of skin.
* fungal enter through skin.
*patients who are low Ig A and IgG antibodies.
*skin theraphy , transplantation.
Prognosis-Very poor
*Surgery can done
depend upon area
Treatment-Antifungal medicine, usually amphotericin B, through a vein.
Staphylococcus aureus,a bunch of grapes
commonly found on the skin or in the nose of even healthy individuals
cause skin infections but can cause pneumonia, heart valve infections, and bone infections.
TaxonomyKingdom: Fungi
Division: Zygomycota
Class: Mucormycotina
Order: Mucorales
Family: Mucoraceae
Genus: Mucor
Morphology- →Common contaminant. →Colonies are fast-growing and resemble white-to-gray cotton candy. →Hyphae are wide, 6-15μ. →No rhizoids →Sporangiophores are long, branch, Large (50-300μ).
culture media
Life cycle - vegetative , asexual, sexual
epidemology,
Clinical feature,
Rhinocerebral-Opportunistic infection of sinuses , nasal passages , oral cavity.
→Rapid death.
→Grow rapidly and release air-borne spores.
→Enter through nose, oral mucosa and throat.
→Attack immunelow peoples
Pulmonary-Rare diseases occur in patients who have prolonged neutropaenia.
Treatment with deferoxamine
Indistinguishable from Invasive Pulmonary Aspegillosis.
Symptoms: fever , Cough , dyspnoea, Chest Pain, Pleural effusion.
Species: Mucormycotina
Spores -3 to 11 µm.
Disseminated- Rare, fatal complication disease.
Multiorgans manifestations.
Symptoms: mental status changes.
Occur who are already sick from medical condition.
Leads to coma.
Gastrointestinal- Transmission: Inhalation of spores.
Common in children.
Affects Immuno-comprised patients.
Symptoms varies depend upon the part of the body.
Common Symptoms: abdominal pain, Bowel Obstruction, Vomiting , Bloody diarrhea,Dyspepsia.
Prognosis is very poor.
cutaneous- Reddish and swollen skin, skin trauma, ulcer.
*mainly painful patches of skin.
* fungal enter through skin.
*patients who are low Ig A and IgG antibodies.
*skin theraphy , transplantation.
Prognosis-Very poor
*Surgery can done
depend upon area
Treatment-Antifungal medicine, usually amphotericin B, through a vein.
Common ubiquitous mold. A species of mold that is found all over the world. More than 185 different types of Aspergillus have been identified and more are continuing to be identified.
paracoccidiodiomycosis- its a acute subacute chronic ,systemic fungal infection
mainly effect respiratory system from there disseminated to various body parts.
Common ubiquitous mold. A species of mold that is found all over the world. More than 185 different types of Aspergillus have been identified and more are continuing to be identified.
paracoccidiodiomycosis- its a acute subacute chronic ,systemic fungal infection
mainly effect respiratory system from there disseminated to various body parts.
Fungal infection of the skin, most common on the exposed surfaces of the body, namely the face, arms and shoulders.
Most common fungal diseases ; Ringworm. A common fungal skin infection that often looks like a circular rash.
Medically Important Histoplasma species .pptxNawangSherpa6
The Presentation here is about Medically important Histoplasma species. How does it infect the Human host? What are it's clinical manifestations and How can we diagnose for their infection and potential application for other studies.
3. Fungal infections
• Most fungal infections are opportunistic –
candida is the most common, causing skin
and soft tissue infection
– Severe infection (mucous membrane,
oesophagus) in AIDS
– Systemic infection in neutropenic
• Aspergillus
– Opportunistic, and affects the most severely
neutropenic
4. Aspergillosis
• Found in the air all around us
• Harmless to normal people – we inhale
hundreds of condidia every day
• Opportunistic disease in the
immunocompromised patient
– Severe neutropenia
– Debilitating disease
– Disruption of normal flora
– Antibiotics, steroids
– Abnormal lung e.g. bronchiectasis, cancer
5.
6. Aspergillus
• >200 species
• Associated with disease: *A. fumigatus,
A. flavus, A. niger
• Less common: A. nidulans, A. terreus,
A. oryzae, A. ustus, A. versicolor
7. Laboratory identification
• Grows on Sabouraud agar
• Colony – colour: black, yellow, green,
white, red, brown
• 3 structures to recognize
– Mycelium - branching, hyaline, septate
– Condial head
– Condidia : shape and arrange help identify
species
22. Many species
• e.g. Mucor spp., Absidia spp., Rhizopus
spp., Rhizomucor spp., Cunninghamella
spp.
• Widely found in the environment
• Immunocompromised patients at risk
(as for aspergillus), trauma patients
23. Zygomycosis: disease
• Invade the bloodstream – disseminated
disease
• Local invasion – pulmonary,
rhinocerebral
• Intravenous drug use - cerebral
infection
• Cutaneous – burns, trauma
24. treatment
• Very high mortality - 96% for
disseminated disease
• Surgery and antifungals
25. Zygomycosis – laboratory
diagnosis
• Tissue – histology
• Culture from deep sites (beware
contamination!) e.g. rhinocerebral, BSL
• That’s all we have lab tests!
27. • Hyaline septate hyphae
• Non-pigmented
• No differentiating features
• Many species of fungi
• When cultured – some are distinct and
can be identified
28. e.g. Fusarium sp.
• Common in soil, plant, environment
• Typical macroconidia
• cause
– Keratitis e.g. with contact lens
– Invasive disseminated disease in
neutropenic
– Skin and subcutaneous lesions in
disseminated disease
30. e.g. Penicillium marneffei
• Most penicillium harmless
• P. marneffei
– Dimorphic – yeast 37 deg C, mould 25 deg C
– Disseminated to the blood in AIDS patients in
SE Asia
– Fever, skin, liver, spleen, multi-organ
33. Pigmented moulds
• Dihydroxynaphthalene melanin in their
cell walls
• Many many species of fungi
• Many types of infection – skin, brain,
lung etc
• Chronic tissue infections
– chromoblastomycosis
– mycetoma
38. Endemic mycoses
• thermally dimorphic fungi
– As moulds in the soil
– Yeast forms in the human body (37 deg C)
• Geographic distribution varies
• Inhalation pulmonary INFECTION
dissemination
• No evidence of transmission among humans
or animals
• Otherwise healthy individuals are infected
39. Endemic mycoses
• Geographical location is important. Get history
of travel; except histoplasmosis (worldwide)
• Clinical suspicion: liver/spleen/lungs/
mucocutaneous involved
• May have no symptoms
• Route of infection: through lungs or direct
inoculation of skin
• Cause skin lesions, pneumonia, liver/spleen
40. Tests for systemic mycoses
• Microscopy
• Fungal culture (2 temperatures!)
• Tissue: histopathology
• Serology – often older methods like
immunodiffusion, complement fixation
• Skin test of limited value
• Others: urinary antigen (e.g.
histoplasma)
42. Case history
A 71-year-old male subject regularly spends several winter
months in Arizona to play golf in the sun. Last March he
experienced a gradual onset of fever and a headache,
followed by a non-productive cough, myalgia and profound
fatigue. His local physician diagnosed bronchopneumonia on
chest radiograph, and prescribed azithromycin. The antibiotic
provided no benefit, and ultimately the patient received two
more courses of different empiric antibiotics. He returned
home with continued cough and fatigue, even though the
fever had abated somewhat. Two months following the initial
onset of symptoms, a bronchoscopy was performed, and
cultures grew Coccidioides species.
43. Other presentations
Months to years following a symptomatic or asymptomatic
infection, the affected lung may show complete resolution or
an area of calcified or uncalcified pulmonary nodule similar
radiographically to cancer. Microscopic examination of
excised tissue identifies the organism. Occasionally the
nodule liquefies to form a thin-walled cavity, which may
close spontaneously or remain and become a nidus for
suprainfection or spontaneous pneumothorax.
Extrapulmonary dissemination can be identified in nearly all
tissues, although skin and soft tissue, bones and meninges
are the most common sites of dissemination. Chronic
fibrocavitary pneumonia is seen infrequently, with chronic
cough and dyspnoea, night sweats and weight loss, and
lung fibrosis with thick-walled cavities.
From BMJ Best Practice
48. HISTOPLASMOSIS
• Aetiology: Histoplasma capsulatum
• Natural reservoir: soil, bat and avian habitats
• Location: May be prevalent all over the world, but
the incidence varies widely
• Microscopy
– Yeast cell in tissue (37°C)
– Hyphae, microconidia and macroconidia
(tuberculate chlamydospore) at 25 °C
55. BLASTOMYCOSIS
• Aetiology: Blastomyces dermatitidis
• Location: America, Africa, Asia
• Microscopy:
– Yeasts at 37°C: bud is attached to the
parent cell by a broad base
– Hyphae and conidia at 25 °C
58. PARACOCCIDIOIDOMYCOSIS
• Aetiology: Paracoccidioides brasiliensis
• Location: Central and South America
• Pathogenesis: Inhalation of conidia
• Microscopy
– At 37°C (in tissue ): multiply budding
yeasts; the buds are attached to the
parent cell by a narrow base
– At 25 °C: hyphae and conidia
Editor's Notes
Legend: Microscopic morphology of a Mucor sp. showing erect, simple sporangiophores forming a terminal, globose sporangium, packed with sporangiospores and with a well developed subtending columella visible (Slide reference #: GK 591). The sporangial wall then dissolves allowing the release of the sporangiospores which exposes the columella (Slide reference #: GK 592). A collarette (remnants of the sporangial wall) is usually visible at the base of the columella following spore dispersal (Slide reference #: GK 593). Stolons and rhizoids are not produced by species of Mucor .
Legend: Culture of P. marneffei showing distinctive red diffusible pigment. On Sabouraud's dextrose agar at 25°C, colonies are fast growing, suede-like to downy, white with yellowish-green conidial heads. Colonies become greyish-pink to brown with age and produce a diffusible brownish-red to wine red-pigment.
Legend: Microscopic morphology of P. marneffei showing hyaline, smooth-walled conidiophores bearing terminal verticils of 3 to 5 metulae, each bearing 3 to 7 phialides. Conidia are globose to subglobose, 2 to 3µm in diameter, smooth-walled and are produced in basipetal succession from the phialides.
Legend: Microscopic morphology of Curvularia lunata showing pale brown multicelled conidia (phragmoconidia) formed apically through a pore (poroconidia) in a sympodially elongating geniculate conidiophore similar to Drechslera . Conidia are cylindrical or slightly curved, with one of the central cells being larger and darker.
