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Medical mycology
The document discusses the classification, laboratory diagnosis, and important diseases caused by fungi. It begins by covering the basic characteristics of fungi and different classification systems including morphological and taxonomic. Major sections are devoted to describing different types of fungi like yeasts, molds, and dimorphic fungi. The laboratory diagnosis of fungi and different fungal diseases affecting the skin, subcutaneous tissues, and systemic mycoses are outlined. Common opportunistic fungi that can cause disease like Aspergillus and Mucor are illustrated with microscopy images.
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Medical mycology
- 1. Classification, Lab diagnosis and Important diseasescaused by Fungi 2/13/2015 1 Mohammad Mukhit Kazi, Lecturer SDCH Pune
- 2. Objectives To know aboutimportant characteristics of fungi To know various classification systems To know medically important fungi To know the lab diagnosis of fungi To know treatment of fungal diseases 2/13/2015 2 Mohammad Mukhit Kazi, Lecturer SDCH Pune
- 3. Mycology • Study offungi – mycology • Mykos – mushroom • All fungi are eukaryotic • Natural habitat- soil, water and decaying organic debris • Obligate or facultative aerobe • Chemotrophic organisms 2/13/2015 3 Mohammad Mukhit Kazi, Lecturer SDCH Pune
- 4. • Differences frombacteria – Posses rigid cell wall – Contain chitin, mannan and polysacharide – Cytopalsmic membrane contain sterols – True nuclei with Nuclear membrane, mitochondria and endopalsmic reticulum – Unicellular or multicellular – Divide by asexually, sexually or by both 2/13/2015 4 Mohammad Mukhit Kazi, Lecturer SDCH Pune
- 5. Classification A. Taxanomic classification Phyllum Thallophyta Four calsses of fungi B. Morphological classification Yeasts Yeasts like fungi Moulds Dimorphic fungi 2/13/2015 5 Mohammad Mukhit Kazi, Lecturer SDCH Pune
- 6. Thallophyta Thallophyta Irregular plant masseslacking definite root, stem and leaf structures Fungi Algae (No chlorophyll) (Chlorophyll) 4 classes Zygomycetes Ascomycetes Basidiomycetes Deuteromycetes or fungi imperfecti • Lower fungi having non-septate hyphae • Forms asexual spores sporangiospores • Sexual spores zygospores and oospres • Septate hyphae • Sexual spores (ascospores) are present within the sac or ascus • Septate hyphae •Sexual spores are basidiospores on a basidium • Septate hyphae •Lack a known sexual state. Most fungi medically important fungi belongs to this class 2/13/2015 6 Mohammad Mukhit Kazi, Lecturer SDCH Pune
- 7. Yeasts i. Round tooval unicelluar ii. Reproduce by budding iii. Creamy mucoid colonies iv. E.g. Cryptococcus neoformans 2/13/2015 7 Mohammad Mukhit Kazi, Lecturer SDCH Pune
- 8. Yeasts like fungi •Partly as yeasts and partly as elongated budding cells • Germ tube to demonstrate pseudohyphae 2/13/2015 8 Mohammad Mukhit Kazi, Lecturer SDCH Pune
- 9. Moulds 1. Grow asbranching filaments – hyphae 2. Hyphae septate or nonseptate 3. Continue growth called as mycelium 4. E.g Dermatophytes, Aspergillus, Penicillium and Rhizophus 2/13/2015 9 Mohammad Mukhit Kazi, Lecturer SDCH Pune
- 10. Dimorphic fungi • Theyexists as yeasts in host tissue and in cultures as mycelial growth • Blastomyces dermatitidis, Paracoccidioides, Coccidiodes immitis, Histoplasma, Sporothrix 2/13/2015 10 Mohammad Mukhit Kazi, Lecturer SDCH Pune
- 11. Reproduction and sporulation •Sexual spores – oospres, ascospores, zygospores and basidiospores • Vegetative spores – – Blastospores:formed by budding from parent cell – Arthrospores: cross septa into hyphae • Aerial spores: Conidiospores, Microconidia, Macroconidia, Sporangiospores 2/13/2015 11 Mohammad Mukhit Kazi, Lecturer SDCH Pune
- 12. Laboratory Diagnosis A. Directmicroscopy – KOH preparation – Gram staining – India ink preparation B. Culture - SDA C. Slide culture test 2/13/2015 12 Mohammad Mukhit Kazi, Lecturer SDCH Pune
- 13. Classification of fungaldiseases A. Superficial mycoses- skin nails hair B. Subcutaneous mycoses – myetoma C. Systemic mycoses - aspergillosis 2/13/2015 13 Mohammad Mukhit Kazi, Lecturer SDCH Pune
- 14. Dermatophytes • They infectsuperficial keratinized tissue (skin, nail and hair) without involving tissue • They break down and utilizes keratin • Incapabale of penetrating subcutaneous tissue • Cause dermatomycoses also known as ringworm 2/13/2015 14 Mohammad Mukhit Kazi, Lecturer SDCH Pune
- 15. Cylindrical macroconidia Fusiform macroconidia Club shaped macroconidia 2/13/2015 15 MohammadMukhit Kazi, Lecturer SDCH Pune
- 16. 2/13/2015 16 Mohammad MukhitKazi, Lecturer SDCH Pune
- 17. Classification – Trichophyton -hair, skin and nail – Microsporum – hair , skin – Epidermophyton – skin and nail Lab diagnosis: Specimen: skin, hair or nail Direct microscopy – LPCB mount Culture Treatment 2/13/2015 17 Mohammad Mukhit Kazi, Lecturer SDCH Pune
- 18. Subcutaneous Mycoses • Mycetoma: crhonic granulomatous infection of subcutaneous tissue usually affects foot • Also known as Madura foot • Mainly in tropical countirs • Common in Tamilnadu • Caused by Actinomycetes and filamentous fungi • Enter through minor trauma • Diagnosis made by observing granules • Treatment- sulphonamides sometime amputation 2/13/2015 18 Mohammad Mukhit Kazi, Lecturer SDCH Pune
- 19. Sporotrichosis • Is nodular,ulcerating disease of skin and subcutaneous tissue • Acces through thorn pricks or injuries • Spread through lymphatics upto regional lymph nodes • Sporothrix schenckii – dimorphic fungi • Lab diagnosis by culture 2/13/2015 19 Mohammad Mukhit Kazi, Lecturer SDCH Pune
- 20. Rhinosporidiosis • Is achronic granulomatous disease characterized by formation of friable polyps, usually confined to nose, mouth or eye • Causative agent Rhinosporidium seeberi • Reported from Srilanka and India • Mode of infection is not known • Lab diagnosis done by demonstration of sporangia 2/13/2015 20 Mohammad Mukhit Kazi, Lecturer SDCH Pune
- 21. Rhinosporidiosis 2/13/2015 21 Mohammad MukhitKazi, Lecturer SDCH Pune
- 22. Systemic mycoses 1. Histoplasmosis –Histoplasma capsulatum – Reticuloendothelial system – Source – soil with excreta of birds – Asymptomatic – Sputum, bone marrow, blood, scrapings, biopsies – Geimsa stain or Wright stain – Culture- SDA – Amphotericin B 2/13/2015 22 Mohammad Mukhit Kazi, Lecturer SDCH Pune
- 23. 2. Blastomycosis – Blastomycesdermatitidis- dimorphic fungi – Infection mainly to skin, bone and genitourinary tract – Inhalation of conidia – Asymptomatic – Sputum, pus or scrapings – 10% KOH, H&E stain and PAS stain – Culture-SDA – Amphotericin B 2/13/2015 23 Mohammad Mukhit Kazi, Lecturer SDCH Pune
- 24. 3. Paracoccidiomycosis – Paracoccidioidesbrasilensis- dimorphic fungi – Inhalation of spores – Same 4. Coccidiodomycosis 5. Crptococcosis - Crptococcus neoformans - Inhalation of dust - Seen in immunocompromised - demosntration of capsule by india ink 6. Opportunistic mycoses- candiasis, aspergillosis, zygomycoses 2/13/2015 24 Mohammad Mukhit Kazi, Lecturer SDCH Pune
- 25. Aspergillus fumigatus 2/13/2015 25 MohammadMukhit Kazi, Lecturer SDCH Pune
- 26. Aspergillus terreus 2/13/2015 26 MohammadMukhit Kazi, Lecturer SDCH Pune
- 27. Aspergillus fumigatus 2/13/2015 27 MohammadMukhit Kazi, Lecturer SDCH Pune
- 28. ASpergillus niger 2/13/2015 28 MohammadMukhit Kazi, Lecturer SDCH Pune
- 29. Typical growth ofAspergillus spp 2/13/2015 29 Mohammad Mukhit Kazi, Lecturer SDCH Pune
- 30. ASpergillus flavus 2/13/2015 30 MohammadMukhit Kazi, Lecturer SDCH Pune
- 31. Mucor 2/13/2015 31 Mohammad MukhitKazi, Lecturer SDCH Pune
- 32. Take home message •Fungi are eukaryotes • Medically important fungi belongs to Fungi imperfecti or Deuteromycetes • Sabourauds dextrose agar is used to culture • Slide culture to demonstrate better morphological characters • KOH mount or LPCB mount for demonstration • Mainly opportunistic infections • E.g. Candidiasis, Cryptococcosis, Aspergillosis 2/13/2015 32 Mohammad Mukhit Kazi, Lecturer SDCH Pune