1. The document discusses various opportunistic mycoses including Candida, Aspergillus, and Zygomycetes.
2. It provides classifications of the organisms, compares true pathogenic fungi to opportunistic fungi, and describes various clinical manifestations including oral and disseminated candidiasis, allergic and systemic aspergillosis, and mucormycosis.
3. Laboratory diagnosis, culture characteristics, and treatment options are covered for each type of mycosis.
Automated system for bacterial identificationDEEKSHANT KUMAR
[DOWNLOAD IT OPEN IT WITH MICROSOFT POWERPOINT THEN YOU WILL BE ABLE TO UNDERSTAND THE TOPIC COVERED.]
1. WHOLE TEXT IS RELIABLE.
2. TEXT HAS BEEN TAKEN FROM STANDARD TEXT BOOK FOR MEDICAL MICROBIOLOGY.
3. SOME PICTURE HAS BEEN TAKEN FROM JOURNAL.
Microsporum a pathogenic fungi Which comes under dermatophytes and cause ringworm infection and fungal infection on skin.
All the Introduction, morphological characteristics, pathogenesis, lab diagnosis and treatment given here.
If you want better understanding go on to mine YouTube channel linked below:
https://youtu.be/2wbsB8jxv6o
There you can find other more interesting topics related to microbiology.
Cryptococcosis also called as Torulosis is a subacute or chronic fungal infection caused by Cryptococcus neoformans. It leads to compications such as fatal meningoencephalitis. It is an opportunistic infection in HIV-infected patients. The PPT discuss on the morphology of the fungus, pathogenesis, laboratory diagnosis and treatment.
Opportunistic Mycosis are: caused by fungi that cannot infect healthy humans but can
cause serious often fatal mycoses in people whose resistance has been lowered (immunocompromised patients).
Many fungi previously considered non- pathogenic are
now recognized as etiological agents of the
opportunistic fungal infections.
The laboratory must identify and report completely
the presence of all fungi recovered from
immunocompromised patient, since every organism is
a potential pathogen
The highly susceptible groups for opportunistic fungal
infection are
- AIDs patients,
-Leukemic patients,
-individuals on chemotherapy for treatment of cancer,
-alcoholics. The commonest causes of opportunistic mycosis are:
-Candidiasis
- Aspergillosis
- Zygomycosis
-Cryptococosis
-Pneumocystis carn
Candidiasis is a relatively common human infection that can
take form of;
superficial,
mucocutanous or
systemic disease.
Principally it is caused by the three species of the genus candida,
namely,
C.albicans,
C.tropicalis and
C.krusei
Superficial and mucocutaneous candidiasis
It is superficial infections of skin and mucous membranes
Through, oral and vaginal candidiasis
- Oesophageal candidiasis
-Skin lesions of folds, groin, axilla, and interdigital areas
- Napkin eruptions in infants
- Paranychial candidiaiasis
Invasive:
Candidemia: initial stage can be transient if phagocytic
system is intact.
Disseminated or hematogenous candidiasis if phagocytic
system is compromised.
Multi organs can be involved with infection: kidney,
prosthetic heart valves, brain, eye, meninges.
Mortality: 30-40%
Predisposing factors
Diabetes
Immunosupperession
T-cell immunodeficiency disorders
Acquired- immunodeficiency syndrome, (AIDS)
Leukaemias, Lymphomas
Steroid treatments
Broad spectrum antibiotics
Laboratory diagnosis
Superficial or mucocutaneous candidiasis is diagnosed by
finding the fungus in tissue scraping and culture
Systemic candidiasis is difficult to diagnose.
Definitive diagnosis is made by the histopathologic
demonstration of the invasion of tissue by the yeast.
Specimens from surface lesions, mouth, vaginal, sputum,
exudates etc are examined using different methods.
Direct examination
a) KOH
Exposed lesions can usually be easily diagnosed by
clinical appearance together with finding typical budding
yeast cells and pseudohyphae and /or true hyphea in lesion
scrapings treated with KOH.
b) Gram-stain
Gram stain smears show large gram-positive budding yeast cells
with pseudohyphea.
Germ tube test
Candida albicans can be presumptively identified based
on the production of a germ tube
Principle
When incubated with serum at 370C for 1 to 3 hours,
C.albicans will form a germ tube.
Procedure
1. Pipette 0.5 ml of serum into a test tube
2. Inoculate the tube with a small amount of the
organism to be
tested.
Automated system for bacterial identificationDEEKSHANT KUMAR
[DOWNLOAD IT OPEN IT WITH MICROSOFT POWERPOINT THEN YOU WILL BE ABLE TO UNDERSTAND THE TOPIC COVERED.]
1. WHOLE TEXT IS RELIABLE.
2. TEXT HAS BEEN TAKEN FROM STANDARD TEXT BOOK FOR MEDICAL MICROBIOLOGY.
3. SOME PICTURE HAS BEEN TAKEN FROM JOURNAL.
Microsporum a pathogenic fungi Which comes under dermatophytes and cause ringworm infection and fungal infection on skin.
All the Introduction, morphological characteristics, pathogenesis, lab diagnosis and treatment given here.
If you want better understanding go on to mine YouTube channel linked below:
https://youtu.be/2wbsB8jxv6o
There you can find other more interesting topics related to microbiology.
Cryptococcosis also called as Torulosis is a subacute or chronic fungal infection caused by Cryptococcus neoformans. It leads to compications such as fatal meningoencephalitis. It is an opportunistic infection in HIV-infected patients. The PPT discuss on the morphology of the fungus, pathogenesis, laboratory diagnosis and treatment.
Opportunistic Mycosis are: caused by fungi that cannot infect healthy humans but can
cause serious often fatal mycoses in people whose resistance has been lowered (immunocompromised patients).
Many fungi previously considered non- pathogenic are
now recognized as etiological agents of the
opportunistic fungal infections.
The laboratory must identify and report completely
the presence of all fungi recovered from
immunocompromised patient, since every organism is
a potential pathogen
The highly susceptible groups for opportunistic fungal
infection are
- AIDs patients,
-Leukemic patients,
-individuals on chemotherapy for treatment of cancer,
-alcoholics. The commonest causes of opportunistic mycosis are:
-Candidiasis
- Aspergillosis
- Zygomycosis
-Cryptococosis
-Pneumocystis carn
Candidiasis is a relatively common human infection that can
take form of;
superficial,
mucocutanous or
systemic disease.
Principally it is caused by the three species of the genus candida,
namely,
C.albicans,
C.tropicalis and
C.krusei
Superficial and mucocutaneous candidiasis
It is superficial infections of skin and mucous membranes
Through, oral and vaginal candidiasis
- Oesophageal candidiasis
-Skin lesions of folds, groin, axilla, and interdigital areas
- Napkin eruptions in infants
- Paranychial candidiaiasis
Invasive:
Candidemia: initial stage can be transient if phagocytic
system is intact.
Disseminated or hematogenous candidiasis if phagocytic
system is compromised.
Multi organs can be involved with infection: kidney,
prosthetic heart valves, brain, eye, meninges.
Mortality: 30-40%
Predisposing factors
Diabetes
Immunosupperession
T-cell immunodeficiency disorders
Acquired- immunodeficiency syndrome, (AIDS)
Leukaemias, Lymphomas
Steroid treatments
Broad spectrum antibiotics
Laboratory diagnosis
Superficial or mucocutaneous candidiasis is diagnosed by
finding the fungus in tissue scraping and culture
Systemic candidiasis is difficult to diagnose.
Definitive diagnosis is made by the histopathologic
demonstration of the invasion of tissue by the yeast.
Specimens from surface lesions, mouth, vaginal, sputum,
exudates etc are examined using different methods.
Direct examination
a) KOH
Exposed lesions can usually be easily diagnosed by
clinical appearance together with finding typical budding
yeast cells and pseudohyphae and /or true hyphea in lesion
scrapings treated with KOH.
b) Gram-stain
Gram stain smears show large gram-positive budding yeast cells
with pseudohyphea.
Germ tube test
Candida albicans can be presumptively identified based
on the production of a germ tube
Principle
When incubated with serum at 370C for 1 to 3 hours,
C.albicans will form a germ tube.
Procedure
1. Pipette 0.5 ml of serum into a test tube
2. Inoculate the tube with a small amount of the
organism to be
tested.
Forms round colonies with a fluorescent greenish color, sweet odor, and b-hemolysis.
Pyocyanin- nonfluorescent bluish pigment;
pyoverdin- fluorescent greenish pigment;
pyorubin, and pyomelanin
Some strains have a prominent capsule (alginate).
Proteases
Serine protease, metalloprotease and alkaline protease cause tissue damage and help bacteria spread.
Phospholipase C: a hemolysin
Exotoxin A: causes tissue necrosis and is lethal for animals (disrupts protein synthesis); immunosuppressive.
Exoenzyme S and T: cytotoxic to host cells. Ear infections
Otitis externa: mild in swimmers; malignant (invasive) in diabetic patients.
Chronic otitis media
Osteochondritis of the foot.
Urinary tract infection
Sepsis: most cases originate from infections of lower RT, UT, and skin and soft tissue. Ecthyma gangrenosum (hemorrhagic necrosis of skin) may be seen in some patients
Anaerobic bacteria: Infection and Managementiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
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.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
3. OPPORTUNISTIC MYCOSES
True Pathogenic Fungi Opportunistic Fungi
Diseases Histoplasmosis
Blastomycosis
Paracoccidioidomycosis
Coccidioidomycosis
Aspergillosis
Candidiasis
Mucormycosis
Cryptococcosis
Host Normal Abrogated/
Compromised
Portal of
Entry
Primary infection is
pulmonary
Various
Monday, January 16, 2012
4. OPPORTUNISTIC MYCOSES
True Pathogenic Fungi Opportunistic Fungi
Prognosis 99% spontaneous resolution Recovery depends on the
severity of impairment of
host defenses
Immunity Resolution results to strong
specific immunity
No specific resistance
infection
to
Host Response Tuberculoid granuloma,
mixed pyogenic
Depends on degree of
impairment necrosis to
pyogenic to
granulomatous
Morphology in
Tissue
All agents showed
dimorphism to a
form
tissue
No change in morphology
Distribution Geographically restricted Ubiquitous
Monday, January 16, 2012
5. CANDIDIASIS
C. albicans is the most common (4-6 um;
budding)
Multiplication: blastospore formation
producing either pseudohyphae or
septate hyphae
Identification: assimilation and
fermentation of CHOs; physiologic and
morphologic responses they exhibit
when grown under controlled
nutritional conditions “germ tubes”
Monday, January 16, 2012
7. FACTORS THAT AFFECT CANDIDA
NORMAL POPULATION
poor oral hygiene
use of antibiotics
use of oral contraceptives
diet
presence of antagonistic inhibitory bacteria
Monday, January 16, 2012
8. Candida albicans is a resident flora of the
skin, mouth, vagina and stool!
Imbalance will lead to infection....HOW?
Changes in the Physiology: e.g.
pregnancy, use of steroids and diabetes
Prolonged administration of antibiotics
Immunocompromised patients
Monday, January 16, 2012
9. MUCOCUTANEOUS CANDIDIASIS
(MC)
a condition caused by a fungus from
the candida family (lives on the
surface of skin) that develops a
diffuse and persistent type of
infection of the mouth, nails, skin, and
at times other organs
affects infants (starts before age 3) and
young adults, is rarely seen in adults
with other diseases
including chronic mucocutaneous
candidaisis or CMCC
Monday, January 16, 2012
16. DISSEMINATED CANDIDIASIS
originate at a gastrointestinal site
CA enters epithelial microvilli through persorption of yeast cells
or by germination (a,c)
In both cases, organisms enter the vasculature (b,d) for
dissemination into tissues such as the kidney (e)
localizes in the cortex (f) where it grows as hyphae/
pseudohyphae
A vigorous host response occurs at this site consisting of both
mononuclear and polymorphonuclear leukocytes
Virulence factors (adhesins, morphogenesis, switch phenotypes,
antioxidant proteins and invasive enzymes) promote the invasion
of the organism
Monday, January 16, 2012
19. LABORATORY DIAGNOSIS:
CADIDIASIS
The presence of the capsule
and budding yeast cells are
considered as the positive
results.
Aside from KOH, other
stains can be used such as
India ink and Papanicolaou
stain.
Monday, January 16, 2012
20. GERM TUBE TEST
Most isolates of
C. albicans produce a
hyphal growth from
blastospores when
they are suspended in
serum at 37°C for 2-3
hours.
Monday, January 16, 2012
21. IN CULTURE...
SDA at either room temperature or at 37°C
Colonies: usually develop in 2-3 days as
white, typical yeast colonies
In vitro: monomorphic, growing as non
encapsulated yeast cells at any temperature
Monday, January 16, 2012
24. TREATMENT OF CANDIDIASIS
Most localized, cutaneous, candidiasis infections may
be treated with any number of topical antifungal
agents (eg, clotrimazole, econazole, ciclopirox,
miconazole, ketoconazole, nystatin).
For Candida onychomycosis, oral itraconazole
(Sporanox)
For Genitourinary tract candidiasis, VVC can be
managed with either topical antifungal agents or
Monday, January 16, 2012
25. TREATMENT OF CANDIDIASIS
Caspofungin acetate (Cancidas) as a 70-mg
loading dose is followed by 50 mg/d IV for a
minimum of 2 weeks after improvement or
after blood cultures have cleared.
Chronic mucocutaneous candidiasis is treated
with oral azoles, either fluconazole (Diflucan)
Monday, January 16, 2012
26. ASPERGILLOSIS
One of the largest of the fungal genera
Hundred of species have been recorded
The most important species:
A. fumigatus
A. flavus
A. niger
Monday, January 16, 2012
29. SPECTRA OF ASPERGILLOSIS
Toxicity due to ingestion of contaminated foods
Allergy and sequelae to the presence of conidia or transient
growth of the organism in body orifices
Colonization without extension in preformed cavities and
debilitated tissues
Invasive, inflammatory, granulomatous, necrotizing disease of
lungs and other organs
Systemic and fatal disseminated disease
Monday, January 16, 2012
30. ALLERGIC ASPERILLOSIS
Allergic aspergillosis maybe benign early on and
severe as the patient grows older
In secondary colonization, a chronic clinical
situation may exist with little distress except
occasional bout of hemoptysis and some
pathological changes in the lungs that may lead to
the formation of fungus ball.
Monday, January 16, 2012
32. SYSTEMIC ASPERGILLOSIS
An extreme serious disorder that is usually
rapidly fatal unless diagnosed early and treated
aggressively
The status of the host’s immune system
contributes to the prognosis of the patient
Monday, January 16, 2012
34. Disease Etiologic Factors
Mycotoxicoses Ingestion of contaminated food
products
Hypersensitivity
peumonitis
Allergic bronchopulmonary
disease
Secondary
colonization
Colonization of preexisting
cavity (pulmonary abscess)
without invasion into
contiguous tissue
Systemic disease Invasive disease involving
multiple organs
Monday, January 16, 2012
35. DISSEMINATED ASPERGILLOSIS
Aerosols of Aspergillus fumigatus conidia are inhaled and
travel to the alveoli
In the healthy host, alveolar macrophages (AM) phagocytose
and kill the organism after swelling of the conidium, an
essential pre-germination stage
The production of reactive oxygen intermediates by AM is
required to eliminate the organism, but
polymorphonuclear cells (PMNs) also contribute
In the immunosuppressed patient, reduced numbers of PMNs
and inefficient AM allow growth of the fungus
Consequently, the conidia germinate and escape from the AM
Monday, January 16, 2012
36. LABORATORY DIAGNOSIS
Aspergillosis is easy to isolate and identify....BUT!
also important to distinguish a true pathogen
from a contaminant
If sputum sample is to be collected, it is expected
to be thick and gelatinous
In invasive sampling, lung aspirates or tissue
biopsy is used
Monday, January 16, 2012
37. LABORATORY DIAGNOSIS
Direct microscopic examination will show
hyaline, dichotomously branched and septate
hyphae
Occasionally in sputum, in cases of pulmonary
aspergillosis, one may also sees very small, rough
walled spores (3-4 um in diameter).
Monday, January 16, 2012
39. TREATMENT
Amphotericin B was used
for many years BUT!!! with
disappointing results
In 1990 itraconazole was
introduced as a new broad
spectrum anti-fungal agent.
Monday, January 16, 2012
41. ZYGOMYCOSIS/PHYCOMYSIS
Repeated isolation of the
organisms from consecutive
specimens provides strong
evidence that the organisms
may be relevant, even though
coenocytic hyphal elements
are not seen in
histopathologic examination
of tissue.
Monday, January 16, 2012
43. CATEGORIES COMMENTS
Rhinocerebral It is the most frequent presentation
ketoacidosis.
overall and classically affects diabetics with
Usually presents with facial and/or eye pain, proptosis and progressive signs of
involvement of orbital structures (muscles, nerves and vessels).
Common complications include cavernous sinus and internal carotid artery
thrombosis.
Pulmonary It occurs most frequently among neutropenic patients.
It presents with nonspecific symptoms such as fever, cough and dyspnea;
hemoptysis may occur with vascular invasion.
Radiological presentation includes segmental consolidation that progresses to
contiguous areas of the lung, with occasional cavitation.
Gastrointestinal Usually affects patients with severe malnutrition
May involve the stomach, ileum, and colon
Clinical picture mimics intra-abdominal abscess. The diagnosis is often made at
autopsy.
Cutaneous It has been
burns.
reported with minor trauma, insect bites, no sterile dressing, wounds, and
The necrotic lesions progressively evolve from the epidermis into dermis and even
muscle.
Others Heart, bone, kidneys, bladder, trachea, and mediastinum
Monday, January 16, 2012
44. DIRECT EXAMINATION: ZYGOMYCOSIS
A rapid diagnosis is critical
Fungal elements are usually not numerous in discharges
Scrapings from the upper turbinates, aspirated material
from sinuses, sputum in pulmonary disease, and biopsy
material mounted in 10% KOH typically contain thick-
walled, refractile hyphae 6-15 um in diameter
Swollen cells (up to 50 um) and distorted hyphae may be
present
Monday, January 16, 2012
45. IN CULTURE...
Sabouraud dextrose agar:
Incubate at 30°C
DON’T: cycloheximide =
sensitive
Sterile bread:
for recovery of Zygomycetes
when other media fail
WHY bread???
Monday, January 16, 2012
46. TREATMENT
Control of the diabetes
Aggressive surgical
debridement of involved tissue
High doses of amphotericin B
are recommended
Monday, January 16, 2012