Systemic mycoses can result from inhalation of fungal spores that then differentiate into yeast or other forms in the lungs. This document focuses on four specific systemic mycoses: Coccidioides, Histoplasma, Blastomyces, and Paracoccidioides. Coccidioides causes valley fever through inhalation of spores in dry soil in the southwestern US and Central/South America. Paracoccidioides causes a similar disease through inhalation in parts of Central/South America. Both fungi exist as molds in soil and yeasts in tissues. Symptoms range from asymptomatic to disseminated disease. Diagnosis involves microscopy, culture, and ser
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.
Toxoplasma Gondii.
Toxoplasmosis - Congenital Toxoplasmosis
The transition between tachyzoites and bradyzoites.
T.gondii as an Epigenator.
Immune Response Pathway.
Behavior Changer by T.gondii infection.
Do you know Mycoacterium leprae cannot e cultured in normal medium? Do you know leprosy is one of the least contagious diseases? To know more interesting facts see the slide
Data is collected and this ppt is Created by Sweta Chaudhary. All rights are reserved to her. Contact vivekchaudhary.707@gmail.com for more inquiry. Thank you ...
Toxoplasma Gondii.
Toxoplasmosis - Congenital Toxoplasmosis
The transition between tachyzoites and bradyzoites.
T.gondii as an Epigenator.
Immune Response Pathway.
Behavior Changer by T.gondii infection.
Do you know Mycoacterium leprae cannot e cultured in normal medium? Do you know leprosy is one of the least contagious diseases? To know more interesting facts see the slide
Data is collected and this ppt is Created by Sweta Chaudhary. All rights are reserved to her. Contact vivekchaudhary.707@gmail.com for more inquiry. Thank you ...
Il Giornalino della classe 4A, scuola primaria Oneto, IC2 Novi Ligure, anno scolastico 2015/16. Premiato tra i 100 migliori giornalini scolastici dall'Associazione Nazionale di Giornalismo Scolastico - Targa d'Argento del Presidente della Repubblica
BlastomycosisClinical Presentation Patient is a 36 yjenkinsmandie
Blastomycosis
Clinical Presentation
Patient is a 36 year-old African American male from Baton Rouge, La. He was admitted into the ER suffering from shortness of breath and productive cough for two weeks. Ulcerative lesions are found on the patient’s left calf. Patient reports pain located at the knees. HIV test was positive. Chest x-rays and tissue biopsy were performed. The tissue biopsy of the ulcerative lesions showed fungal organism that suggest Blastomyces dermatidis. In addition, a sputum test was performed and found fungal organism present confirming Blastomyces dermatidis.
Patient began working on a construction site along the river about two months ago. Reports
of patients suffering similar symptoms have been found in the past year in the same area
that this patient worked at. Officials are testing the soil to determine if conidia of
Blastomyces dermatidis are present.
Patient was put on itraconazole for two weeks. Initial progress was slow but the fungal
infection eventually cleared up. Lesions are beginning to heal and patient reports that he
no longer have trouble breathing. His coughs are reduced as well. Long-term treatment with
itraconazole is required in order to prevent a reoccurrence.
What is Blastomycosis?
Blastomycosis is a fungal infection caused by a fungus called Blastomyces dermatidis
It is found in moist soil, specifically in rotting vegetation
It is contracted through inhalation, and it starts by infecting the lungs
From the lungs it disseminates into the bloodstream and lymphatics where it spread to the rest of the body
Also involves the skin, joint, bones, organs, central nervous system
weakened immune systems, such as those with HIV or who have had an organ transplant
Uncommon but can deadly in adults
Clinical Manifestation
Chronic illness
low-grade fever
productive cough
fatigue
night sweats
weight loss
Respiratory Signs of Blastomycosis
Rapidly progressive, and severe disease, eg, multilobar pneumonia or ARDS
fever
shortness of breath
tachypnea
hypoxemia
finally hemodynamic collapse
Acute illness analogous to bacterial pneumonia
high fever
chills
productive cough
pleuritic chest pain
mucopurulent or purulent sputum
Flu like symptoms
fever
chills
myalgia
headache
nonproductive cough
Clinical Manifestation
Osteoarticular lesions
bone or joint pain
soft-tissue swelling
involvement of any bone may be involved
most common sites
vertebrae and pelvis
Extrapulmonary manifestations present in 25-40% of cases
Genitourinary
prostatitis and epididymitis
asymptomatic or painful urination
Central nervous system
Intracranial abscesses
Epidural abscesses
meningitis
Cutaneous lesions
verrucous or ulcerative
asymptomatic
Other organ sites reported include the eye, liver, breast, thyroid, and adrenal gland.
Initial Diagnosis
Clinically, blastomycosis can be difficult to recognize even in the endemic areas where clinicians are aware of this pr ...
The main aim of Corona is transmission of disease from person to person, and it had also been declared as a global pandemic which has caused disaster in the respiratory system of more than five million people and killed more than half a billion people across the world. Patients surviving from Covid-19 have lower immunosuppressive CD4+ T and CD8+ T Cells. And most of the patients are in severe need of mechanical ventilation. This is the reason for a longer stay in hospital for a particular patient. Gradually, these patients have been discovered to develop fungal co-infection. This infection is deadly leading to loss of hearing, loss of sight and eventually death. The fungal infection is referred to as Mucormycosis, the black fungus. The causative agent for this infection is Mucormycotina which is a member of Mucorales. Mucormycotina usually habitats in soil and decaying organic matter. The infection of Mucormycotina is associated with a wide range of human diseases including arthritis, gastritis, renal disorders and pulmonary diseases. This infection is closely associated with the mucous layer of skin, precisely cutaneous layer. This infection is present in the nasal and upper respiratory tract. In the lower respiratory tract these infections are difficult to diagnose and treat due to the lack of precise methods. It was found those neutroponia patients are more
prone to this infection. This is caused by extensive use of chemotherapy resulting in impaired immunity. In recent times, in the case of pulmonary Mucormycosis, necrotizing pneumonia is a major symptom. A combination of antifungal and antimicrobial
agents is being used for a higher clinical recovery in the Mucormycosis case.
Presentation on meningitis and epiglottis. We made this presentation on epiglottis and meningitis. Their pathogenesis, mode of action, transmission, diagnosis, treatment, microbial group , symptoms , medication, and prevention been discussed in here.
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.
2. Systemic Mycosis
These infections result from inhalation of the spores of dimorphic
fungi that have their mold forms in the soil.
Within the lungs, the spores differentiate into yeasts or other
specialized forms.
Most lung infections are asymptomatic and self-limited.
However, in some persons, disseminated disease develops in which
the organisms grow in other organs, cause destructive lesions, and
may result in death.
Infected persons do not communicate these diseases to others.
5. General Characteristics
Mode Of Transmission: Inhalation; Respiratory droplet
Primary site of infection- LUNGS, 90% of infection is
asymptomatic or they resolved spontaneously
accompanied by high degree of specific resistance to
infections
Causes dissemination to other sites
Geographically restricted
Dimorphic
25 C- grows as filamentous mold
37C- yeast cell
6. COCCIDIOIDE
Disease
Coccidioides immitis causes coccidioidomycosis.
Properties
C. immitis is a dimorphic fungus that exists as a
mold in soil and as a spherule in tissue
7. Transmission & Epidemiology Coccidioide
The fungus is endemic in arid regions of the
southwestern United States and Latin America.
People who live in Central and Southern California,
Arizona, New Mexico, Western Texas, and Northern
Mexico, a geographic region called the Lower
Sonoran Life Zone, are often infected.
In soil, it forms hyphae with alternating
arthrospores
and empty cells.
Arthrospores are very light
and are carried by the wind.
They can be inhaled and
infect the lungs.
8. Pathogenesis of Coccidioide
In the lungs, arthrospores form spherules that are large,
have a thick, doubly refractive wall, and are filled with
endospores.
Upon rupture of the wall, endospores are released
and differentiate to form new spherules.
The organism can spread within a person by direct
extension or via the bloodstream.
Granulomatous lesions can occur in virtually any organ
but are found primarily in bones and the central
nervous system (meningitis)
Dissemination from the lungs to other organs occurs in
people who have a defect in cell-mediated immunity.
9. Pathogenesis of Coccidioide
Most people who are infected by C. immitis develop
a cell-mediated (delayed hypersensitivity) immune
response that restricts the growth of the organism.
One way to determine whether a person has
produced adequate cell-mediated immunity to the
organism is to do a skin test (see below).
In general, a person who has a positive skin test
reaction has developed sufficient immunity to
prevent disseminated disease from occurring.
If, at a later time, a person's cellular immunity is
suppressed by drugs or disease, disseminated
disease can occur.
10.
11. Clinical Findings of Coccidioide
Infection of the lungs is often asymptomatic and is
evident only by a positive skin test and the presence of
antibodies.
Some infected persons have an influenza like illness
with fever and cough.
About. 50% have changes in the lungs (infiltrates,
adenopathy, or effusions) as seen on chest x-ray.
10% develop erythema nodosum.
This syndrome is called "valley fever" or "desert
rheumatism"; it tends to subside spontaneously.
Disseminated disease can occur in almost any organ;
the meninges, bone, and skin are important sites.
12. Clinical Findings of Coccidioide
The overall incidence of dissemination in
persons infected with C. imrnitis is 1%, although
the incidence in Filipinos and African Americans
is 10 times higher.
Women in the third trimester of pregnancy also
have a markedly increased incidence of
dissemination.
Erythema nodosum (EN) manifests as red, tender
nodules ("desert bumps") on extensor surfaces
such as the shins.
It is a delayed (cell-mediated) hypersensitivity
response to fungal antigens and thus is an
indicator of a good prognosis.
13. Clinical Findings of Coccidioide
There are no organisms in these lesions; they are not
a sign of disseminated disease. EN is not specific for
coccidioidomycosis; it occurs in other granulomatous
diseases, e.g, histoplasmosis, tuberculosis, and
leprosy.
In infected persons, skin tests with fungal extracts
cause at least a 5mm induration 48 hours after
injection (delayed hypersensitivity reaction).
Skin tests become positive within 2-4 weeks of
infection and remain so for years but are often
negative in patients with disseminated disease.
14. Laboratory Diagnosis of Coccidioide
In tissue specimens,
spherules are seen
microscopically.
Cultures on
Sabouraud's agar
incubated at 25 °C show
hyphae with arthrospores.
(Caution: Cultures are highly
infectious; precautions against
inhaling arthrospores must be
taken.)
15. Laboratory Diagnosis of Coccidioide
In serologic tests, IgM and IgG precipitins appear
within 2-4 weeks of infection and then decline
in subsequent months.
Complement-fixing antibodies occur at low titer
initially, but the titer rises greatly if
dissemination occurs
16. Treatment & Prevention of Coccidioide
No treatment is needed in asymptomatic or mild
primary infection.
Amphotericin B (Fungizone) or itraconazole is used
for persisting lung lesions or disseminated disease.
Ketoconazole is also effective in lung disease.
Fluconazole is the drug of choice for meningitis.
Intrathecal amphotericin B may be required and
may induce remission, but long-term results are
often poor.
There are no means of prevention
except avoiding travel to endemic areas.
18. General characteristics
Etiologic Agent: P. brazieliensis
Central & South America & has high incidence in Brazil,
Venezuela & Colombia
Natural reservoir: isolated in soil that have high
humidity & average temperature of 23 C
Equal distribution among males & females, but clinical
disease is about 9X higher in males
Transition of fungi from mold to yeast can be induced in
vitro by raising the temperature of 25 C to 37 C
M-17-beta- estradiol inhibits transformation of the fungi
Testosterone,corticosterone & 17 alpha estradiol had
NO inhibitory on the transformation
19. Disease of Paracoccidioides
Paracoccidioides brasiliensis causes
paracoccidioidomycosis,
also known as South American blastomycosis.
20. Paracoccidioidomycosis
Etiologic Agent: P. brazieliensis
Central & South America & has high incidence in Brazil,
Venezuela & Colombia
Natural reservoir: isolated in soil that have high humidity &
average temperature of 23 C
Equal distribution among males & females, but clinical
disease is about 9X higher in males
Transition of fungi from mold to yeast can be induced in
vitro by raising the temperature of 25 C to 37 C
21. Properties of Paracoccidioides
P. brasiliensis is a dimorphic fungus that exists
as a mold in soil and as a yeast in tissue.
The yeast is thick walled with multiple buds, in
contrast to B. derrnatitidis, which has a single
bud .
22. Transmission & Epidemiology of Paracoccidioides
The spores are inhaled, and early lesions occur
in the lungs.
Asymptomatic infection is common.
This fungus grows in the soil and is endemic in
rural Latin America. Disease occurs only in that
region.
23. Pathogenesis & Clinical Findings of Paracoccidioides
The spores are inhaled, and early lesions occur in the lungs.
Asymptomatic infection is common.
Alternatively oral mucous membrane lesions, lymph node
enlargement, and sometimes dissemination to many organs
develop.
Ulceration, granulomatous infection of oral and nasal mucosa
24.
25. Laboratory Diagnosis of Paracoccidioides
In pus or tissues, yeast cells with multiple buds
are seen microscopically.
26. A specimen cultured for 2-4 weeks may grow
typical organisms.
Skin tests are rarely helpful.
Serologic testing shows that when significant
antibody titers (by immunodiffusion or complement
fixation) are found, active disease is present
27. Treatment & Prevention of Paracoccidioides
The drug of choice is itraconazole taken orally
for several months.
There are no means of prevention.
