This document provides an overview of subcutaneous mycoses. It discusses several types including mycetoma, sporotrichosis, rhinosporidiosis, chromoblastomycosis, phaeohyphomycosis, and lobomycosis. For each condition, it summarizes the causative agent, clinical features, pathogenesis, diagnosis including direct examination and culture techniques, and treatment approaches. The document emphasizes that these infections usually follow trauma and develop subcutaneously at the site of inoculation, presenting with characteristic clinical features like tumefaction, draining sinuses, and presence of grains or granules.
paracoccidiodiomycosis- its a acute subacute chronic ,systemic fungal infection
mainly effect respiratory system from there disseminated to various body parts.
paracoccidiodiomycosis- its a acute subacute chronic ,systemic fungal infection
mainly effect respiratory system from there disseminated to various body parts.
Fungal Infections/ Mycoses ppt by Dr.C.P.PRINCEDR.PRINCE C P
PPT prepared by :
DR.PRINCE C P
Associate Professor &HOD
Department of Microbiology,
Mother Theresa Post Graduate & Research Institute of Health Sciences (Government of Puducherry Institution)
According to tissue involved, MYCOSES are classified into:
Superficial (Surface )
Cutaneous
Subcutaneous
Deep Cutaneous
Systemic (Primary )
Systemic ( Opportunistic)
Mycotic Poisoning
most of the fungal infections are opportunistic in nature.
candida albicans is the common Fungal pathogen.
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nd invade the genital ridges in the sixth week of
development. here they form primitive sex cords. in
the absence of tdf, medullary cords disappear and
get replaced by a vascular stroma (ovarian medulla).
cortical cords develop and surround one or more
primitive germ cells. the germ cells subsequently
develop into oogonia, while the surrounding epithelial
cells form the follicular cells. this differentiates
undifferentiated gonads into ovaries. stroma of ovary
develops from basal mesenchyme. granulosa and theca
cells develop from celomic epithelium.
development of genital ducts
development of genital duct system and the external
genitalia occurs under the influence of hormones
circulating in the fetus. sertoli cells in the fetal testes
produce a nonsteroidal substance known as müllerian
inhibiting substance (mis) that causes regression of
müllerian ducts. androgen from the fetal testes causes
masculinization of external genitalia. in the absence of
mis, müllerian ducts develop and mesonephric duct
system regresses. in the absence of androgen, external
genitalia differentiate into female phenotype. the
müllerian duct develops between the fifth and sixth
weeks lateral to intermediate cell mass and wolffian
duct. the müllerian duct has the following three parts:
•cranial vertical portion that opens into celomic
cavity. later it differentiates into fallopian tubes.
•horizontal part crosses the mesonephric duct.
•caudal vertical part that fuses with its partner
from opposite side. this fused part later differ
entiates into uterus, cervix, and upper one-third
of the vagina.
the dorsal celomic epithelium (which forms
müllerian duct) remains open at its site of origin and
ultimately forms the fimbriated ends of the fallopian
tubes. at their point of origin, each of the müllerian
ducts forms a solid bud. each bud penetrates the
mesenchyme lateral and parallel to the wolffian duct.
as the solid buds elongate, a lumen appears in the
cranial part, beginning at each celomic opening. the
caudal end of each müllerian duct crosses the way
Myself Dr. Manish Tiwari Tutor Department of microbiology at saraswati medical college and research center( unnao) making presentation is only for MBBS and MD students.
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!
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
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
- 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
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Title: Sense of Smell
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 primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
2. INTRODUCTION
Heterogenous group of fungal infections
which are characterized by development of
clinical lesions in subcutaneous tissues at
the site of inoculation of etiological agents.
Disease process starts following a trivial
trauma, which is the sole source of
infection.
mycology aruna, Microbiology
3. 16/12/07
INTRODUCTION
Usually follow trauma.
Lesions develop at the site of implantation of
the etiological agent in the subcutaneous
tissue.
Includes – Mycetoma
- Sporotrichosis
- Rhinosporidiosis
- Chromoblastomycosis
- Phaeohyphomycosis
- Lobomycosis
4. 16/12/07
MYCETOMA
Chronic, slowly progressive granulomatous
infection of skin & subcutaneous tissues with
the involvement of underlying fasciae &
bones commonly affecting the extremities.
Reported by Gill from Madurai, S.India.
Maduramycosis or Madura foot.
Tropical & subtropical countries of Asia ,
Africa, Central & S.America.
5. smsmc
Classification of Mycetoma
Based on the causative agent
True Fungi – Eumycetoma
Aerobic filamentous bacteria (actinomycetes) -
Actinomycetoma
Based on the colour of grains
Bacterial agents – white to yellow grains except
Actinomadura pelletieri (red or pink)
Fungal agents – black as well as white grains.
6. ETIOLOGY
Fungal agents (25 agents)-saprotrophic
environmental fungi-Deuteromyctes(10
agents) or Ascomycetes(3 agents) cause
white grain mycetoma
Others cause black grain Mycetoma
smsmc micro
7. 16/12/07
Colour/texture of grains in Mycetoma
of various etiology
White to yellow/soft Brown to black Red
Nocardia
asteroides/brasiliensis
Madurella
mycetomatis/hard
Actinomadura
pelletieri
Acremonium/Fusarium
/Aspergillus nidulans
Madurella grisea/soft
Actinomadura madurai Phialophora
jeanselmei/soft
Streptomyces
somaliensis
Curvularia
geniculata/hard
Pseudollescheria
boydii
8. smsmc
Epidemiology
More prevalent in developing countries,
especially in the rural areas.
Young men 20 to 40 yrs of age
Field workers, farmers – prone to thorn prick
injury & trauma.
Prevalence in world : Eumycetoma (40%)
Actinomycetoma (60%)
9. ssmsmc
Pathogenesis & Pathology
Causative agent present in soil
Accidental trauma by thorns or splinter injury
Minor trauma & skin abrasions
Mycetoma of ear – use of wicks for removal
of earwax.
Mycetoma of back – carrying goods like
wood, grain bags, stones, etc
Mycetoma of the head & neck – bundles of
wood
10. smsmc
Pathogenesis & Pathology
Lesion begins as a small subcutaneous
swelling of the foot, which enlarges burrowing
into the deeper tissues & tracking to the
surface as multiple sinuses discharging
viscid, seropurulent fluid containing granules
or grains which are microcolonies of the
causative agent.
11. smsmc
Clinical features
Characterised by a triad of
clinical features irrespective
of the causative agent:
1. Tumefaction – tumor like
swelling
2. Multiple draining sinuses
3. Presence of grains or
granules in sinuses.
13. smsmc
Diagnosis
Radiodiagnosis – Xray, CT, MRI.
Laboratory diagnosis
- Proper h/o patient
- Gross examination of lesion by a microbiologist
Specimen – grains or granules
- pus / exudates or biopsy
Lesions cleaned with antiseptics & the grains
collected by pressing the sinus from the
periphery.
Gross examination of grains – size, shape,
texture, colour
14. smsmc
Direct Examination
KOH mount – grains
Eumycetoma : 2-6µ, wide interwoven hyphae
with large, swollen cells (chlamydospores) at the
margin of the lesion.
Actinomycetoma : filaments with a diameter of
0.5 - 1µ, coccoid to bacillary forms.
If hyphae seen on KOH mount, use special
stains.
15. smsmc
Direct Examination
Gram stain – gram +ve
branching filamentous
bacteria embedded in the
grain material.
Modified Acid fast staining
with 1% sulphuric acid – pink
colored filamentous bacteria
i.e. Nocardia Sps whereas
other actinomycetes are
non- acid fast.
16. smsmc
Culture
Different sets of media – both possibilities of
fungi & bacteria .
When Actinomycetoma is suspected on direct
examination - wash grains several times with
NS & then inoculate on SDA without
antibiotics, BA, LJ & BHIA.
When Eumycetoma is suspected – wash
grains several times in NS with antibiotics(Pn)
& inoculate it on SDA with antibiotics.
- actidione not added.
- incubated at 25° & 37°C
17. smsmc micro
Treatment & prophylaxis
Eumycetoma – Oral Ketoconazole &
Itraconazole
AMB for Madurella & Fusarium species.
Actinomycetoma – Sulfonamides,
Tetracyclines, Streptomycin, Amoxycillin,
Clavunate & Amikacin
Protracted case – Surgery (debridement with
skin graft)
19. smsmc micro
SPOROTRICHOSIS
Caused by Sporothrix schenckii, a dimorphic
fungus.
Most common in USA.
Found on plant, thorns & timber
Infection is acquired through thorn pricks or
other minor injuries
20. smsmc micro
Pathogenesis & pathology
Spreads from primary site
to the regional LNs through
lymphatics
Mostly involves upper limbs
Pyogranulomatous reaction
Clinical features - Nodules
on the skin, subcutaneous
tissue and in the LNs which
later soften & ulcerate.
Lymphocutaneous sporotrichosis
21. smsmc micro
Laboratory Diagnosis
Specimens – pus, exudate & aspirate from
nodules.
- curettage or swabs from open lesions.
Direct Examination
Gram’s stain – gram+ve, irregularly stained
yeast cells.
CFW – very useful.
22. smsmc micro
Direct examination
Tissues – organisms appear as cigar shaped
bodies (yeast cells) 3-5µ in diameter.
“Asteroid bodies” in the lesion – central
fungus cell surrounded by a refractile
eosinophilic halo, called “ Splendore-Hoeppli”
phenomenon : due to immune complex
deposition around the organism.
24. smsmc micro
LPCB mount from Culture
septate hyphae - very thin & carry flower like
clusters of small conidia on delicate sterigmata.
25. smsmc micro
Treatment & Prophylaxis
Saturated solution of KI – drug of choice
Oral Ketoconazole or Itraconazole
AMB – disseminated & CNS disease.
26. smsmc micro
RHINOSPORIDIOSIS
Caused by a hydrophilic protist,
Rhinosporidium seeberi
1st identified in Argentina, but majority of cases
occur in India and Sri lanka.
High incidence among people who frequently
bathe along with domestic animals in ponds,
tanks, lakes
27. smsmc micro
Clinical Features
Chronic granulomatous disease of mucous
membrane.
Characterised by the development of friable
polyps in the nose, mouth or eye.
Miscellaneous forms –
Buccal cavity,vagina,
vulva, penis, urethra
or rectum
28. smsmc micro
Laboratory Diagnosis
Cannot be cultured
Direct Examination
FNAC, Biopsy of lesion, Nasal washing
- Contains sporangia
filled with thousands of
sporangiospores(6-9µ)
embedded in a stroma
of connective tissue &
capillaries
29. smsmc micro
Treatment & Prophylaxis
Radical Surgery:- Excision/ Electrocautery
Medical therapy :- not useful
DDS (widely used)
Recurrence common
30. smsmc micro
CHROMO BLASTOMYCOSIS
Caused by dematiaceous (pigmented) fungi
Commonest fungi - Fonsecaea Species
Phialophora verrucosa
Cladosporium carrionii
Also called as Verrucous dermatitis
31. smsmc micro
Clinical features
Soil saprobes enter the skin by traumatic
implantation and lesions develop slowly around
the site of implantation
Warty cutaneous nodules which resembles
flouts of cauliflower - Verrucous dermatitis
Frequently ulcerate
Confined to the subcutaneous tissue of the feet
and lower legs
32. smsmc micro
Laboratory Diagnosis
Direct Examination
Dry crusty material from the surface of the
lesions
1. KOH w/m –
dark brown, multicellular structures, 5-12μ in
diameter that divide by transverse septation.
-Called sclerotic bodies, medlar bodies, copper-
pennies bodies or muriform cells
34. smsmc micro
Direct examination
Medlar bodies - characteristic tissue form -
facilitates survival of organism in host tissues.
2. Tissue Stains - for Biopsy specimens
HE, Giemsa & Fontana- Masson
- Sclerotic bodies very well seen
Fungal culture - SDA with actidione and
antibiotics
35. smsmc micro
Treatment & Prophylaxis
Responds poorly to available therapies.
Cryotherapy, Thermotherapy, Laser
therapy,Chemotherapy and Surgery.
Flucytosine (commonly used drug)
Itraconazole, Fluconazole, Terbinafine
*Relapses are frequently seen
36. smsmc micro
PHAEOHYPHOMYCOSIS
Seen in debilitated & immunodeficient hosts.
Causes subcutaneous & systemic infection.
Caused by dematiaceous fungi. Commonest
genera involved - Alternaria, Bipolaris,
Curvularia, Exophiala, Phialophora, etc.
37. smsmc micro
Clinical Features
Clinical types:
1. Brain abscess caused by Cladosporium
2. Subcutaneous or intramuscular lesions with
abscess or cysts - single circumscribed
lesion with a central cavity filled with pus
and surrounded by a fibrous wall
3. Cutaneous lesions
38. smsmc micro
Laboratory Diagnosis
Specimen
Aspirates from cysts
Curreting from plaques, nodules and drained
abscess
Direct Examination
KOH mount
- Pigmented hyphae 3-4µ in dia.
39. smsmc micro
Fungal Culture
SDA with actidione at 25º & 37ºC.
Treatment & Prophylaxis
Local excision for subcutaneous forms
Invasive infections – I.V. AMB + Oral
Flucytosine.
40. smsmc micro
LOBOMYCOSIS
Caused by Lacazia loboi
(Hydrophilic fungus) : exists
only as yeast cells.
Involves exposed parts
Presence of macule, papule,
keloid, verrucous, nodular
lesions or plaques & tumors.
Lesions are painless with
slight pruritis
41. smsmc micro
Laboratory Diagnosis
Direct Examination of curettage / biopsy -
crushed
a. KOH w / m
b. CFW
- spheroid, yeast - like cells, 5 -12µ
- thick - walled & multinucleate.
- form chain with cells joined by bridges.
c. HE – may show ‘asteroid bodies’
• Culture – cannot be cultured