paracoccidiodiomycosis- its a acute subacute chronic ,systemic fungal infection
mainly effect respiratory system from there disseminated to various body parts.
Medical Mycology Black Piedra and White Piedra.pptxDeborahAR1
Black piedra is a fungal infection of the hair shafts. It is also known as Trichomycosis nodosa. The fungal elements are attached to the hair shaft to form nodules along the hair shaft. It predominantly affects scalp hair, although involvement of the beard, mustache and pubic hairs is also known.
White Piedra is a superficial fungal infection of the hair caused by Trichosporon asahii. It is also known as trichomycosis nodosa or trichomycosis nodularis.
paracoccidiodiomycosis- its a acute subacute chronic ,systemic fungal infection
mainly effect respiratory system from there disseminated to various body parts.
Medical Mycology Black Piedra and White Piedra.pptxDeborahAR1
Black piedra is a fungal infection of the hair shafts. It is also known as Trichomycosis nodosa. The fungal elements are attached to the hair shaft to form nodules along the hair shaft. It predominantly affects scalp hair, although involvement of the beard, mustache and pubic hairs is also known.
White Piedra is a superficial fungal infection of the hair caused by Trichosporon asahii. It is also known as trichomycosis nodosa or trichomycosis nodularis.
he culture media are classified in many different ways: Based on the physical state Liquid media Solid media Semisolid media Based on the presence or absence of oxygen Anaerobic media Aerobic media Based on nutritional factors Simple media Synthetic media Complex
Mycology is the branch of biology concerned with the study of fungi, including their genetic and biochemical properties, their taxonomy and their use to humans as a source for tinder, traditional medicine, food, and entheogens, as well as their dangers, such as toxicity or infection.
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Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
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Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
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Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
The prostate is an exocrine gland of the male mammalian reproductive system
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Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
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Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
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1. INSTITUTE OF PUBLIC HEALTH, DHAKA
Department of Laboratory Medicine
BSc in Health Technology (Laboratory)- L4
MYCOLOGY
Lecture –Introduction & Lab Diagnosis
By
Sk. MIZANUR RAHMAN
Assistant Bacteriologist,
PhD Candidate
MS in BGE; MS in Microbiology; MPH in Epidemiology
2. The Fungi
Learning outcomes- Students should be able to:
• Establish familiarity with the scientific terminology
peculiar to mycology
• Describe the dimorphic nature of the pathogenic fungi
used in making a clinical diagnosis.
• Emphasize the eukaryotic nature of the fungi.
• To explore the nature of the pathogenesis of fungal
infections.
• To gain familiarity with the classification of medically-
important fungi.
• To develop an understanding of the nature and mode of
action of anti-fungal agents
3. Recommended Textbooks
Theory
• Medical Mycology and Human Mycoses ES Beneke and AL Rogers Star
Publishing Company 1996 Belmont CA
Laboratory
• Identifying Filamentous Fungi: A Clinical Laboratory Handbook St-
Germain G and Summerbell R Rogers Star Publishing Company 1996
Belmont CA
Additional Reading
• - Introductory Mycology Alexopoulos CJ Mims CW Blackwell M Fourth
Edition John Wiley &Sons Inc 1996 New York NY
• - Medical Mycology KJ Kwon-Chung and JE Bennett Lea &Febiger 1992
Philadelphia PA
• - Medical Microbiology A Laboratory Manual: Section II WG Wu Third
Edition Star Publishing Company 1995 Belmont CA
8. What is a Fungus ?
• Eukaryotic – a true nucleus
• Do not contain chlorophyll
• Have cell walls
• Produce filamentous structures
• Produce spores
9.
10. Species of Fungi
• 100,000 – 200,000 species
• About 300 pathogenic for man
11. Fungal Morphology and Structure
Eukaryotic organisms, distinguished by a rigid cell
wall composed of chitin and glucan, and a cell
membrane in which ergosterol is substituted for
cholesterol as the major sterol component.
Fungal taxonomy relies heavily on morphology and
mode of spore production
Fungi may be unicellular or multicellular.
The simplest grouping based on morphology divides
fungi into either yeast or mold forms.
12. Features of Fungi and its value in our
life:
The fungi are a ubiquitous and diverse organisms, that degrade organic
matter.
Fungi have heterotrophic life; they could survive in nature as:
Saprophytic: live on dead or decaying matter
Symbiotic: live together and have mutual advantage
Commensal: one benefits and other neither benefits nor harmed.
Parasitic: live on or within a host, they get benefit and harm the other.
Fungi mainly infect immunocompromised or hospitalized patients with
serious underlying diseases.
The incidence of specific invasive mycoses continues to increase with
time
The list of opportunistic fungal pathogens likewise increases each year “It
seems there are no non-pathogenic fungi anymore ! “
This increase in fungal infections can be attributed to the ever-growing
number of immunocompromised patients.
13. Characteristics of fungi
A. eukaryotic, non- vascular organisms
B. reproduce by means of spores (conidia), usually wind-
disseminated
C. both sexual (meiotic) and asexual (mitotic) spores may be
produced, depending on the species and conditions
D. typically not motile, although a few (e.g. Chytrids) have a motile
phase.
E. like plants, may have a stable haploid & diploid states
F. vegetative body may be unicellular (yeasts) or multicellular
moulds composed of microscopic threads called hyphae.
G. cell walls composed of mostly of chitin and glucan.
14. More Characteristics of Fungi
H. fungi are heterotrophic ( “other feeding,” must feed on
preformed organic material), not autotrophic ( “self feeding,”
make their own food by photosynthesis).
- Unlike animals (also heterotrophic), which ingest then digest,
fungi digest then ingest.
-Fungi produce exoenzymes to accomplish this
I. Most fungi store their food as glycogen (like animals). Plants
store food as starch.
K. Fungal cell membranes have a unique sterol, ergosterol, which
replaces cholesterol found in mammalian cell membranes
L. Tubule protein—production of a different type in microtubules
formed during nuclear division.
15. Structure
•The body of fungi is termed thallus (non-
reproductive)
•The thalli of yeast are small, globular and are single
celled
•The thalli of mold are composed of long, branched
tubular filaments called hyphae.
16. Structure
• The thallus of a mold is composed of hyphae
intertwined to form a tangled mass called
mycelium.
22. Classification of fungi
They are classified by several methods:
1- Morphological classification
2- Systematic classification
3- Clinical classification
25. Yeast Reproduction
• FISSION
• “even” reproduction, nucleus divides forming
two identical cells, like bacteria
• BUDDING
• “uneven” reproduction, parent cell’s nucleus
divides and migrates to form a bud and then
breaks away
26.
27. Molds
• Multicellular, tubular structures (hyphae)
• Hyphae can be septate (regular crosswalls) or
nonseptate (coenocytic) depending on the
species (grow by apical extension)
– Vegetative hyphae grow on or in media (absorb
nutrients); form seen in tissue, few distinguishing
features
– Aerial hyphae contain structures for production of
spores (asexual propagules); usually only seen in
culture
28. • The fungal thallus consists of hyphae; a
mass of hyphae is a mycelium.
Molds
29. Moulds are multicellular organisms consisting of threadlike tubular
structures called Hyphae that elongate by apical extension.
Hyphae are either:
Coenocytic: hollow and multinucleate
Septate: divided by partitions or cross-walls
Hyphae form together to produce a mat-like structure
called a Mycelium.
Vegetative hyphae, grow on or under surface of culture medium,
Aerial Hyphae: project above surface of medium
Aerial H. produce Conidia (asexual reproductive elements)
Conidia can easily airborne and disseminate the fungus.
Many medical fungi are termed dimorphic because they exist in yeast
and mould forms.
33. Dimorphic Fungi
• Growth as a mold or as a yeast
• Most pathogenic fungi are dimorphic fungi
• At 37o C yeast-like
• At 25o C mold-like
• Can also occur with changes in CO2
• Fungi grow differently in tissue vs
nature/culture; often dictated by temp
34. • Some fungi are
dimorphic
depending on
environmental
conditions
• These organisms
produce both
yeast-like and
mold-like thalli
• Many are
pathogenic
• Candida albicans
Dimorphism
38. Subcutaneous Mycoses
• Confined to subcutaneous tissue and
rarely spread systemically. The
causative agents are soil organisms
introduced into the extremities by
trauma
39. Systemic Mycoses
• Involve skin and deep viscera
• May become widely disseminated
• Predilection for specific organs
40. Opportunistic Fungi
Ubiquitous saprophytes and occasional
pathogens that invade the tissues of
those patients who have:
• Predisposing diseases:
Diabetes, cancer, leukemia, etc.
• Predisposing conditions:
Agammaglobulinemia, steroid or antibiotic
therapy.
41. • Systemic mycoses Deep within body
• Subcutaneous mycoses Beneath the skin
• Cutaneous mycoses Affect hair, skin, nails
• Superficial mycoses Localized, e.g., hair
shafts
• Opportunistic mycoses Caused by normal
microbiota or
fungi
Fungal Diseases (mycoses)
44. Detection and recovery of fungi from
clinical specimens
Dermatophytosis and Agents of Superficial Mycosis
Specimen and direct microscopic examination
Skin, nail scraping and hair shaft
Placed in one or two drops of 10-20% KOH
A cover slip is placed on top and the preparation
is heated gently
Nails may require a strong alkali solution (25%KOH) and
long clearing time
N. B. combination of KOH plus Dimethyl sulfaoxide
(DMSO) may be used for nail specimens
45. Fungal Culture, Non-Dermal Sites (FCUL): Fungal culture only; no smear
Fungal Culture and Smear, Non-Dermal (FCULSM): Fungal culture and smear
Fungus CSF Culture/CAD (FUNCSF): For use with CSF only; fungal culture and
cryptococcal antigen detection
Cryptococcus Ag Detection (CAD): Cryptococcal antigen on serum only; does not
include culture
Fungal Blood Culture (HISTCL): Histoplasma blood or bone marrow culture
Fungus Screen (FUNGSC): Fungal screen only; for use when looking for yeast only
Fungal Culture and Smear: Hair, Skin, Nail (FHSNSM): Fungal culture plus smear
on hair, skin, nail
Fungal Culture: Hair, Skin, Nails (ACFSC): Culture only for dermatophytes (hair,
skin, nail); does not include smear
Mycology order codes
46. Human Mycosis-1
• Dermatophytosis /Superficial Mycoses/ Cutaneous
Mycoses/ Ringworm / Tinea ..
• Involve superficial keratinize.. Dead tissues.. skin, hair,
Nails.. Caused by Dermatophytes: Trichophyton -
Microsporium -, Epidermophyton species
• Worldwide distribution.. Spores, Hyphae fragments..
Common in nature, skin human, animals.
• Tinea versicolor / Pityriasis versicolor, Yeast
• Clinical Features: Erythematic Skin lesions..Rare
inflammation.. Allergic reaction.. Common under stress
conditions.. Fever, Unknown Factors.
47. Human Mycosis-2
• Skin spots commonly affect the back, underarm, upper arm,
chest, lower legs, and neck. Occasionally it can also be present
on the face.
• The yeasts can often be seen under the microscope within the
lesions with typically round yeasts & filaments. Light to Dark
patches on skin. Difficult to culture.
• Hair: Tinea capitis, Hairshaft /hair follicles. Scalp, Endo-
Exothrix, Common in Children.. Rare Adults.. Infection
Outbreaks .
• Nail: Tinea unguium &Tinea pedis.. Feet fingers, Feet
interspace, moist skin lesions, Common in Adults, develop
Chronic
• Causative agents: Dermatophytes.. Trichophyton -
Microsporium -, Epidermophyton species.
48. Important considerations:
Proper collection
Rapid delivery to the laboratory
Prompt and correct processing
Inoculation into proper and appropriate medium
Incubation at a suitable temperature
Collection, handling and processing of clinical
mycology specimens
49. Transport of Specimen:
Antibiotics may be incorporated in body fluid
specimens to prevent proliferation of bacteria:
50, 000 units of Penicillin
100,000 units of Streptomycin
0.2 mg of Chloramphenicol
Collection, handling and processing of clinical
mycology specimens
50. Transport of Specimen:
Storage temperature of specimen for fungal culture:
Blood & CSF: 30 – 37 OC
Dermatological: 15 – 30 OC
Others: 4 OC
Collection, handling and processing of clinical
mycology specimens
51. SPUTUM
first early morning sample
Deep cough specimen; may be induced by:
o Aqueous aerosol
o Bronchial tap
Volume: 5 – 10 ml
Collection, handling and processing of clinical
mycology specimens
52. BLOOD and BONE MARROW
Transport medium: at 1:10 proportion
TSB-Tryptic soy broth or TSA-Tryptic soy Agar
(biphasic agar or broth)
BHI(Brain heart infusion) transport medium
Thioglycollate broth
Volume: 10 ml
Collection, handling and processing of clinical
mycology specimens
53. CEREBROSPINAL:
Transport immediately. Do not refrigerate.
For suspected Cryptococcus, Coccidioides
infections, containers must be leak proof and
lab manipulations should be done under a hood
Collection, handling and processing of clinical
mycology specimens
54. DERMATOLOGICAL SPECIMENS
SKIN LESIONS
Sterilized area with
70% alcohol or sterile
water
Collect at the the active
border
Collection - usually by physician/nursing staff /Lab scientist/MT
Collection, handling and processing of clinical
mycology specimens
55. • Skin - cleaned with 70% alcohol to remove dirt, oil and surface
saprophytes
Collection, handling and processing of clinical
mycology specimens
56. • Nails - cleaned same as for skin. Usually clipped; need to be
finely minced before inoculating to media
Collection, handling and processing of clinical
mycology specimens
57. NAILS
Clean with 70% alcohol If:
Dorsal plate:
scrape the deeper portion
Nail plate:
scrape beneath the nail plate
Whole nail or clippings
Collection, handling and processing of clinical
mycology specimens
58. HAIR
Collect from:
Areas of scaling
Alopecia
Hair that fluoresce under
Wood’s lamp
Collection, handling and processing of clinical
mycology specimens
59. • Hair - obtained from edge of infected area of scalp,. Use a
Wood's lamp (fluorescence) to help locate infected hair. Hair
can be obtained by plucking, brushing, or with a sticky tape.
Collection, handling and processing of clinical
mycology specimens
60. • Body fluids - normal sterile collection procedures
Collection, handling and processing of clinical
mycology specimens
61. EXUDATES & PUS
Undrained or unruptured abscess
Aspirate using sterile syringe, recap
needle and transport to lab
immediately
Failed aspiration, do skin biopsy
Collection, handling and processing of clinical
mycology specimens
62. URINE
First early morning
Transport and perform test ASAP (as
soon as possible) within 2 hours
If not possible, refrigerate specimen.
Collection, handling and processing of clinical
mycology specimens
63. VAGINAL SECRETIONS
Sterile swabs
Put in transport medium or
primary isolation broth
immediately (ex: TSB-Tryptic
soy broth)
Collection, handling and processing of clinical
mycology specimens
64. TISSUES & Biopsy specimens:
Collect aseptically at the center and edge of the
lesion
Place in between sterile gauze wet with sterile
NSS (Normal Saline Solution) or transport medium.
Collection, handling and processing of clinical
mycology specimens
Respiratory Mycoses
Disseminated fungal infection
67. 1. Wet Mount
2. Skin test
3. Serology
4. Fluorescent antibody
5. Biopsy and histopathology
6. Culture
7. DNA probes
Diagnosis
68. 1. Wet Mount
2. Skin test
3. Serology
4. Fluorescent antibody
5. Biopsy and histopathology
6. Culture
7. DNA probes
Diagnosis
69. 1.Direct Microscopic examination
a) Wet preparation
- uses KOH or NaOH as clearing agent
b) Calcofluor white stain
- shows fungal elements in exudats & small skin scales under fluorescent
microscope
c) Nigrosin or India Ink
d) Wright stain or Giemsa stain
85. for detection of antigen or antibody
-complement-fixation, Agglutination, Precipitin test
-useful only for systemic & opportunistic mycoses
• complement-fixation is used in suspected cases of
coccidiodomycoses, blastomycoses, histoplasmosis
Immunologic
86.
87. Most serological tests for fungi measure
antibody. Newer tests to measure antigen
are now being developed
ANTIGEN DETECTION PRESENTLY AVAILABLE
Cryptococcosis
Histoplasmosis
Aspergillosis
88. Diagnosis
1. Wet Mount
2. Skin test
3. Serology
4. Fluorescent antibody
5. Biopsy and
histopathology
6. Culture
7. DNA probes
89. DIRECT FLUORESCENT ANTIBODY
1. HISTOLOGIC SECTIONS
2. CULTURE
• Viable organisms
• Non-viable organisms
CAN BE APPLIED TO
90.
91. Diagnosis
1. Wet Mount
2. Skin test
3. Serology
4. Fluorescent antibody
5. Biopsy and
histopathology
6. Culture
7. DNA probe
92. • Periodic Acid Shift
• Gomori Methenemine Silver Stain
• Calcofluor white
• Fluorescent Antibody Stain
- for rapid diagnosis of fungal; cell wall
Histologic stains
97. Diagnosis
1. Wet Mount
2. Skin test
3. Serology
4. Fluorescent antibody
5. Biopsy and
histopathology
6. Culture
7. DNA probes
98. • Slow growers
• Medium: Sabouraud Dextrose Agar, Potato Dextros Agar, Blood
agar Corn Meal Agar
IDENTIFICATION OF FUNGUS
a. Macroscopic examination
- study the mycotic colony, mycelium & the pigment produced
b.Microscopic examination
- uses a drop of Lactophenol Cotton Blue (LPCB)
-observe the size, shape, septation & color of spores
Culture
99. •IDENTIFICATION OF YEAST CULTURES
- is based on morphologic characteristics & biochemical tests
•IDENTIFICATION OF FILAMENTOUS FUNGAL CULTURES
- uses an immunologic method called exoantigen test
* antigen extracted are immunodiffused against known antisera
102. 1. Wet Mount
2. Skin test
3. Serology
4. Fluorescent antibody
5. Biopsy and
histopathology
6. Culture
7. DNA probes
Diagnosis
103. DNA Probes
• Rapid (1-2 Hours)
• Species specific
• Expensive
DNA probe test
-identify colonies growing in culture at an earlier stage of
growth
-available for coccidioides, histoplasmas, blastomyces,
Cryptococcus