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FUNGAL ORGANISMS OF
MEDICAL IMPORTANCE
Fungi
Kingdom Fungi:
• Eukaryotes
• Fungi lack chorophyll
• Fungal cell walls contain a carbohydrate called chitin
• Fungal cell membranes contain ergosterol
• Fungi are heterotrophic
• Two phases of life cycle
– Growth (vegetative) phase
– Reproductive phase
Fungi
Groups
• Molds: long, tangled filaments of cells that
give rise to visible colonies
• Yeasts: unicellular organisms whose colonies
resemble those of bacteria
• Dimorphic: grow as filamentous molds at 25ºC
but convert to unicellular pathogenic yeast
forms at 37ºC
Fungi
• Culture medium for isolation: Sabouraud agar
• Hyphae
– Masses of intertwined filaments
– Morphological unit of a filamentous fungus
– Visible only with the aid of a microscope

Fungal Structure
Mycelium
• Thick mass of
hyphae
• Large enough to be
seen with the naked
eye

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Fungal Structure
Septa: hyphal cross walls
• Septate
• Nonseptate
Fungal diseases of
the skin
Cutaneous Mycosis
Dermatomycosis
• Caused by dermatophytes
• Fungi that colonize the hair, nails, and the
outer layer (stratum corneum) of the
epidermis
• Grow on keratin in these areas causing tinea
(ringworms)
• Moisture in these areas favor fungal infections
Dermatomycosis
• Tinea capitis: ringworm of the scalp
• Tinea cruris: ringworm of the groin (jock itch)
• Tinea corporis: ringworm of the body
• Tinea pedis: ringworm of the feet
• Tinea unguium: nail ringworm
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Dermatomycosis
• Three genera of fungi involved in cutaneous
mycosis
– Trichophyton: infects hair, skin or nails
– Microsporum: involves only the hair or skin
– Epidermophyton: affects only the skin and nails
• Diagnosis: KOH, Wood lamp
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Malassezia furfur
• Causes pityriasis versicolor
• Oval or irregular spots with occasional scaling
in back, underarm, upper arm, chest and neck
• Hyperpigmented or hypopigmented
• Yeast feeds on skin oils (lipids) as well as dead
skin cells
• “Spaghetti and meatball” appearance of the
yeast
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Subcutaneous Mycosis
• More serious than cutaneous mycosis
• Penetrate the skin through small wound that allows
entry into subcutaneous tissues
• Most common disease: sporotrichosis
– Caused by Sporothrix schenkii
• Occurs among gardeners or others working with soil
• Infection frequently forms a small ulcer on the hands
Madura Foot
• Chronic, granulomatous, fungal disease
• Mainly affects the foot
• Abscess discharges pus, serum, and blood
through sinuses
• Most pathogenic agents: Madurella grisea and
Exophiala jeanselmei
• Presence of colored grains, composed of
compacted hyphae, in the exudate
• Treatment is surgical excision
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Fungi causing
systemic infections
Histoplasma capsulatum
• Thermal dimorphic fungus
• Transmission is by inhalation of airborne asexual
spores (microconidia)
• Microconidia enter the lungs and differentiate
into yeast cells
• Yeast cells are ingested by macrophages and
multiply within them
• Most prevalent in central North America,
especially the Ohio and Mississippi River Valleys
Tongue
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Coccidioides immitis
• Disease: Coccidioidomycosis
• Thermally dimorphic fungus
• Transmission is by inhalation of airborne
arthrospores
• Develops in the lungs and disseminate within the
body
• Occur in southwestern United States and Central and
South America (“Valley fever”)
Lung
Spleen
Blastomyces dermatitidis
• Thermally dimorphic fungus
• Produces microconidia, most often in the soil,
which become airborne and enter the lungs
• Manifest as ulcerated granulomas in the
urogenital tract
• Most common in the South Central and South
Eastern United States
• More common in adult males than in females or
children
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Paracoccidioides brasiliensis
• Thermally dimorphic fungus
• Transmission: inhalation of airborne conidia
• Inhaled conidia differentiate in the lungs and
disseminate to many organs
• Restricted to Central and South America
• >90 percent of patients males
– Estrogen may inhibit formation of the yeast form
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Fungi causing opportunistic
infections
Aspergillus fumigatus
• Disease: invasive aspergillosis; allergic
bronchopulmonary aspergillosis
• Transmission: inhalation of airborne
conidia
• Organism invades blood vessels causing
thrombosis and infarction
• “Fungus ball” or aspergilloma develops in
the lung
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Candida albicans
• Diseases: thrush, disseminated candidiasis, chronic
mucocutaneous candidiasis
• Part of the normal flora of the skin, mucous
membranes, vagina and GI tract
• Microscopic examination reveals yeasts and
pseudohyphae
• Germ tube formation: characteristic of C. albicans
– Not present in other Candida species
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Cryptococcus neoformans
• Disease: Cryptococcosis (especially
cryptococcal meningitis)
• Habitat is soil (enriched by pigeon droppings)
• Transmission: inhalation of airborne yeast
cells
• Cause influenza-like syndrome or pneumonia
• Spread via bloodstream to the meninges
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Pneumocystis jiroveci
• Formerly, P. carinii
• Still often referred to as PCP, for P. carinii
pneumonia
• Ergosterol, which is an essential component of
most fungal membranes, is lacking
• One of the most common opportunistic
diseases of individuals infected with HIV-1