LESSON 1: Medical Mycology

OUTLINE 3. Fungi - heterotrophic; eukaryotes;

o obtain nutrients through absorption
I Overview of the Microbial World
o Main nutrient of fungi are carbohydrates (CHO)
A. Introduction o starch is vital for fungi
i. Anton van Leeuwenhoek a. Yeasts - unicellular fungi, reproduce
ii. Prokaryotes asexually/fusion with other yeast; do NOT
iii. Eukaryotes form hyphae or mycelia
iv. Microbes b. Moulds/Molds - filamentous forms,
B. Taxonomy reproduce asexually and sexually/change
C. Eukaryotes from being asexual to becoming sexual
i. Cytoplasmic Structures Note!
D. Microbial Nutritional Requirements for Growth
E. Environmental Factors Affecting Growth  Multicellular fungi have filaments (hyphae)
which interweave to form mats called mycelia.
II Mycology
 Generally, yeasts and molds are nonpathogenic
A. Fungi to humans
i. Primary Route of Infection  Human temperature or in incubator, the fungi
ii. Role of Fungi in the Economy present is yeast.
B. Importance of Medical Mycology
 Outside the incubator (cold temperature), the
C. The Immunosuppressed Patient
fungi present is mold.

OVERVIEW OF THE MICROBIAL WORLD c. Dimorphic - some fungi assume both

INTRODUCTION morphologies (yeast and hyphae/mycelia
● Anton van Leeuwenhoek forms)
o Dutch biologist  growing as yeast at incubator or
o Beasties in a water droplet (with his homemade human temperature
microscope)  and filamentous form at room
o First to visualize RBCs temperature
o Father of protozoology & bacteriology  dimorphic fungi produce systemic
o He used a microscope that has the same size as a diseases in human hosts.
ballpen or a person’s palm Dimorphic may be from the conversion of:
● Prokaryotes a. yeast to mold
o NO true nucleus, nuclear membrane, mitochondria, b. mold to yeast
ER, and Golgi apparatus
o NOT a true cell Table No. 1 Forms of dimorphic fungi
 Ex. bacteria - unicellular FORM TEMPERATURE
● Eukaryotes
o With complex cell structures in which the genetic Yeast Incubator / Human temperature
material is organized into a membrane bound nucleus
Filamentous Room temperature
Note!

“EU” in eukaryotes means true = “true nucleus”

4. Viruses – not filterable
● Microbes o smallest infectious particles (virions)
1. Bacteria – unicellular o virion - virus outside of the cell
o no nuclear membrane, mitochondria, Endoplasmic o cannot be seen in an ordinary light microscope
Reticulum, nor golgi apparatus o neither prokaryotic nor eukaryotic
o no true nucleus o affect on cell lines (viral diseases) such as inclusions
o classified as prokaryotes (rounding up of cells)
2. Parasites – eukaryotic as unicellular o syncytium (cell fusion of host cells into
o Ex. Protozoa (e.g. Giardia lambdia) - obtain their multinucleated infected forms
nutrition through ingestion; some are capable of o cells increase in size if they are virally infected
locomotion (motile) How to distinguish cells with viral disease?
o has locomotive structures such as flagella (whip-like,
pseudopodia (false feet); or cilia (eyelash); ● Viruses consist of DNA or RNA, but NOT both; genome
o can be non-motile may be dsDNA, ssDNA, dsRNA, or ssRNA.
o others are multicellular (tapeworm)
 LESSON 1: Medical Mycology

● Viruses are acellular, lack cytoplasmic membranes, and c. Staining characteristics (Gram-
are surrounded by a protein coat. positive or Gram-negative)

● Obligate intracellular parasites that require host cells  Gram (+) – purple
for replication (increase in number does NOT involve  Gram (-) – pink
mitosis, meiosis, or binary fission) and metabolism;
“takes over” host cell function to produce virus; growth d. Nutritional requirements,
(increase in size) does NOT occur in viruses. physiologic and biochemical
characteristics
● Viruses are mostly host and/or host cell specific:
 Ex. fungi (needs CHO and
○ Human immunodeficiency virus (HIV) infects T starch)
helper lymphocytes, NOT muscle cells, in humas
e. Susceptibility or resistance to
○ Rabies - can infect dogs, skunks, bats, and human antibiotics or chemicals
(brain)
 Sensitivity testing
● Bacteriophage – viruses/other microbes that can
possibly destroy bacterial cell
Table No. 3 Taxonomy according to levels of classification or
TAXONOMY subsets:
● Recent taxonomists said that organisms are in 3 domains LEVEL EXAMPLE/DEFINITION
(replaced some kingdoms).
● Each of these domains are divided into kingdom based on Domain Bacteria/Archaea; Eukarya for plants and
similarities of RNA, DNA and protein sequences. protists
● Prokaryotes - includes domains Archaea (archaebacteria) & Kingdom Animalia, protista, monera (e.g. bacteria,
bacteria (eubacteria) fungi)
○ Archaea - not encountered in Clinical Microbiology (ex.
Salt loving and heat loving cells (extremes) (Fungi - kingdom mycota)
● Eukaryotes - includes fungi, parasites, algae, protozoa, animals
and plants; larger and contain membrane encased organelles Phyla (division)
(with specific function) or compartments (Fungi - chytridiomycota, glomeromycota,

Table No. 2 Taxonomy according to classification & identification Family -viridae

TYPE DEFINITION
Genus (genera)
Genotype  Genetic makeup of an organism, or
Species
combinations of forms of one or a few
genes under scrutiny in an organism's Strains (variant)
genome.
 Ex. basic sequencing of DNA or RNA, and
DNA base composition ratio to measure EUKARYOTES
the relatedness of 2 organisms CYTOPLASMIC STRUCTURES
● Nucleus - has DNA with discrete chromosomes (genes)
Phenotype  Readily observable physical and covered with basic proteins called histones. Nucleus has a
functional features of an organism bilayer nuclear membrane
expressed of phenotypic characteristics: ● Nucleolus – site of ribosomal RNA synthesis
● Endoplasmic Reticulum
a. Macroscopic (colony morphology on ○ Rough ER – membranes covered with ribosomes; the
media) site of protein synthesis
○ Smooth ER – No ribosomes; does not synthesize
 Ex. Salmonella (black colony
protein but synthesize phospholipids (like rough ER)
when cultured) and S. aureus ● Golgi apparatus – modify and package protein sent to it by
(metallic shin when cultured) rough ER
● Mitochondria – main site of energy production; contain
b. Microscopic (size, shape,
their own DNA and the electron transport system that
arrangement into groups or chains produce energy for cell functions.
of organism morphology) ● Lysosomes – contain hydrolytic enzymes for degradation
of macromolecules and microorganisms within the cell
 Ex. chain, spiral
(breakdown)

ELAINE JOY A. DELA PENA AND ESTHER VICTORIA H. TOLENTINO | BSMT 3-3 2
 LESSON 1: Medical Mycology

● Peroxisomes – contain protective enzymes that break ○ Saprophytes - lives on dead organic matter, enriched
down H2O2 and other peroxides generated within the cell by nitrogenous matter (foul-smelling), but are
● Chloroplasts – for plant cells, site of photosynthesis capable of maintaining a separate existence as an
(energy production), produces glucose from CO2 and H2O. opportunistic pathogen in humans or animals. Fungal
○ Fungi are NOT plants and therefore have NO infections are generally NOT communicable in a
chloroplasts. usual sense from person-to-person.
○ Parasites - lives on living organisms
MICROBIAL NUTRITIONAL REQUIREMENTS FOR GROWTH ○ Dermatophytes - fungi that infect the skin and grow
● Autotrophs in the keratin layer
○ Needs sunlight
○ grow simply using CO2 as the sole source of carbon FUNGI
with only water and inorganic salts required in PRIMARY ROUTE OF INFECTION
addition.
○ obtain energy by:
 photosynthesis (phototrophs) + sunlight
 oxidation of inorganic compounds
(chemolithotrophs).
○ Fungi are NOT autotrophic
● Heterotrophs
○ require more complex substances for growth;
require an organic source of carbon such as glucose
(starch), and obtain energy by oxidizing or
fermenting organic substances (glucose as both
carbon and energy source)
○ Ex. fungi (needs fermentation)

ENVIRONMENTAL FACTORS AFFECTING GROWTH

1. Obligate aerobes - requires oxygen for growth (bacteria);
other gases must not be present.
2. Aerotolerant anaerobes - facultative aerobes, needs (Source: Ebel, F.)
carbon dioxide; can survive in the presence of oxygen but Fungi enters the nostrils through inhalation  lungs  alveoli 
does not use oxygen in metabolism blood  blood vessel  heart  other parts of the body (some
3. Obligate anaerobes - cannot grow in the presence of stay in the lungs)
oxygen;
4. Facultative anaerobe - can grow with or without oxygen ● Humans become accidental hosts for fungi by inhaling
5. Capnophilic – anaerobe; organisms grow best when the spores or by the introduction of fungal elements into
tissue by trauma. Humans are relatively resistant to fungal
atmosphere is enriched with extra CO2 (5% to 10%)
infections, EXCEPT for disease caused by dimorphic fungi.
● Alteration in the host particularly in the immune system
Table No. 4 Host-microbe relationship causes fungal infection; or caused by immunosuppressive
Relationship Definition agents or serious underlying disease - lead to infection by
organisms that are normally nonpathogenic (ex.
Symbiosis Living together; both benefit from one
Progressive infections such as HIV, Diabetes mellitus, or in
another (host and organism) – mutualism patients with impaired immunologic function resulting
Commensalism Organism benefits but NO beneficial or from corticosteroid or antimetabolite chemotherapy
(immunocompromised)
harmful effect to the host
● No fungus species can be considered completely
Parasitism One specie (organism/microbe) benefits at innocuous (not harmful). Mushrooms look innocuous but
the expense of the other (host) are deadly.
ROLE OF FUNGI IN THE ECONOMY
Fungi are essential in recycling of elements, especially carbon. Life
MYCOLOGY would be impossible without fungi (decomposers)
● Fungi are eukaryotic, spore-bearing, heterotrophic 1. Industrial uses of fungi
organisms that produce extracellular enzymes and absorb ● Mushrooms (Class Basidiomycetes); 200 edible
their nutrients ● Truffles (Class Ascomycetes)
Fungi – Kingdom Mycota ● Natural food supplement for wild animals
Divisions – Phyla: Chytridiomycotina, Glomeromycota, ● Yeast as food supplement, supplies vitamins
Zygomycota, Basidiomycota, Ascomyocota, ● Penicillium roquefort - ripens cheese, adds flavor
Microsporidia, Neocallimastigomycota (roquefort cheese - French cheese from goat’s and
● Fungi are dependent upon enzyme systems to derive ewe’s (female sheep) milk, contain blue mold; P.
energy from organic substrates. camemberti

ELAINE JOY A. DELA PENA AND ESTHER VICTORIA H. TOLENTINO | BSMT 3-3 3
 LESSON 1: Medical Mycology

Penicillium does not necessarily mean it is an antibiotic. THE IMMUNOSUPPRESSED PATIENT

This is associated with blue cheese. ● AIDS
● Fungi used to alter texture, improve flavor of natural ● Drugs - immunosuppressant drugs used in organ
and processed foods. transplant patients, cancer and leukemia patients.
2. Fermentation
● Fruit juices (ethyl alcohol)
● Saccharomyces cerevisiae - brewer’s and baker’s REFERENCES
yeast Notes from the discussion of Mrs. Flordeliza A. De Guzman,
● Fermentation of industrial alcohol, fats, proteins, RMT, MAT - PHYS
acids, etc. Notes from the synchronous session of Mrs. Flordeliza A. De
3. Antibiotics Guzman, RMT, MAT - PHYS
● First observed by Alexander Fleming; noted Cavite State University powerpoint presentation: Lesson 1 -
suppression of bacteria by a contaminating fungi of a Medical Mycology
culture plate
● Penicillium notatum - antibiotic produced by
deuteromycete
4. Plant Pathology
● Most plant diseases are caused by fungi - Chestnut
blight, Dutch Elm disease, Apple scab, Brown rot
● Many smuts (produce black powdery masses of
spores) and rusts attack cereals
● Agaricus campestris - mushroom found in the
grocery
● Shiitake mushroom - anti-cancer
5. Medical importance
● 100-150 species are recognized human pathogens
● Most prefer to be free-living saprophytes; and only
accidentally become pathogens
● To be pathogenic, they must tolerate the
temperature of the host site and possess an
enzymatic system that allows them to utilize animal
tissues
● Increased incidence of fungal infections in recent
times
● Some fungi cause human diseases:
○ Ringworm, athlete’s foot, Histoplasmosis (systemic
disease)
● Cyclosporine - drug used to suppress immune
responses in patient’s receiving organ transplant was
produced from fungi
● Some fungi are poisonous (cyclopeptides are toxic
substance found in mushrooms)
● Ergot - type of fungus (Claviceps purpurea); causes
nervous spasm, convulsion, psychotic delusion,
gangrene
● In 1722, Ergot was called St. Anthony’s fires and its
outbreak caused many to be burned at the stake as
witches

IMPORTANCE OF MEDICAL MYCOLOGY

 During the time period between 1941-1973, the number of
reported deaths in the US due to scarlet fever, typhoid,
whooping cough, diphtheria, dysentery and malaria
decreased from 10,165 cases to 107; but reported deaths
due to mycoses during the same time period, increased
from 324 to 530.
 Increased mobility - we can travel to a geographical area
where a fungus exists as part of the commensal flora of
the local population, or is endemic to the area
 We have an aging population.

ELAINE JOY A. DELA PENA AND ESTHER VICTORIA H. TOLENTINO | BSMT 3-3 4