Fungal skin infections, including the common condition known as ringworm, represent a significant dermatological concern affecting millions worldwide. This review delves into the multifaceted nature of fungal skin infections, elucidating their etiology, clinical manifestations, and therapeutic approaches. Fungal skin infections are caused by various species of fungi, with dermatophytes being the primary culprits behind ringworm. The clinical presentation of fungal skin infections varies, encompassing symptoms such as itching, redness, scaling, and characteristic circular lesions. Diagnosis typically involves clinical examination, microscopy, and culture of skin scrapings. Treatment strategies range from topical antifungal agents for mild cases to systemic therapy for severe or recurrent infections. Additionally, preventive measures and lifestyle modifications play pivotal roles in managing and preventing fungal skin infections. A comprehensive understanding of fungal skin infections, including ringworm, is essential for healthcare practitioners to facilitate timely diagnosis and effective management, thereby improving patient outcomes.
Key Words: Fungal skin infections, ringworm, dermatophytes, antifungal therapy, diagnosis, prevention, dermatology
Fungi are a separate kingdom from plants and animals that play an important role in decomposition. Dermatomycoses are fungal infections of the skin, hair, or nails caused by dermatophytes from three genera: Trichophyton, Microsporum, and Epidermophyton. Dermatophytes are transmitted through direct or indirect contact with infected skin or hair. Diagnosis involves microscopic examination of skin or hair samples in potassium hydroxide or culturing samples on growth media. Treatment depends on the severity but may include topical imidazole creams for mild cases or oral antifungals like griseofulvin for more severe or persistent infections.
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.
1. Cutaneous mycoses are fungal infections of the skin, hair, and nails caused by dermatophytes like Trichophyton, Microsporum, and Epidermophyton. Laboratory diagnosis involves microscopic examination of skin scrapings or nail clippings in KOH to identify fungal elements, as well as fungal culture.
2. Subcutaneous mycoses involve fungal infection of the subcutaneous tissue and overlying skin, such as mycetoma, chromoblastomycosis, sporotrichosis, and rhinosporidiosis. They are caused by a heterogeneous group of fungi introduced through the skin via minor trauma.
This document provides an introduction to mycology and virology for public health second-year students. It defines key terms related to fungi and outlines the objectives, characteristics of fungi, medical importance of fungi, and types of fungal infections including superficial, cutaneous, subcutaneous, and systemic mycoses. Specific fungi that cause different types of infections are described along with their symptoms, transmission, and clinical presentation.
Mycology has become clinically important due to rising immunocompromised patients. The document defines key terms related to fungi including their cell structure, types of growth (yeast, hyphae, molds), reproduction, and classification. It discusses several medically important superficial and cutaneous fungal infections caused by dermatophytes, yeasts, and dimorphic fungi; and their diagnosis and treatment.
This document discusses various pathogenic fungi and the diseases they cause. It describes different types of fungal infections including superficial mycoses affecting the skin surface, cutaneous mycoses like ringworm that infect the skin, and subcutaneous mycoses which occur beneath the skin. Specific fungi that cause diseases like athlete's foot, ringworm, and mycetoma are outlined. The modes of transmission between environments, people, and animals are also summarized. Treatment options and laboratory diagnosis methods for different fungal infections are mentioned.
This document discusses cutaneous mycoses, including the causative organisms, clinical manifestations, laboratory diagnosis, treatment, and prevention. It describes several common fungal infections of the skin caused by dermatophytes, including athlete's foot, ringworm, jock itch, and nail fungus. It provides details on the characteristic features of common dermatophyte genera (e.g. Trichophyton, Microsporum, Epidermophyton) and discusses methods for laboratory diagnosis through direct microscopy, culture, and identification of fungal structures. Treatment involves topical and oral antifungal drugs while prevention focuses on maintaining good hygiene and cleanliness to avoid spreading fungal spores.
Fungi are a separate kingdom from plants and animals that play an important role in decomposition. Dermatomycoses are fungal infections of the skin, hair, or nails caused by dermatophytes from three genera: Trichophyton, Microsporum, and Epidermophyton. Dermatophytes are transmitted through direct or indirect contact with infected skin or hair. Diagnosis involves microscopic examination of skin or hair samples in potassium hydroxide or culturing samples on growth media. Treatment depends on the severity but may include topical imidazole creams for mild cases or oral antifungals like griseofulvin for more severe or persistent infections.
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.
1. Cutaneous mycoses are fungal infections of the skin, hair, and nails caused by dermatophytes like Trichophyton, Microsporum, and Epidermophyton. Laboratory diagnosis involves microscopic examination of skin scrapings or nail clippings in KOH to identify fungal elements, as well as fungal culture.
2. Subcutaneous mycoses involve fungal infection of the subcutaneous tissue and overlying skin, such as mycetoma, chromoblastomycosis, sporotrichosis, and rhinosporidiosis. They are caused by a heterogeneous group of fungi introduced through the skin via minor trauma.
This document provides an introduction to mycology and virology for public health second-year students. It defines key terms related to fungi and outlines the objectives, characteristics of fungi, medical importance of fungi, and types of fungal infections including superficial, cutaneous, subcutaneous, and systemic mycoses. Specific fungi that cause different types of infections are described along with their symptoms, transmission, and clinical presentation.
Mycology has become clinically important due to rising immunocompromised patients. The document defines key terms related to fungi including their cell structure, types of growth (yeast, hyphae, molds), reproduction, and classification. It discusses several medically important superficial and cutaneous fungal infections caused by dermatophytes, yeasts, and dimorphic fungi; and their diagnosis and treatment.
This document discusses various pathogenic fungi and the diseases they cause. It describes different types of fungal infections including superficial mycoses affecting the skin surface, cutaneous mycoses like ringworm that infect the skin, and subcutaneous mycoses which occur beneath the skin. Specific fungi that cause diseases like athlete's foot, ringworm, and mycetoma are outlined. The modes of transmission between environments, people, and animals are also summarized. Treatment options and laboratory diagnosis methods for different fungal infections are mentioned.
This document discusses cutaneous mycoses, including the causative organisms, clinical manifestations, laboratory diagnosis, treatment, and prevention. It describes several common fungal infections of the skin caused by dermatophytes, including athlete's foot, ringworm, jock itch, and nail fungus. It provides details on the characteristic features of common dermatophyte genera (e.g. Trichophyton, Microsporum, Epidermophyton) and discusses methods for laboratory diagnosis through direct microscopy, culture, and identification of fungal structures. Treatment involves topical and oral antifungal drugs while prevention focuses on maintaining good hygiene and cleanliness to avoid spreading fungal spores.
Mycosis is a fungal infection that can present as superficial, subcutaneous, or systemic. Superficial mycoses like tinea versicolor and piedra involve the skin surface and are acquired through contact. Common dermatophytes that cause cutaneous infections like tinea corporis are Trycophyton, Microsporum, and Epidermophyton. Diagnosis involves microscopic examination of skin or nail samples in potassium hydroxide to identify fungal elements. Culture allows identification of the infecting species. Treatment involves topical or oral antifungal agents.
Dermatophytosis is a common fungal infection caused by dermatophytes that can infect the skin, hair, and nails. It is transmitted through direct contact with infected humans or animals or contact with contaminated surfaces. Common symptoms depend on the infected area and include ring-shaped lesions, hair loss, scaling, and inflammation. Treatment involves topical or oral antifungal medications.
Majocchi Granuloma, Masquerading As Psoriasis: A ReviewSpurthiPunam
Majocchi’s granuloma (MG) is a rare, atypical yet well recognized deep infection of dermal and subcutaneous tissue caused by dermatophytes such as anthropophilic Trichophyton rubrum; however, other dermatophytes including T. mentagrophytes T. epilans, T. violaceum, M. audouinii, M. gypseum, M. ferrugineum, and M. canis may be the causative agent usually limited to the superficial epidermis. In both healthy individuals and immunocompromised hosts MG is characterized clinically by papular, pustular or nodular inflammatory lesions occurring typically on the limbs or face, immunocompromised patients are at increased risk for infection. A favorable factor for the infection is an injury caused by epilation, which together with an existing fungal infection. The aim of this article is to provide a detailed review on clinical manifestations, diagnosis, risk factors, pathophysiology and pharmacological treatment options.
This document discusses several types of deep fungal infections:
1. Subcutaneous mycoses like sporotrichosis, chromoblastomycosis, and mycetoma which are caused by fungi entering through the skin.
2. Systemic mycoses like histoplasmosis which are acquired by inhalation and can disseminate through the bloodstream. Histoplasmosis is caused by Histoplasma capsulatum and presents as pulmonary infection, disseminated infection affecting organs, or cutaneous lesions. Treatment involves antifungals like amphotericin B or itraconazole.
3. Rarer infections like lobomycosis caused by Lacazia loboi which
Subcutaneous mycoses are fungal infections that enter the subcutaneous tissue through the skin. The main types are mycetoma, chromoblastomycosis, sporotrichosis, and rhinosporidiosis. Mycetoma is caused by fungi or bacteria that enter through the feet, causing nodules and sinuses. Chromoblastomycosis causes rough, verrucous skin nodules through fungal implantation. Sporotrichosis is caused by Sporothrix schenckii entering through skin trauma, causing lymphocutaneous nodules. Rhinosporidiosis is caused by Rhinosporidium seeberi, producing polyps in the nose or other mucous membranes
Fungi are eukaryotic organisms that can be single-celled or multicellular. Their cell walls contain chitin and glucans. Fungi can cause superficial infections of the skin and nails, subcutaneous infections beneath the skin, and systemic infections of internal organs. Common fungal diseases include ringworm, athlete's foot, histoplasmosis, and coccidiomycosis. Fungi are classified based on their modes of reproduction and microscopic structures. Identification and diagnosis involves microscopic examination, culturing, and serological tests.
Classification of Fungi. Superficial Mycoses & Systemic Mycoses. Dermatophyte...Eneutron
This document discusses medical fungi that can cause superficial and systemic mycoses. It covers the general characteristics of fungi including their morphology, classification, and modes of infection. Specific types of mycoses are described such as dermatophytoses caused by fungi like Trichophyton that infect the skin, hair, and nails. Deeper mycoses like sporotrichosis that infect subcutaneous tissue via minor trauma are also outlined. The document provides details on laboratory diagnostics and culturing of different fungi as well as antifungal therapies.
This document summarizes various fungal diseases that affect humans and animals. It describes five main groups of fungal diseases: superficial mycoses, cutaneous mycoses, subcutaneous mycoses, systemic mycoses, and opportunistic mycoses. For each group, it provides examples of pathogenic fungi, the locations they infect, and the resulting diseases. It also discusses the transmission routes and typical symptoms for some of the major fungal diseases like blastomycosis, coccidioidomycosis, cryptococcosis, and histoplasmosis.
Sporotrichosis is a fungal infection caused by Sporothrix schenckii. It typically presents as firm, painless nodules on the skin that can spread and ulcerate. The fungus is commonly found in soil and plants, and infection usually occurs through skin trauma from these sources. Symptoms range from minimal to widespread depending on immune status. Treatment involves antifungal medications like itraconazole or potassium iodide for localized infection, and amphotericin B for more severe cases. Sporotrichosis can also affect animals like cats and is occasionally transmitted between animals and humans through skin contact.
Chap 7 fungi and other organism (human)Alia Najiha
This document discusses various types of parasitic fungi and human mycoses (fungal diseases). It describes systemic mycoses that affect deep tissues, cutaneous mycoses that infect the skin/hair/nails, subcutaneous mycoses beneath the skin, and superficial mycoses of hair and skin. Specific fungal diseases are provided as examples for each category like histoplasmosis, ringworm, and athlete's foot. Opportunistic mycoses caused by generally harmless fungi that infect individuals with weakened immunity are also outlined.
mycology 12345.pptx development of mmmmmbbbbbsssssssssAnuragKumarKumar4
This document provides an overview of mycology, which is the study of fungi. It discusses the classification of fungi based on morphological forms, sporulation, type of infection, and site of infection. The key classifications described are yeasts, dimorphic fungi, and filamentous fungi. It also covers various fungal infections including superficial mycoses of the skin, subcutaneous mycoses, and systemic mycoses. Laboratory methods for fungal identification and diagnosis are mentioned such as microscopy, culture, and staining techniques.
This document provides an overview of mycology, which is the study of fungi. It discusses the classification of fungi based on morphological forms, sporulation, type of infection, and site of infection. The key classifications described are yeasts, dimorphic fungi, and filamentous fungi. It also covers various fungal infections including superficial mycoses like tinea versicolor and tinea nigra, subcutaneous mycoses like mycetoma and sporotrichosis, and systemic mycoses. Laboratory methods for fungal identification and diagnosis are also mentioned such as microscopy, culture, and staining techniques.
This document provides information on deep cutaneous mycosis, specifically focusing on subcutaneous mycoses. It discusses several types of subcutaneous mycoses including sporotrichosis, mycetoma, and chromoblastomycosis. For each condition, it describes the causative organisms, epidemiology, clinical presentation, diagnosis, and treatment. Sporotrichosis is caused by Sporothrix schenckii and can manifest as lymphatic or fixed cutaneous lesions. Mycetoma is characterized by grain formation and can be caused by fungi or actinomycetes. Chromoblastomycosis features slow growing exophytic lesions caused by pigmented fungi that form sclerotic bodies in tissue.
This document discusses various mycoses (fungal infections) that affect humans. It describes 10 specific mycoses - mycetoma, chromomycosis, sporotrichosis, rhinosporidiosis, subcutaneous phycomycosis, cryptococcosis, blastomycosis, paracoccidioidomycosis, coccidioidomycosis, and histoplasmosis. For each, it provides details on the causative agents, clinical manifestations, pathogenesis, diagnosis, and laboratory identification. Key diagnostic methods mentioned include microscopy, histopathology, culture, and serology. The document is intended as an educational reference for medical professionals regarding these important fungal diseases.
Mucormycosis is a serious fungal infection caused by common soil molds called mucormycetes. It mainly affects those with health problems or weak immune systems from medicines. The fungi can infect the sinuses, lungs, or skin through spore inhalation or skin injuries. It becomes life-threatening for diabetics and others with weakened immunity. The fungi are found everywhere in soil, plants, decaying matter. Symptoms include sinus pain, eye or face swelling. Prevention focuses on cleanliness, hygiene and controlling health conditions like diabetes.
This document provides information about Sporotrichosis, including its definition, etiology, clinical features, diagnosis, and treatment. It is caused by the dimorphic fungus Sporothrix schenckii, which can cause subcutaneous nodules and ulceration. Diagnosis involves microscopic examination, culture, histology, and serology to demonstrate the presence of the fungus. Treatment typically involves oral antifungal medication such as itraconazole or potassium iodide for at least 4-6 weeks after symptoms resolve.
DEDICATED FOR MOLAR PSPDG UMY 2012
#M10
drg. Suryono, PhD
1. The document discusses different types of fungal infections (mycoses) that can affect the skin, including superficial mycoses like pityriasis versicolor and tinea versicolor, cutaneous mycoses like various forms of ringworm, and subcutaneous mycoses.
2. It also discusses opportunistic and systemic mycoses that can spread to multiple organ systems in individuals with weakened immunity. Common opportunistic fungi mentioned are Candida albicans and Aspergillus niger.
3. Oral candidiasis
Mycosis is a fungal infection that can present as superficial, subcutaneous, or systemic. Superficial mycoses like tinea versicolor and piedra involve the skin surface and are acquired through contact. Common dermatophytes that cause cutaneous infections like tinea corporis are Trycophyton, Microsporum, and Epidermophyton. Diagnosis involves microscopic examination of skin or nail samples in potassium hydroxide to identify fungal elements. Culture allows identification of the infecting species. Treatment involves topical or oral antifungal agents.
Dermatophytosis is a common fungal infection caused by dermatophytes that can infect the skin, hair, and nails. It is transmitted through direct contact with infected humans or animals or contact with contaminated surfaces. Common symptoms depend on the infected area and include ring-shaped lesions, hair loss, scaling, and inflammation. Treatment involves topical or oral antifungal medications.
Majocchi Granuloma, Masquerading As Psoriasis: A ReviewSpurthiPunam
Majocchi’s granuloma (MG) is a rare, atypical yet well recognized deep infection of dermal and subcutaneous tissue caused by dermatophytes such as anthropophilic Trichophyton rubrum; however, other dermatophytes including T. mentagrophytes T. epilans, T. violaceum, M. audouinii, M. gypseum, M. ferrugineum, and M. canis may be the causative agent usually limited to the superficial epidermis. In both healthy individuals and immunocompromised hosts MG is characterized clinically by papular, pustular or nodular inflammatory lesions occurring typically on the limbs or face, immunocompromised patients are at increased risk for infection. A favorable factor for the infection is an injury caused by epilation, which together with an existing fungal infection. The aim of this article is to provide a detailed review on clinical manifestations, diagnosis, risk factors, pathophysiology and pharmacological treatment options.
This document discusses several types of deep fungal infections:
1. Subcutaneous mycoses like sporotrichosis, chromoblastomycosis, and mycetoma which are caused by fungi entering through the skin.
2. Systemic mycoses like histoplasmosis which are acquired by inhalation and can disseminate through the bloodstream. Histoplasmosis is caused by Histoplasma capsulatum and presents as pulmonary infection, disseminated infection affecting organs, or cutaneous lesions. Treatment involves antifungals like amphotericin B or itraconazole.
3. Rarer infections like lobomycosis caused by Lacazia loboi which
Subcutaneous mycoses are fungal infections that enter the subcutaneous tissue through the skin. The main types are mycetoma, chromoblastomycosis, sporotrichosis, and rhinosporidiosis. Mycetoma is caused by fungi or bacteria that enter through the feet, causing nodules and sinuses. Chromoblastomycosis causes rough, verrucous skin nodules through fungal implantation. Sporotrichosis is caused by Sporothrix schenckii entering through skin trauma, causing lymphocutaneous nodules. Rhinosporidiosis is caused by Rhinosporidium seeberi, producing polyps in the nose or other mucous membranes
Fungi are eukaryotic organisms that can be single-celled or multicellular. Their cell walls contain chitin and glucans. Fungi can cause superficial infections of the skin and nails, subcutaneous infections beneath the skin, and systemic infections of internal organs. Common fungal diseases include ringworm, athlete's foot, histoplasmosis, and coccidiomycosis. Fungi are classified based on their modes of reproduction and microscopic structures. Identification and diagnosis involves microscopic examination, culturing, and serological tests.
Classification of Fungi. Superficial Mycoses & Systemic Mycoses. Dermatophyte...Eneutron
This document discusses medical fungi that can cause superficial and systemic mycoses. It covers the general characteristics of fungi including their morphology, classification, and modes of infection. Specific types of mycoses are described such as dermatophytoses caused by fungi like Trichophyton that infect the skin, hair, and nails. Deeper mycoses like sporotrichosis that infect subcutaneous tissue via minor trauma are also outlined. The document provides details on laboratory diagnostics and culturing of different fungi as well as antifungal therapies.
This document summarizes various fungal diseases that affect humans and animals. It describes five main groups of fungal diseases: superficial mycoses, cutaneous mycoses, subcutaneous mycoses, systemic mycoses, and opportunistic mycoses. For each group, it provides examples of pathogenic fungi, the locations they infect, and the resulting diseases. It also discusses the transmission routes and typical symptoms for some of the major fungal diseases like blastomycosis, coccidioidomycosis, cryptococcosis, and histoplasmosis.
Sporotrichosis is a fungal infection caused by Sporothrix schenckii. It typically presents as firm, painless nodules on the skin that can spread and ulcerate. The fungus is commonly found in soil and plants, and infection usually occurs through skin trauma from these sources. Symptoms range from minimal to widespread depending on immune status. Treatment involves antifungal medications like itraconazole or potassium iodide for localized infection, and amphotericin B for more severe cases. Sporotrichosis can also affect animals like cats and is occasionally transmitted between animals and humans through skin contact.
Chap 7 fungi and other organism (human)Alia Najiha
This document discusses various types of parasitic fungi and human mycoses (fungal diseases). It describes systemic mycoses that affect deep tissues, cutaneous mycoses that infect the skin/hair/nails, subcutaneous mycoses beneath the skin, and superficial mycoses of hair and skin. Specific fungal diseases are provided as examples for each category like histoplasmosis, ringworm, and athlete's foot. Opportunistic mycoses caused by generally harmless fungi that infect individuals with weakened immunity are also outlined.
mycology 12345.pptx development of mmmmmbbbbbsssssssssAnuragKumarKumar4
This document provides an overview of mycology, which is the study of fungi. It discusses the classification of fungi based on morphological forms, sporulation, type of infection, and site of infection. The key classifications described are yeasts, dimorphic fungi, and filamentous fungi. It also covers various fungal infections including superficial mycoses of the skin, subcutaneous mycoses, and systemic mycoses. Laboratory methods for fungal identification and diagnosis are mentioned such as microscopy, culture, and staining techniques.
This document provides an overview of mycology, which is the study of fungi. It discusses the classification of fungi based on morphological forms, sporulation, type of infection, and site of infection. The key classifications described are yeasts, dimorphic fungi, and filamentous fungi. It also covers various fungal infections including superficial mycoses like tinea versicolor and tinea nigra, subcutaneous mycoses like mycetoma and sporotrichosis, and systemic mycoses. Laboratory methods for fungal identification and diagnosis are also mentioned such as microscopy, culture, and staining techniques.
This document provides information on deep cutaneous mycosis, specifically focusing on subcutaneous mycoses. It discusses several types of subcutaneous mycoses including sporotrichosis, mycetoma, and chromoblastomycosis. For each condition, it describes the causative organisms, epidemiology, clinical presentation, diagnosis, and treatment. Sporotrichosis is caused by Sporothrix schenckii and can manifest as lymphatic or fixed cutaneous lesions. Mycetoma is characterized by grain formation and can be caused by fungi or actinomycetes. Chromoblastomycosis features slow growing exophytic lesions caused by pigmented fungi that form sclerotic bodies in tissue.
This document discusses various mycoses (fungal infections) that affect humans. It describes 10 specific mycoses - mycetoma, chromomycosis, sporotrichosis, rhinosporidiosis, subcutaneous phycomycosis, cryptococcosis, blastomycosis, paracoccidioidomycosis, coccidioidomycosis, and histoplasmosis. For each, it provides details on the causative agents, clinical manifestations, pathogenesis, diagnosis, and laboratory identification. Key diagnostic methods mentioned include microscopy, histopathology, culture, and serology. The document is intended as an educational reference for medical professionals regarding these important fungal diseases.
Mucormycosis is a serious fungal infection caused by common soil molds called mucormycetes. It mainly affects those with health problems or weak immune systems from medicines. The fungi can infect the sinuses, lungs, or skin through spore inhalation or skin injuries. It becomes life-threatening for diabetics and others with weakened immunity. The fungi are found everywhere in soil, plants, decaying matter. Symptoms include sinus pain, eye or face swelling. Prevention focuses on cleanliness, hygiene and controlling health conditions like diabetes.
This document provides information about Sporotrichosis, including its definition, etiology, clinical features, diagnosis, and treatment. It is caused by the dimorphic fungus Sporothrix schenckii, which can cause subcutaneous nodules and ulceration. Diagnosis involves microscopic examination, culture, histology, and serology to demonstrate the presence of the fungus. Treatment typically involves oral antifungal medication such as itraconazole or potassium iodide for at least 4-6 weeks after symptoms resolve.
DEDICATED FOR MOLAR PSPDG UMY 2012
#M10
drg. Suryono, PhD
1. The document discusses different types of fungal infections (mycoses) that can affect the skin, including superficial mycoses like pityriasis versicolor and tinea versicolor, cutaneous mycoses like various forms of ringworm, and subcutaneous mycoses.
2. It also discusses opportunistic and systemic mycoses that can spread to multiple organ systems in individuals with weakened immunity. Common opportunistic fungi mentioned are Candida albicans and Aspergillus niger.
3. Oral candidiasis
Similar to Understanding Fungal Skin Infections and Ringworm: Causes, Symptoms, and Treatment Options.pdf (20)
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Recent theoretical progress indicates that spacetime and gravity emerge together from the entanglement structure of an underlying microscopic theory. These ideas are best understood in Anti-de Sitter space, where they rely on the area law for entanglement entropy. The extension to de Sitter space requires taking into account the entropy and temperature associated with the cosmological horizon. Using insights from string theory, black hole physics and quantum information theory we argue that the positive dark energy leads to a thermal volume law contribution to the entropy that overtakes the area law precisely at the cosmological horizon. Due to the competition between area and volume law entanglement the microscopic de Sitter states do not thermalise at sub-Hubble scales: they exhibit memory effects in the form of an entropy displacement caused by matter. The emergent laws of gravity contain an additional ‘dark’ gravitational force describing the ‘elastic’ response due to the entropy displacement. We derive an estimate of the strength of this extra force in terms of the baryonic mass, Newton’s constant and the Hubble acceleration scale a0 = cH0, and provide evidence for the fact that this additional ‘dark gravity force’ explains the observed phenomena in galaxies and clusters currently attributed to dark matter.
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Ahota Beel, nestled in Sootea Biswanath Assam , is celebrated for its extraordinary diversity of bird species. This wetland sanctuary supports a myriad of avian residents and migrants alike. Visitors can admire the elegant flights of migratory species such as the Northern Pintail and Eurasian Wigeon, alongside resident birds including the Asian Openbill and Pheasant-tailed Jacana. With its tranquil scenery and varied habitats, Ahota Beel offers a perfect haven for birdwatchers to appreciate and study the vibrant birdlife that thrives in this natural refuge.
Sexuality - Issues, Attitude and Behaviour - Applied Social Psychology - Psyc...PsychoTech Services
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Neutralizing antibodies, pivotal in immune defense, specifically bind and inhibit viral pathogens, thereby playing a crucial role in protecting against and mitigating infectious diseases. In this slide, we will introduce what antibodies and neutralizing antibodies are, the production and regulation of neutralizing antibodies, their mechanisms of action, classification and applications, as well as the challenges they face.
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Centrifugation is a powerful technique used in laboratories to separate components of a heterogeneous mixture based on their density. This process utilizes centrifugal force to rapidly spin samples, causing denser particles to migrate outward more quickly than lighter ones. As a result, distinct layers form within the sample tube, allowing for easy isolation and purification of target substances.
Discovery of An Apparent Red, High-Velocity Type Ia Supernova at 𝐳 = 2.9 wi...Sérgio Sacani
We present the JWST discovery of SN 2023adsy, a transient object located in a host galaxy JADES-GS
+
53.13485
−
27.82088
with a host spectroscopic redshift of
2.903
±
0.007
. The transient was identified in deep James Webb Space Telescope (JWST)/NIRCam imaging from the JWST Advanced Deep Extragalactic Survey (JADES) program. Photometric and spectroscopic followup with NIRCam and NIRSpec, respectively, confirm the redshift and yield UV-NIR light-curve, NIR color, and spectroscopic information all consistent with a Type Ia classification. Despite its classification as a likely SN Ia, SN 2023adsy is both fairly red (
�
(
�
−
�
)
∼
0.9
) despite a host galaxy with low-extinction and has a high Ca II velocity (
19
,
000
±
2
,
000
km/s) compared to the general population of SNe Ia. While these characteristics are consistent with some Ca-rich SNe Ia, particularly SN 2016hnk, SN 2023adsy is intrinsically brighter than the low-
�
Ca-rich population. Although such an object is too red for any low-
�
cosmological sample, we apply a fiducial standardization approach to SN 2023adsy and find that the SN 2023adsy luminosity distance measurement is in excellent agreement (
≲
1
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) with
Λ
CDM. Therefore unlike low-
�
Ca-rich SNe Ia, SN 2023adsy is standardizable and gives no indication that SN Ia standardized luminosities change significantly with redshift. A larger sample of distant SNe Ia is required to determine if SN Ia population characteristics at high-
�
truly diverge from their low-
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counterparts, and to confirm that standardized luminosities nevertheless remain constant with redshift.
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The pathway(s) to seeding the massive black holes (MBHs) that exist at the heart of galaxies in the present and distant Universe remains an unsolved problem. Here we categorise, describe and quantitatively discuss the formation pathways of both light and heavy seeds. We emphasise that the most recent computational models suggest that rather than a bimodal-like mass spectrum between light and heavy seeds with light at one end and heavy at the other that instead a continuum exists. Light seeds being more ubiquitous and the heavier seeds becoming less and less abundant due the rarer environmental conditions required for their formation. We therefore examine the different mechanisms that give rise to different seed mass spectrums. We show how and why the mechanisms that produce the heaviest seeds are also among the rarest events in the Universe and are hence extremely unlikely to be the seeds for the vast majority of the MBH population. We quantify, within the limits of the current large uncertainties in the seeding processes, the expected number densities of the seed mass spectrum. We argue that light seeds must be at least 103 to 105 times more numerous than heavy seeds to explain the MBH population as a whole. Based on our current understanding of the seed population this makes heavy seeds (Mseed > 103 M⊙) a significantly more likely pathway given that heavy seeds have an abundance pattern than is close to and likely in excess of 10−4 compared to light seeds. Finally, we examine the current state-of-the-art in numerical calculations and recent observations and plot a path forward for near-future advances in both domains.
Candidate young stellar objects in the S-cluster: Kinematic analysis of a sub...Sérgio Sacani
Context. The observation of several L-band emission sources in the S cluster has led to a rich discussion of their nature. However, a definitive answer to the classification of the dusty objects requires an explanation for the detection of compact Doppler-shifted Brγ emission. The ionized hydrogen in combination with the observation of mid-infrared L-band continuum emission suggests that most of these sources are embedded in a dusty envelope. These embedded sources are part of the S-cluster, and their relationship to the S-stars is still under debate. To date, the question of the origin of these two populations has been vague, although all explanations favor migration processes for the individual cluster members. Aims. This work revisits the S-cluster and its dusty members orbiting the supermassive black hole SgrA* on bound Keplerian orbits from a kinematic perspective. The aim is to explore the Keplerian parameters for patterns that might imply a nonrandom distribution of the sample. Additionally, various analytical aspects are considered to address the nature of the dusty sources. Methods. Based on the photometric analysis, we estimated the individual H−K and K−L colors for the source sample and compared the results to known cluster members. The classification revealed a noticeable contrast between the S-stars and the dusty sources. To fit the flux-density distribution, we utilized the radiative transfer code HYPERION and implemented a young stellar object Class I model. We obtained the position angle from the Keplerian fit results; additionally, we analyzed the distribution of the inclinations and the longitudes of the ascending node. Results. The colors of the dusty sources suggest a stellar nature consistent with the spectral energy distribution in the near and midinfrared domains. Furthermore, the evaporation timescales of dusty and gaseous clumps in the vicinity of SgrA* are much shorter ( 2yr) than the epochs covered by the observations (≈15yr). In addition to the strong evidence for the stellar classification of the D-sources, we also find a clear disk-like pattern following the arrangements of S-stars proposed in the literature. Furthermore, we find a global intrinsic inclination for all dusty sources of 60 ± 20◦, implying a common formation process. Conclusions. The pattern of the dusty sources manifested in the distribution of the position angles, inclinations, and longitudes of the ascending node strongly suggests two different scenarios: the main-sequence stars and the dusty stellar S-cluster sources share a common formation history or migrated with a similar formation channel in the vicinity of SgrA*. Alternatively, the gravitational influence of SgrA* in combination with a massive perturber, such as a putative intermediate mass black hole in the IRS 13 cluster, forces the dusty objects and S-stars to follow a particular orbital arrangement. Key words. stars: black holes– stars: formation– Galaxy: center– galaxies: star formation
3. Friday, September 29,
2023
3
I. Fungi
II. Fungal skin infections / Mycoses
a. Epidimology
b. Classification of Mycoses
1. Cutaneous Mycoses
a. Types of Cutaneous mycoses
2. Sub-cutaneous Mycoses
a.Types of Sub-cutaneous Mycoses
3. Systemic Mycoses
a.Types of Systemic Mycoses
4. Opportunistic Mycoses
a.Types of Opportunistic Mycoses
LIST OF CONTENTS
4. I. FUNGI :
4
Fungi (singular: fungus) are a kingdom of usually multicellular
eukaryotic organisms that are heterotrophs (cannot make their
own food).
includes microorganisms such as yeasts and molds, as well as
the more familiar mushrooms.
classified as a kingdom, fungi, which is separate from the
other eukaryotic life kingdoms of plants and animals.
Mycology is the branch of biology concerned with the
systematic study of fungi, including their genetic and
biochemical properties, their taxonomy, and their use to humans
as a source of medicine.
Friday, September 29,
2023
5. II. FUNGAL SKIN INFECTIONS
o MYCOSIS:
(PLURAL: MYCOSES)
Mycosis is a fungal infection
of animals, including humans.
mycosis often start on the
skin or in lungs.
Micrograph showing a
mycosis (aspergillosis). The
Aspergillum (which is
spaghetti-like) is seen in the
center and surrounded by
inflammatory cells.
Friday, September 29,
2023
5
6. a. EPIDIMOLOGY:
Fungal infections of the
skin were the 4th most
common skin disease in
2010 affecting 984 million
people. 6%
11%
21%
62%
percentages
opputunistic cutaneous
subcutaneous systemic
Friday, September 29,
2023
6
7. b. CLASSIFICATION OF MYCOSIS:
Friday, September 29,
2023
7
mycosis
subcutaneous
mycoses
Cutaneous
mycoses
Systemic
mycoses
Opportunistic
mycoses
8. 1. CUTANEOUS MYCOSIS:
INTRODUCTION:
Also called dermatophytoses
these common diseases are caused by a group of related
fungi, the dermatophytes (RING WORM)
Dermatophytes fall into three genera, each with many
species:
Trichophyton (skin, hair and nails), Epidermophyton
(skin and hair) and Microsporum (skin and nails)
Friday, September 29,
2023
8
10. ETIOLOGY:
The causative organisms of the dermatophytoses are
often distinguished according to their natural habitats:
anthropophilic (residing on human skin), zoophilic
(residing on the skin of domestic and farm animals), or
geophilic (residing in the soil).
Most human infections are by anthropophilic and
zoophilic organisms.
Transmission from human to human or animal to human
is by infected skin scales.
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2023
10
11. CLINICAL MANIFESTATIONS:
DURATION:
months to years or life time
SYMPTOMS:
• Usually asymptomatic
• Pruritus
• Pain with bacterial super infection
RISK FACTORS:
• late childhood or young adult life, commonly 20-25 years
• Males > females
• Predisposing factors: hot and humid weather, occlusive
footwear, excessive sweating.
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2023
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12. PATHOPHYSIOLOGY:
dermatophytes have the ability to use keratin as a
source of nutrition
This ability allows them to infect keratinized tissues and
structures, such as skin, hair, and nails
all three genera attack the skin, Microsporum does
not infect nails and Epidermophyton does not infect
hair.
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2023
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13. CLINICAL SIGNIFICANCE:
Dermatophytoses are characterized by itching, scaling
skin patches that can become inflamed and weeping
Specific diseases are usually identified according to
affected tissue (for example, scalp, pubic area, or feet),
but a given disease can be caused by any one of several
organisms, and some organisms can cause more than
one dis-ease depending, for example, on the site of
infection or condition of the skin.
The following are the most commonly encountered
dermatophytoses.
Friday, September 29,
2023
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15. TINEA PEDIS:
Also known as “Athlete’s foot”
Causative agents:
Trichophyton rubrum, Trichophyton
mentagrophytes, and Epidermophyton
floccosum
Site of Attack:
initially between the toes, but can
spread to the nails, which become yellow
and brittle. Skin fissures can lead to
secondary bacterial infections, with
consequent lymph node inflammation
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16. TINEA CORPORIS:
Also known as “Ringworm”
Causative Agent:
E.floccosum and several species of
Trichophyton and Microsporum
Site of Attack:
Although any site on the body can
be affected, lesions most often occur on
non-hairy areas of the trunk.
Lesions appear as advancing annular
rings with scaly centers. The
periphery of the ring, which is the
site of active fungal growth, is usually
inflamed and vesiculated.
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2023
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17. TINEA CAPITIS
Also known as “Scalp Ringworm”
Causative Agent:
Several species of Trichophytonand
Microsporumhave been isolated from scalp
ringwormlesions, the predominant infecting
species depending on the geo-graphic
location of the patient. In the United
States, for example,the predominant
infecting species is Trichophyton
tonsurans.Disease manifestations range
from small, scaling patches,
toinvolvement of the entire scalp with
extensive hair loss (Figure20.5C). The
hair shafts can become invaded by
Microsporumhyphae, as manifested by
their green fluorescence in long-
waveultraviolet light (Wood lamp
Friday, September 29,
2023
17
18. TINEA CRURIS:
Also known as “jock itch”.
Causative agents:
Causative organisms are E. floccosum and
T. rubrum.
Disease Manifestations:
Disease manifestations are similar to
ringworm,except that lesions occur in the
moist groin area, where they canspread from
the upper thighs to the genitals.
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2023
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19. TINEA UNGUIUM:
Also known as “onychomycosis”
Causuative Agent:
The causative organism is most
often T. Rubrum
The nails are thickened,
discolored, andbrittle. Treatment
must be continued for three to four
months untilall infected portions
of the nail grow out and are
trimmed off
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2023
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20. LABORATORY DIAGNOSIS
Skin scales should be examined microscopically in a KOH
preparation for the presence of hyphae.
The organism is identified by the apperance of its
mycelium and it’s asexual spores on Sabouraud’s
Dextrose Agar.
Serologic tests are not useful.
Friday, September 29,
2023
20
21. TREATMENT:
● PHARMACOLOGICAL:
Removal of infected skin, followed by topical application of
antifungal antibiotics such as miconazole or clotrimazole
(applied to effective area for 2-4 weeks), is the first course of
treatment.
Refactory infections such as tinea unguium and tinea capitis
usually respond well to oral griseofulvin (500 mg/OD or 250
mg/BD)
Infections of the hair and nails usually require systemic
(oral) therapy which includes:
Topical anti-fungal treatment 2x/week; (selenium
sulphide shampoo or terbinafine cream
Terbinafine (250 mg/OD) is the drug of choice for
onychomycosis.
Friday, September 29,
2023
21
25. 2. SUBCUTANEOUS MYSOSES:
These are caused by fungi that grow in soil and on
vegetation and are introduced into dermis, subcutaneous
tissues and bone.
EPIDIMOLOGY:
The high prevalence of subcutaneous mycotic infections
shows that 20-25% of the world's population has skin
mycoses, making these one of the most frequent forms
of infection.
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2023
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26. a. TYPES OF SUBCUTANEOUS MYCOSES
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2023
26
27. SPOROTRICHOSIS
CASUATIVE AGENT:
Sporothrix schenckii
CHARACTERISTICS:
• Also known as “Gardener’s
Rose Disease.”
• Thermally dimorphic.
• Habitat is soil or vegetation.
TRANSMISSION:
• Mold spores enter skin in
puncture wounds caused by rose
thorns and other sharp objects in
garden.
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2023
27
28. PATHOPHYSIOLOGY:
When introduced into the skin,
typically by a thorn, it causes a
local pustule or ulcer with nodules
along the draining lymphatics.
• There is a little systemic illness.
• Lesions may be chronic.
RISK FACTORS:
• It occurs most often in
gardeners, especially those
who prone roses, because
they may be struck by a rose
thorn.
Friday, September 29,
2023
28
29. LABORATORY DIAGNOSIS:
• Cigar-shaped budding yeasts
visible in pus or tissue specimens.
• Culture on Sabouraud’s agar
shows typical morphology of
hyphae bearing oval conidia in
clusters at the tip of slender
conidiophores (resembling a
daisy).
Friday, September 29,
2023
29
30. TREATMENT:
Oral Itraconazole is the
choice of drug for skin lesions,
prescribed as;
200 mg, BD × 1 wk.
Mycological cure rate is 63%.
PREVENTION:
It can be prevented by
protecting skin by touching
Plants
Moss
Wood
Friday, September 29,
2023
30
31. CASUATIVE AGENTS:
Soil fungi such as Fonsecaea,
Phialophora, Cladosporium etc.
CHARACTERISTICS:
• Slowly progressive
granulomatous infection.
TRANSMISSION:
• The fungi is introduced into skin
through trauma. These fungi
are collectively called as
“dematiaceous fungi”.
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2023
31
32. • They are named so because their
conidia or hyphae are dark-
coloured, either gray or black.
• Wart-like lesions with crusting
abcesses extend along the
lymphatics.
DISEASE OCCURANCE:
• This disease occurs mainly in
Tropics and is found on bare feet
and legs.
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2023
32
33. LABORATORY DIAGNOSIS:
• In the clinical laboratory, dark
brown, round fungal cells are seen
in leukocytes of giant cells.
Friday, September 29,
2023
33
34. TREATMENT:
This disease is treated with;
Oral Flucytosine + local
surgeory:
Dosage Forms & Strengths;
o Capsule:
250mg
500mg
‡ Adults, 50-150 mg/kg/d div
q6hr PO
‡ Child, same as adult dosing; 50-
150 mg/kg/d div q6hr PO
‡ Neonates (<28 days old), 80-
160 mg/kg/d div q6hr PO
Friday, September 29,
2023
34
35. CAUSATIVE AGENTS:
Soil organisms like Petriellidium
& Madurella.
TRANSMISSION:
• These organisms enter through
wounds on the feet, hands or
back and cause abcessions with
pus discharge through sinuses.
The pus contains compact
coloured granules.
• Actinomycetes such as
Nocardia can cause similar
lesions known as
“Actinomycotic mycetoma.”
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2023
35
36. TREATMENT:
• There is no effective drug
against the fungal form;
surgical excision is
recommended.
Friday, September 29,
2023
36
38. 3. SYSTEMIC MYCOSIS
These infections results from inhalation of the spores of dimorphic
fungi that have their mold forms in soil.
Within the lungs, the spores differentiate into yeasts or other
specialized forms. Most lung infections are asymptomatic and
self-limited.
However, in some patients, 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.
EPIDIMOLOGY:
• Systemic mycoses showed a very low prevalence of eight per
100,000 persons and three per 1 million persons.
Friday, September 29,
2023
38
41. HISTOPLASMOSIS
CAUSATIVE AGENT:
• Histoplasma capsulatum
CHARACTERISTICS:
• Thermally dimorphic i.e. a yeast
at body temperature and a mold
in the soil at ambient
temperature.
• The mold grows prefrentially in
soil enriched with bird droppings.
• Mostly endemic in central &
eastern United States, especially
in Ohio and Mississipi River
Valleys.
Friday, September 29,
2023
41
42. TRANSMISSION:
• Inhalation of airborne asexual
spores (microconidia)
PATHOPHYSIOLOGY:
• Spores enter the lungs and
diffrentiate into yeast cells.
• The yeast cells are ingested by
alveolar macrophages and
multiply within them.
Friday, September 29,
2023
42
43. • An immune
response is
mounted and
granulomas forms.
• Most infections are
contained at this
level but
suppression of
cell-mediated
immunity can lead
to disseminated
disease.
Friday, September 29,
2023
43
44. RISK FACTORS:
The risk factors include
• AIDS
• Primary immunodeficiencies
• Drug-induced immunosuppressive states
• The extremes of age.
SKIN TESTS:
• Histoplasmin, a mycelial extract, is the antigen. Useful for
epidemiologic purposes to determine the incidence of infection.
• A positive result indicates only that infection has occured; it can
not be used to diagnose active disease. Because skin testing can
induce anti-bodies, serologic tests must be done first.
Friday, September 29,
2023
44
45. LABORATORY DIAGNOSIS:
• Sputum or tissue can be examined microscopically and cultured on
SDA.
• Yeasts are visible in macrophages.
• The presence of tuberculate chlamydospores in culture at 25°C
is diagnostic.
• A rise in anti-body titer is useful for diagnosis, but cross-section
with other fungi (e.g. Coccidioides) occurs.
Friday, September 29,
2023
45
46. TREATMENT:
• Amphotericin-B
Dosage Forms & Strengths;
powder for injection
• 50mg/vial
ADULTS:
Test dose: 1 mg IV x1 infused over 20-30 min
Load: 0.25-0.5 mg/kg IV infused over 2-6 hr
Maintenance: 0.25-1 mg/kg IV qDay OR up to 1.5 mg/kg IV
qOD (may increase gradually by 0.25 mg-increments/day)
Friday, September 29,
2023
46
47. PEDIATRIC:
Test dose: 0.1 mg/kg IV, not to
exceed 1 mg; administer over 20-60
min
Initial dose: 0.25 mg/kg/dose IV
qDay/qOD
Maintenance: Increase by 0.25
mg/day increments as tolerated to
1-1.5 mg/kg/day
PREVENTION:
•No vaccine is available.
•Itraconazole can be used for
chronic suppresion in AIDS patients.
Friday, September 29,
2023
47
48. COCCIDIOIDOMYCOSIS
CASUATIVE AGENT:
• Coccidioides immitis
CHARACTERISTICS:
• Thermally dimorphic. At 37°C in
the body, it forms spherules
containing endospores. At
25°C, either in soil or on agar
in the laboratory, it grows as a
mold.
• The cells at the tip of hyphae
grows into asexual spores
(arthrospores).
• Natural habitat is soil.
Friday, September 29,
2023
48
49. TRANSMISSION:
• Inhalation of airborne arthrospores.
PATHOPHYSIOLOGY:
• In the bronchioles, the arthroconidia enlarge to form spherules,
which are round double-walled structures measuring
approximately 20-100 μm in diameter.
• The spherules undergo internal division within 48-72 hours and
become filled with hundreds to thousands of offspring (ie,
endospores).
• Rupture of the spherules leads to the release of endospores,
which mature to form more spherules, thereby disseminating
the infection within the body.
• A cell-mediated response containes the infection in some
people , but those who are immunocompromised are at high
risk.
Friday, September 29, 2023
49
50. RISK FACTORS:
This risk persists when analyses are controlled for;
o Age
o Sex
o additional demographic features
o concurrent medical problems
o duration of exposure
o occupation
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50
51. LABORATORY DIAGNOSIS:
• Sputum or tissue can be
examined microscopically for
spherules and cultured on
SDA.
• A rise in IgM (using precipitin
test) anti-bodies indicate
recent infection.
• An increase in IgG anti-bodies
(using complement-fixation
test) indicates dissemination.
Friday, September 29, 2023
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52. SKIN TEST:
• Either Coccidiodin, a mycelial extract, or Spherulin, an
extract of spherules, is an antigen.
• Useful in determining whether the patient has been
infected.
• A positive test indicates prior infection but not
necessarily active disease.
Friday, September 29, 2023
52
53. TREATMENT:
Amphotericin-B for disseminated disease;
Dosage Forms & Strengths:
powder for injection; 50mg/vial
Test dose: 1 mg IV x1 infused over 20-30 min
Load: 0.25-0.5 mg/kg IV infused over 2-6 hr
Maintenance: 0.25-1 mg/kg IV qDay OR up to 1.5 mg/kg IV qOD
(may increase gradually by 0.25 mg-increments/day)
PREVENTION:
• No prophylactic drug is available.
Friday, September 29, 2023
53
54. BLASTOMYCOSIS
CAUSATIVE AGENT:
Blastomyces dermatitidis
CHARACTERISTICS:
• thermally dimorphic. Mold in
soil and yeast in the body at
37°C.
• The yeast form has a single,
broad-based bud and a thick,
refractive wall.
• Natural habitat is rich soil (e.g.
near beaver dams), especially in
the upper midwestern region of
United States.
Friday, September 29, 2023
54
mold
yeast
55. TRANSMISSION:
•Inhalation of air borne
spores (conidia).
PATHOGENESIS:
• Inhaled conidia
differentiate into yeasts,
which initially causes
abscesses followed by
formation of
granulomas.
• Dissemination is rare,
but when it occurs,
bones and skin are most
commonly involved.
Friday, September 29, 2023
55
56. RISK FACTORS:
The mean age at diagnosis is approximately 45 years, with
most patients aged 30-69 years. However, persons of any
age can acquire the disease, including infants and very
elderly persons.
The disease is rare in children and adolescents.
LABORATORY DIAGNOSIS:
• Sputum or skin lessions are examined microscopically for
yeasts with a broad-based bud culture on SDA. Serological
tests are not useful.
SKIN TEST:
• The skin test lacks specificity and has little value.
Friday, September 29, 2023
56
57. PREVENTION:
• No vaccine or prophylactic drug is available.
TREATMENT:
• Itraconazole is the drug of choice given as;
Dosage Forms & Strengths;
capsule
65mg (Tolsura)
100mg (Sporanox, generic)
oral solution
10mg/mL (Sporanox, generic)
Friday, September 29,
2023
57
58. • Sporanox
200 mg PO qDay
If no improvement, or evidence of
progressive fungal disease, increase
dose in 100-mg increments to a
maximum of 400 mg/day
Divide doses >200 mg/day into 2
doses
• Tolsura
130 mg PO qDay
If no improvement, or evidence of
progressive fungal disease, increase
dose in 65 mg increments to a
maximum of 260 mg/day (130 mg
BID)
Divide doses >130 mg/day into 2
doses
Friday, September 29,
2023
58
59. PARACOCCIDIOIDOMYCOSIS
CAUSATIVE AGENT:
• Paracoccidioides
brasiliensis
CHARACTERISTICS:
• Thermally dimorphic. Mold in
soil, yeast in body at 37°C.
• The yeast form has multiple
buds (resembles the steering
wheel of a ship).
TRANSMISSION:
• Inhalation of airborne conidia
(spores).
Friday, September 29, 2023
59
60. PATHOPHYSIOLOGY:
• After inhalation of the conidia, the
fungus transforms into yeast cells
within the alveolar macrophages.
• This transformation induces a
nonspecific inflammatory response,
which generally limits the disease at
this point. Therefore, in most patients
who are immunocompetent, the
infection is asymptomatic and resolves
without medical intervention.
• Less commonly, after an incubation
period of weeks to decades, the
fungus can disseminate through the
venous and lymphatic systems,
causing granulomatous disease in
multiple tissues.
Friday, September 29, 2023
60
61. SIGNS AND SYMPTOMS:
rimary lung infection - Cough (productive or nonproductive),
dyspnea, malaise, fever, and weight loss are common symptoms
Chronic pulmonary sequelae - Develop in one third of patients; can
include pulmonary fibrosis, bullae, and emphysematous changes that
can contribute to pulmonary hypertension and cor pulmonale in 5%
of cases.
Mucous membrane involvement - Occurs in 50% of patients with
acute pulmonary infection; includes laryngeal and pharyngeal lesions
Oral lesions - May be associated with nasal and pharyngeal ulcers
(Aguiar-Pupo stomatitis) and with mandibular or cervical lymph node
enlargement
Cutaneous lesions - Caused by hematologic dissemination from the
lungs; occur in 25% of patients; crusted papules, ulcers, nodules,
plaques, and verrucous lesions are typical
Lymphadenopathy - Most common in the cervical region
Friday, September 29, 2023
61
62. LABORATORY DIAGNOSIS:
The diagnosis of paracoccidioidomycosis is most commonly
made by visualization of the yeast cells in tissue, wet
preparations (eg, sputum), or superficial scrapings (eg, skin
lesions).
Serological tests are available in areas of highest endemicity.
In patients with active paracoccidioidomycosis, chest
radiography reveals interstitial infiltrates (in 64% of cases) or
mixed lesions with linear and nodular infiltrates.
Friday, September 29, 2023
62
63. TREATMENT:
Itraconazole is considered the drug of choice for
paracoccidioidomycosis, with a reported effectiveness of 95%.
The course of therapy is typically 200 mg/day for 6 months.
itraconazole is considered superior to ketoconazole because of
shorter treatment course, lower toxicity profile, and lower
relapse rate (3-5%)
Ketoconazole is also an effective agent for
paracoccidioidomycosis, with a cure rate of 85-90% and an
associated relapse rate of less than 10%. A dose of 200-400
mg/day in adults or 5 mg/kg/day in children for 6-18
months is required.
Friday, September 29, 2023
63
65. 4. OPPORTUNISTIC MYCOSES
Opportunistic mycoses occurs in immunocompromised
individuals but rare in healthy persons.
The organisms involved are cosmopolitan fungi which
have a very low inherent virulence. The increased
incidence of these infections and the diversity of fungi
causing them, has parallelled the emergence of AIDS,
more aggressive cancer and post-transplantation
chemotherapy and the use of antibiotics, cytotoxins,
immunosuppressives, corticosteroids and other macro
disruptive procedures that result in lowered resistance of
the host.
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65
66. EPIDYMOLOGY
The epidemiologic features, including incidence, of some
of these mycoses are markedly different in Latin
America than they are in other parts of the world. The
most consistent epidemiologic data are available for
candidemia, with a large prospective study in Brazil
reporting an incidence that is 3- to 15-fold higher than
that reported in studies from North America and
Europe. Species distribution also differs: in Latin
America, the most common Candida species (other
than Candida albicans) causing bloodstream infections
are Candida parapsilosis or Candida tropicalis,
rather than Candida glabrata.
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66
68. CANDIDIASIS:
CASUATIVE AGENT:
Candida albicans
CHARACTERISTICS:
• It is a yeast when part of
normal flora of mucous
membranes but forms
pseudohyphae and hyphea
when invades tissue.
• Not thermally dimorphic.
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68
69. TRANSMISSION:
• Part of normal flora of mucous membranes, skin and GI tract.
• No person-to-person transmission.
PATHOPHYSIOLOGY:
• Opportunistic pathogen.
• When local or systemic host defenses are impaired, disease may
result.
• C.albicans causes;
Thrush (white patches) in mouth.
Vulvovaginitis with itching.
Skin invasion occurs in warm, moist areas which become red and
weeping.
Fingers and nails are involved when repeatedly immersed in
water.
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69
70. SIGNS AND SYMPTOMS:
• Sore and painful mouth
• Dysphagia
• Thick, whitish patches on the
oral mucosa
• Retrosternal pain
• Epigastric pain
• Nausea and vomiting
• Abdominal pain
• Fever and chills
• Erythematous vagina and
labia; a thick, curdlike
discharge
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71. LABORATORY DIAGNOSIS
• Microscopic examination of tissue reveals yeasts and
pseudohyphae.
• If only yeasts are found, colonization is suggested.
• The yeast is gram positive and forms colonies on SDA.
• Serologic tests are not useful.
TREATMENT:
• Skin and mucous membrane disease can be treated with any
oral or topical anti-fungal agents such as;
Miconazole (50mg); Apply buccal tab to gum region qDay for 14
consecutive days.
• Disseminated disease requires;
Amphotericin-B (50mg/vial); 0.25-0.5 mg/kg IV infused over 2-
6 hr
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72. RISK FACTORS:
Granulocytopenia
Bone marrow transplantation
Solid organ transplantation (liver, kidney)
Recent chemotherapy or radiation therapy
Corticosteroids
Broad-spectrum antibiotics
Burns
Prolonged hospitalization
Acute and chronic renal failure
Mechanical ventilation for longer than 3 days
PREVENTION:
• Predisposing factors should be reduced or eliminated.
• There is no vaccine.
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73. ASPERGILLOSIS
CASUATIVE AGENT:
Aspergillus fumigatus
CHARACTERISTICS:
• Mold with septate hyphae that
branch at a V-shaped angle .
• Not dimorphic.
• Habitat is soil.
TRANSMISSION:
• Inhalation of airborne spores.
• Aspergillus primarily affects the
lungs.
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74. PATHOPHYSIOLOGY:
• Aspergillus causes a spectrum of disease, from colonization to
hypersensitivity reactions to chronic necrotizing infections to
rapidly progressive angioinvasion, often resulting in death.
• Rarely found in individuals who are immunocompetent, invasive
Aspergillus infection almost always occurs in patients who are
immunosuppressed by virtue of underlying lung disease,
immunosuppressive drug therapy, or immunodeficiency.
• Human host defense against the inhaled spores begins with the
mucous layer and the ciliary action in the respiratory tract.
Macrophages and neutrophils encompass, engulf, and eradicate
the fungus. However, many species of Aspergillus produce
toxic metabolites that inhibit macrophage and neutrophil
phagocytosis. Corticosteroids also impair macrophage and
neutrophil function.
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76. SIGNS AND SYMPTOMS:
•Fever
•Cough
•Night sweats
•Weight loss
•Leukemia
•Lymphoma
•Cough with mucous plugs
•Subacute pneumonia
•Pleuritic chest pain
DIAGNOSIS:
• Chest radiographs show a
mass in a preexisting cavity,
usually in an upper lobe,
manifested by a crescent of air
partially outlining a solid mass.
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77. • Definitive diagnosis of invasive aspergillosis or CNPA
depends on the demonstration of the organism in tissue, as
follows:
• Visualization of the characteristic fungi using Gomori
methenamine silver stain or Calcofluor
• Positive culture result from sputum, needle biopsy, or
bronchoalveolar lavage (BAL) fluid (however, a negative
result does not exclude pulmonary aspergillosis)
SKIN TEST:
• Not available.
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78. TREATMENT:
Amphotericin-B (50mg/vial); 0.25-0.5 mg/kg IV infused over 2-6
hr
Some lesions (e.g. fungal balls) can be surgically removed.
Steroid therapy is recommended for allergic brochopulmonary
aspergillous.
RISK FACTORS:
• Occurs in persons with asthma and those with cystic fibrosis (CF)
• Occurs in patients with underlying disease (eg, steroid-dependent
chronic obstructive pulmonary disease [COPD], alcoholism)
• Occurs in patients with prolonged neutropenia or immunosuppression
• Organ transplantation, especially bone marrow but also lung, heart,
and other solid organ transplants
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80. Friday, September 29, 2023
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ALL CONTENT:
i. Warren Levinson (ninth edition);Review of Medical Microbiology
and Immunology.
ii. https://archive.org/details/Lippincotts_Illustrated_Reviews_Microbi
ology_3rd_Edition_by_Richard_A._Harvey Cy
iii. https://emedicine.medscape.com/article/296052
iv. https://www.dermnetnz.org/topics/skin-manifestations-of-
systemic-mycoses
v. https://en.wikipedia.org/wiki/Mycosis#Epidemiology
ALL PICTURES:
i. https://www.google.com