MYCOLOGY
weeks
- Branch of Biology concerned with the
study of fungi,including their genetic
and biochemical properties, their
taxonomy, and their use to humans as
well as their dangers
-talks about fungi including the yeast, molds
and the mushrooms
CHARACTERISTICS OF FUNGI
- Non-motile eukaryotes
Eukaryotes meaning they have a nucleus
Fungi contain nucleus ,mitochondria , and ATS
ribosomes
- Possess rigid cell wall
-that determine their shape and protects them
from osmotic and other environmental stresses
The cell wall is composed of
polysaccharides,polypeptides and cysteine
Cell membrane of fungi contains sterol
Sterol-prevent many antibacterial antibiotics
being affecting against fungi
- Larger than bacteria
-bacteria ranges to 0.5 – 5 um
Fungi 2-10 um
Obligate or facultative aerobes
-they need oxygen in able to survive
- Lacks chlorophyll
-they are non photosynthetic
Fungi need others in able to produce their own
nutrition
- Relatively simple nutritional
requirements, wide range of growth
rates
Fungi- They form visible colonies in days to
- Chemotrophic- they secrete enzymes
that degrade a wide variety or organic
substrate into a more soluble nutrients,
and thus they are being absorbed or
taken out by the cell.
- Most pathogenic fungi are exogenous
their natural habitats being water, soil,
and organic debris
- Unicellular or multicellular depending
on their species
- 400/80,000 species are medically
important
- <50/400 specie causes more than 90%
of fungal infections
- Fungi-it can be divided into 3 the mold ,
the yeast and dimorphic fungi
BENEFITS OF FUNGI
- Essential in breaking down and
recycling of organic matter .
- Production of food such as cheese,
bread, and beer
- Provide useful bioactive secondary
metabolites- such as penicillin or
immunosuppressive drugs like
microsporin
- Used as model systems for the
investigations of a variety of eukaryotic
processes (cellular growth and
development)
FUNGI- they are phytopathogens
ONE DISADVANTAGE IS
Phytopathogens these are microorganisms
that cause disease in plants.kaya
nagkakaroon ng huge crop loses in
agricultural industry every year
MYCOSES
- Refers to infections that are caused by
fungi
 2 most prevalent diseases the candidiasis - Candida
and dermatophytosis albicans
and other
CANDIDIASIS Candida
- Mycoses with the highest incidence species
SUBCU - - Sporothrix
- -Incidence meaning the occurrence of
TANEO sporotric schenckii
new cases of disease in a new
US hosis
population prescribe period of time.
-
DERMATOPHYTOSIS Chromobl - Phialophor
astomyco a
- Fungi that are frequent components of sis verrucosa,
the normal flora and highly adapted to - Fonsecaea
survival on human host Mycetom pedrosoi
a and others
-pathogenic fungi do not produce potent - - Exophiala,B
toxins and the mechanism of fungal Phaehyph ipolaris,Exs
p[pathogenicity are complex and polygenic omycosis erohilium,
and other
MOST MYCOSES ARE DIFFICULT TO TREAT
dematiace
BECAUSE FUNGI ARE EUKARYOTES THEY ous molds
SAHRE MANY HOMOLOGOUS GENES, GENE ENDE Coccidiod - Coccidioide
PRODUCTS AND PATHWAYS WITH THEIR MIC omycosis s posadasii
HUMAN HOST. (prima and
ry ,syst Coccidioide
emic) s immitis

CLASSIFICATION OF MYCOSIS Histoplas - Histoplasm

mosis a
CATEG MYCOSIS CAUSATIVE capsulatum
ORY FUNGAL AGENTS
Syperfi Pityriasis Malassezia species
cial versicolor Hortaea werneckii
Tinea Trichosporon
nigra species - Blastomyce
White Piedraia hortae Blastomy s
Piedra cosis dermatitidi
Black s
piedra
Cutan Dermato - Microsporu
eous phytosis m species,
Candidias Trichophyt
is of on species, - Paracoccidi
skin,muc and Paracocci oides
osa, or Epidermop dioidomy brasiliensis
nails hyton cosis
floccosum
OPPUR Systemic - Calbicans of the
TUNIS candidiasi and many Order
TIC s other Mucorales
Candida
species
Cryptococ - Cryptococc
cosis us Pneumoc - Pneumocys
neoforman ystis tis jiroveci
s and pneumani
Cryptococc a
Aspergillo us gattii
sis - Aspergillus penicillios
fumigatus is - Talaromyce
and other s marneffei
Aspergillus
species
- Species of
fusarium, Melanin responsible to brown and black
Hyalohyp Paecilomyc
homycosi es,Trichosp
s oron and FUNGI HAS 2 BASIC GROWTH
other
hyaline MOLDS AND YEAST
molds MOLDS- occurs by the production of
multicellular branching cylindrical
tubules called hyphae. size may vary 3-
-cladophialophora 15 um
bantiana; species
Phaeohyp of YEAST- are single cells, usually spherical
homycosi Alternaria,Cladosp to ellipsoid in shape and reproduce by
s orium,Bipolaris, budding size may vary 3-15 um
Exserohilum, and Yeast colonies:soft , Usually observe
numerous other opaque 1-3 mm in size and cream color
dematiaceous
molds Take note:-If a fungus grows simply as
a single cell it is called a yeast

- Maxilla-mass of hyphae maxilla growth

occurs it is called molds
- Species of
Mucormy Rhizopus,Li
cosis chthemia,C
unningham
ella, and
other
membrane
 - - AERIAL- projects above the surface of
the mycelium and it is usually bear
reproductive structure of molds
- TAKE NOT: AERIAL HYPHAE- it is only
seen in culture

HYPHAE- measures 2-10 um in width

- Are tubular, branching filaments of

molds and mushroom (form of growth)

THALLUS- it is a vegetative body of a fungus

PSEUDOHYPHAE
MYCELIUM
- Are serial of elongated buds or
- Mass or mat of intertwined hyphae that blastoconidia by some yeast
accumulates during active growth - These remain attached to each other
CLASSIFICATION OF HYPHAE and form a hyphal-like structure
1. Hyphae may be dematiaceous or -
hyaline

-HYPHAE is a demasesous or hyline

The cell wall contains melanin

The colonies are dark kapag hyaline they

are colorless

2. It can be septate or aseptate

Kapag septate there is a division or
compartments
Aseptate- they are oftren refer to us a
coenocytic- meaning meron silang one
long cell that does not divided into
compartments DEFINITION OF TERMS
3. It is either vegetative or aerial
BUDDING
- Vegetative hyphae it can penetrates the
supporting medium and anchor the - A common mode of asexual
colony and absorb nutrients reproduction, typical of yeasts
ANAMORPH
- mitotic or asexual reproductive state of fungi
TELEMORPH
- Sexual reproductive state of fungi
PERFECT FUNGI
- Capable of sexual reproduction
IMPERFECT FUNGI
- Lack sexual reproduction or they are
not capable in sexual reproduction
DIMORPHIC FUNGI
- Have 2 growth forms
- yeast and the mold depends for
environmental conditions such as
temperature and available nutrients
Take note: FUNGAL CELL IT MAY PRODUCE
SINGLE OR MULTIPLE BUDS
Factor its temperature and available nutrients
FUNGI- exist as a mold at room temperature ,
room temperature is 30 degrees Celsius but a
Yeast is 37 degrees Celsius or body
temperature
DIMORPHIC FUNGAL THEY ARE MOST SERIOUS
PATHOGENS Ex. Blastomyces dermatitidis – it
forms hyphae invitro and yeast naman nasa
tissue
SPORES
- Are specialized propagule with enhance
survival value, such as resistance to
adverse conditions or structural
features that promotes dispersion
- May result from asexual or sexual
reproduction
ASEXUAL SPORES
-Conidia - are asexual spores formed either
from the transformation of a vegetative yeast
or hyphal cell or from a conidiogenous cell or at
the end of conidiophores
The note: the conidial type is used to identify
fungal imperfecti or phylum deuteromycota
also known fungi imperfecti- no sexual stage .
BLASTIC CONIDIOGENESIS
- Result in the production of
blastoconidia that bud from a mother
cell.known as blastospores
- They can elongate to form pseudo
hyphae
- Take note : chloroconidia ,phialoconidia
and annellokonija are all produce by
blastic conidiogenesis
ASEXUAL SPORES
- In the process of thallic cnidogenesis,
the daughter conidium develops after
the formation of a septum near the end
of a parent cell.
MACROCONIDIA AND microconidia-these are
the characteristics of dermatophitic fungal they
are produce by thallic conidiogenesis
MACROCONIDIA- Large or muti cellular conidia
MICROCONIDIA- small conidia
ARTHRIC CONIDIOGENESIS
- Results in the formation of
arthroconidia- resulting from
fragmentation of hyphal cells
ASEXUAL SPORES
- Chlamydoconidia- are large , spherical,
thick-walled survival conidia that can
occur either at a terminal site , an
intercalary site, or a sessile site.
- TERMINAL SITE – meaning at the end
They are seen in molds
 - Sporangiospores- are formed by
internal cleavage of the contents of a
sporangium , a sac that is supported by
a sporangiophore
SEXUAL SPORES
-Zygospores- are formed by fusion of two
compatible hyphal arms and are
surrounded by a thick walled, protective
zygosporangium= ZYGOMYCOTA
Ascospores – are sexual spores produced by
fungi in the phylum
Basidiospores- are sexual spores that protrude
out of a mother cell called a basidium.
2 largest fyla
Ascomycota-also known as sac mycota
Basidiomycota -club fungai
- IN MEOSIS we have 4-8 meospores – is
a spore forms in the meosis that
contain haploid sets of chromosomes
VIRULENCE DETERMINANTS which enable
pathogenic fungi to withstand the defenses and
stressful environment of the host.
1. Morphological transformation
2. Genetic switching of metabolic
processes in response to the host
environment
3. Production of surface adhesion that
bind to host cell membranes secretion
of enzymes that attack host substrate
4. Cell wall component that resist
phagocytosis
5. Formation of biofilms
LABORATORY DIAGNOSIS
SPECIMEN
1. Sample from the area most likely
affected
2. All specimens should be obtained
using aseptic technique
3. Adequate amount
Use aseptic technique
Take note : to minimize bacterial
growth specimens should be
transported diagnostic laboratory
within 2 hours
Transport
1. Blood and bone marrow are
collected into a BHI broth for
transportation to the laboratory.
The use of Dupont Isolator tubes for
transport and processing enhances
fungal recovery from blood and the
bone marrow specimens
2. CSF is aseptically collected and
transported immediately to the
laboratory
3. Hair, nails and skin are initially
cleaned with 70 % alcohol to
remove surface contaminants.
Scrapings and plunked hair are
placed in a sterile petri plate for
transportation
4. Respiratory tract specimens should
be collected in the morning and put
into a sterile for transport
5. Tissues and biopsy specimens are
aseptically collected and kept moist
with sterile saline for transport
6. Scrapings from wounds and lesion
may be placed into sterile saline for
transport
7. Vaginal and cervical specimens are
typically collected on sterile swabs,
then placed into transport media or
both
8. Urine specimens are collected in
the morning in the sterile container
 and sent immediately to the mounts for permanent smears and scotch tape
laboratory preps can be made using this stain

- Lactophenol cotton blue stain (LCBS) – the

phenol kills the microorganisms; the lactic acid
preserve the fungal structures and the cotton
blue stains the chylin in the fungal cell wall

6. India ink is recommended for observing

LABORATORY FOR DIAGNOSIS
- PREPARATIONS OF SPECIMEN FOR
TRANSPORT
1. Hair and nails are sent in a dry
envelope , inside proper container.
Other specimens are usually sent
frozen or on dry ice
2. Packaging must meet biohazard
regulations.
encapsulated yeast, especially Cryptococcus
neoformans
7. Gram’s stain used primarily to observe yeast
and pseudohyphae present in clinical specimens
8. Papanicolaou stain is good for initial
differentiation of dimorphic fungi
- it works well in sputum smears

LABORATORY FOR DIAGNOSIS KEY FUNGAL STRUCTURES OBSERVED IN

MICROSCOPIC EXAMINATIONS OF CLINICAL
1. One or two drops of an aqueous or
SPECIMENS
serous specimen can be placed on a
glass slide in a drop of 10-20% KOH and
examined under LPO and HPO

-sensitivity is improved by addition of

calcofluor white.

2. detection of fungi in pus, viscous exudates

and minced tissues can also be examined with
KOH preps by gently heating the slide

3. in formalin-fixed biopsy specimens, fungi can

be detected with the routine H&E staining

4. Saline wet mounts allow the observation of

budding yeast, hyphae, conidia, and hyphal
filaments – for vaginal specimens

5. Lactophenol cotton blue stain can be used for

direct smears or stains of fungal isolates. Tease
  the most definitive methods to establish
LABORATORY DIAGNOSIS
 CULTURE – more sensitive than the direct
examination
- Tube media is used rather than plated
media – because it has a less chance of
spore release into the environment, it
has a less chance for dehydration,
easier storage
- The agar in a tube is inoculated in a
straight line. Preliminary identification
is based on differential growth patterns
on various media
Different medium used for fungi
1. Sabouraud’s dextrose agar (SDA)
contains glucose and modified
peptone (pH 7.0), supports the
growth of fungi, and restricts the
growth of bacteria
- SDA – traditional mycological medium
and it is the standard medium for
culturing fungi
- Histoplasma capsulatum – is some
strains of nocardia asteroides, fail to
grow on SDA
2. Inhibitory mold agar (IMA) enhances
the recovery of fungi from clinical
specimens
- It is used primarily to recover
pathogenic fungi exclusive of
dermatophytes
Note: culture medically important fungi
from non-sterile specimens – urine, we
have to add antibacterial antibiotic such
as gentamycin and chloramphenicol –
these two is used to prevent the growth
of bacteria; cycloheximide – to prevent
the growth of host
Note: SDA with cycloheximide and
chloramphenicol is reserve for skin,
hair, and nail specimen
the diagnosis of a fungal infection are the
culture of the pathogen, microscopic
examinations, detection of species specific
fungal DNA and serology
3. Potato dextrose agar (PDA) is used
to enhance sporulation and
pigmentation. It stimulates the
production of conidia.
- It uses as a subculture medium rather
than a primary plating medium
4. Corn meal tween 80 agar (CMT 80) is
used for the demonstration of
blastoconidia, pseudohyphae,
arthroconidia, and chlamydospores
in the identification of candida
species and other yeasts
5. Dermatophyte test medium (DTM) is
a screening used for the isolation of
dermatophytes
6. Mycosel agar is used to recover
dermatophytes
7. Birdseed agar (Caffeic acid agar) is
used for growth of Cryptococcus
neoforms
8. Germ tube media (rabbit, fetal calf,
or human serum) is used to
demonstrate germ tube production
by the yeast candida albicans
9. Urea agar slant is used to
demonstrate urease production. A
positive test is development of a
pinkish purple within 48 hours after
inoculation
- Urease positive fungi – trichosporon,
rhodotorula, and Cryptococcus
- Urease negative fungi – geotrichum,
saccharomyces, and most candida spp.
 10. BHI agar (BHIA) is very nutritious and 3. Multilocus sequence typing (MLST)
supports the growth of bacteria and have indentified phylogenetic
fungi including Histoplasma and subpopulations of many pathogenic
nocardia fungi, including species of Candida,
- BHI with blood – recommended for cryptococcus, aspergillus, and
converting dimorphic fungi from mold coccidioides
to yeast phase/tissue phase 4. Matrix-assisted laser desorption
- BHI with blood, cycloheximide and ionization-time of flight mas
chloramphenicol – very nutritious but spectrometry (MALDI-TOF-MS) has
inhibits the growth of nocardia proven to be more accurate and faster
Note: chloramphenicol it inhibits the than conventional culture methods.
yeast phase of dimorphic fungi 5. Clotting cascaed of the horsehoe carb
- BHI supports the growth of (limulus) hemolymph is triggered by
dermatophytes isolate from the skin, fungal cell wall B-(1-3)-d-glucan. This
hair and nail polysaccharide is shed during infection
and its coagulation of hemolymph has
FUNGAL GROWTH
been exploited to quantify its
 Fungal growth concentration in blood and spinal fluid.
1. Yeast grow better at 37 degrees celcius
2. Molds grow better at 30 degrees celcius
- Most fungi grow at room temperature
(25-30 degrees celcius)
- Some yeast grow overnight, saprophites
are fast grower it takes several days.
Generally, cultures are held at least 4
weeks
- Routine cultures should be examined
every other day
 Serology
1. Doagnostic tests for identification of the
systemic fungi include antigenic akin
tests, seromycology, and DNA testing
2. In ummunocompetent patients, positive
antibody tests may confirm the
diagnosis, and negative tests may
exclude fungal disease
 Molecular methods
1. Polymerase chain reaction (PCR) is used
to amplify fungus-specific sequences of
ribosomal DNA or other conserved
genes
2. Peptide nucleic acid fluorescent in situ
SUPERFICIAL AND CUTANEOUS
hybridization test kit (PNA-FISH) is used
MYCOSES
to detect fungal cells slide
Superficial Mycoses  Predisposing conditions: Predisposing –
these are factors that put a patient at race
 They are usually confined to the
at developing disorder
outermost layer of the skin and hair
 Immune status of the patient
mucosa
 Genetic factors
 TAKE NOTE: They do not invade
living tissues  Elevated temperature
 Humidity
Superficial Mycoses
NOTE: Pityriasis versicolor the caused are
 Do not elicit an immune response largely cosmetic problem
 Patients feel no discomfort
Clinical Manifestations: the infection is
 Caused by cosmetic problems
characterized by discrete, serpentine,
 Limited to stratum corneum – the
hyperpigmented or hypopigmented maculae.
outermost layer of the epidermis
Maculae are spots.
NOTE: These mycoses are non-invasive
 Maculae that develop on the skin (chest,
infectious
upper back, arms or abdomen)
Superficial Mycoses  Scaling, inflammation and irritation are
minimal
 Four infections:
 Chalky appearance
1. Pityriasis versicolor
 Painless
2. Tinea Nigra
3. Black Piedra NOTE: Pityriasis versicolor affects all ages and
4. White Piedra annual incidents is reportedly 5-8%.
Pityriasis versicolor

 Highly prevalent, chronic superficial

infection of stratum corneum
 Caused by lipophilic yeast (Malassezia)
 NOTE: the vast majority of the cases of
Pityriasis versicolor are caused by:
o Malassezia furfur
o Malassezia globosa
o Malassezia sympodialis
 These Malassezia species caused
hypopigmentation or
hyperpigmentation on the trunk of Clinical diagnosis:
the body
 Direct KOH - microscopic examination
 They are rich in sebaceous gland or
of scraping of infected skin. Treated
lipophilic yeast, and they can be
with 10-20% potassium hydroxide to
isolated from normal skin and scalp
increase their sensitivity.
 They are considered part of
 Under the microscope when you
cutaneous mycobiota
are diagnosis with Pityriasis
 NOTE: Malassezia species require
versicolor and maoobserved
lipid and the medium for growth.
natin is short unbranched non
pigmented hyphae and
 spherical cells. These
observations commonly
described as:
o Spaghetti and
meatballs appearance
 Lesions fluoresce under Wood’s lamp
Treatment:

 Selenium sulfide – applied daily

 Topical or oral azoles – for small
lesions
NOTE: The goal of treatment is not to eradicate
Malassezia from the skin but richest the
cutaneous population to commensal levels Clinical diagnosis:

Epidemiology:  Microscopic exam of skin scrapings

 Rarely cause an opportunistic fungemia
 Usually infants receiving TPN -
Total Parenteral Nutrition
 Malassezia restricta – implicated as
cause or contributor to seborrheic
dermatitis (dandruff) - Elevated with
treatment Ketoconazole.
Tinea Nigra
from the periphery of the lesion reveal
branched, septate hyphae and budding
yeasts cells with melanized cell walls.
 NOTE: Confirmatory test for Tinea
Nigra is made by culture - we used
Sabouraud Media for the confirmation

 Superficial chronic and asymptomatic

infection of the stratum corneum
 Caused by the dematiaceous fungus
Exophiala werneckii. Dematiaceous
fungus eto yung nag proproduced ng
melanin. Our melanin they are
responsible to brown to black pigment. Treatment:
As the name itself Nigra.
 More prevalent in warm coastal regions  Keratolytic solutions
and among young women.  Salicylic acid
 Azole antifungal drugs
Clinical Manifestation:
- Brown to black, non-scaly patches on Piedra
the palms of the hands
- Painless  Infection of the hair shaft that
- No itching produces hair breakage. It is endemic
in a tropical country
 NOTE: The treatment of Piedra is
cutting or shaving infected hairs and
yeast of topical antifungals. Infections
 may disseminate in immuno around the surface of
compromised individuals hair shaft, the hair
hard, shaft, softer,
Black Piedra difficult to easy to
detach from separate
 Nodular infection of the hair shaft
the hair from hair
 Caused by Piedraia hortae Direct Tightly Arthrospores
 Produces dark thick-walled hyphae examination packed and
with swellings microscopically dichotomous blastophores
branched can be seen
hyphae
Presence of Positive Negative
asci

Treatment:

 Removal of infected hair

 Application of a topical antifungal agent
such as selenium sulfide, thiosulfate,
White Piedra salicylic acid, and hyposulfite.
 Larger, softer, yellowish nodule on Cutaneous Mycoses
the hair around the beard, mustache
hair, genital and scalp hair  Typically caused by dermatophytic
 Caused by Trichosporon species sulfide
1. T. ovoides – causes scalp hair
Dermatophytosis – is a “ringworm” disease of
white piedra
the keratinized tissues (skin, hair, and nails) and
2. T. inkin – causes most cases of
is caused by fungi called dermatophytes. –
pubic white Piedra
keratinophilic meaning they are keratin lovers.
Keratin is a major protein that is found in horns,
skin, nails, and hairs

 Restricted to the nonviable skin -

because most are unable to grow at 37
degrees Celsius or in the presence of
serum.
NOTE: Dermatophytosis is also known as
“Tinea infections”. Are among the most
NOTE: Microscopically the fungus prevalent infections in the world.
demonstrates highly hyphae with blastoconidia  Rarely life-threatening, but treatment
and arthroconidia on CmTAP agar. is costly
Black Piedra vs White Piedra  Skin diagnosis: Presence of hyaline,
Characteristi Black White septate, branching hyphae or chains of
cs Piedra Piedra arthroconidia
Etiology Piedraia Trichosporo
hortae n beigelii
Nodules Over and On the
NOTE: Culture – the many species are closely
related therefore they are often difficult to
identify.
Dermatophytic species are capable of sexual
reproduction, and they produce ascospores.
 DNA sequence analysis – aided the
identification of closely related and
outbreak strains
 Severity of ringworm disease depends
on:
1. Strains or species of fungus
involved
2. Sensitivity of the host to a particular
pathogenic fungus.
Dermatophytes are acquired by contact with
contaminated soil or infected animals or
humans.
Classification:
 Geophilic species – keratin-utilizing
soil saprophytes.
o Ex: Microsporum gypseum and
Trichophyton ajelloi
 Zoophilic species – keratin-utilizing on
hosts (living animals)
o Ex: Microsporum canis (dogs
and cat), Microsporum gallinae
(cow), Microsporum nanum
(pigs), Trichophyton equinum
(horses), and Trichophyton
verrucosum (cattle)
NOTE: Geophilic and Zoophilic
dermatophytes being less adductive to human
cause produce more acute inflammatory
infections that tend to resolve more quickly.
Moreover. The infections of geophilic and
zoophilic dermatophytes produce more irritants
and are more inflammatory than anthropophilic
species.
 Anthropophilic species – keratin-
utilizing on hosts (humans)
o Ex: Epidermophyton floccosum,
Trichophyton mentagrophytes
or T. interdigitale, Trichophyton
rubrum, and Trichophyton
tonsurans
NOTE: They cause the greatest number of
human infections mainly mild or chronic. These
species maybe transmitted by direct contact or
through fomites such as contaminated towels,
clotting, shirt and etc.
 Trichophyton species
o Infect the hair, skin, or nails
o Develop cylindric, smooth-
walled macroconidia and
microconidia
o They are identified as tiger
colonial appearance and
microscopic morphology after
growth after 2 weeks at 25
degrees Celsius on Sabouraud
Dextrose Agar
Trichophyton species
 T. mentagrophytes
 Cottony to granular colonies
 Display abundant grape-like clusters
of spherical microconidia on
terminal branches
 Coiled or spiral hyphae are
commonly found in primary
isolates.
 T. ubrum
- white cottony surface and deep red
non-diffusible colonies on reverse
side
- micronidia are small and piriform
(pear-shaped)
 T. tonsurans
- Flat, powdery to velvety colonies –
becomes reddish brown on reverse
- Characterized by the production of
elongated microconidia attached to a
supporting hypha
Microsporum species
- Infect the hair and skin only
 - Produce distinctive multicellular
macroconidia with echinulate walls
 M. canis
- white cottony surface and deep
yellow color on reverse side
- thick-walled, 8-15 celled
macroconidia with curved or hooked
tips
 M. gypseum
- Tan, powdery colony
- Abundant thin and rough-walled, 4-
6 celled macroconidia
Epidermophyton floccosum
- Infect the skin and nails only
- Only pathogen in the genus
- Produces only macroconidia which
are club-shaped, smooth-walled,
clavate, 2—4 celled and formed in
clusters
- Flat and velvety with a tan to olive
green tinge colonies
- Growth at 37ºC or a test for in vitro
are useful for differentiating certain
species
- atypical isolates can easily be
identified by species specific
polymerase chain reaction test
- Host susceptibility is enhanced by:
1. Moisture
2. Warmth – incidence is
higher in hot humid
climates and under crowded
living conditions
3. Specific skin chemistry
4. Composition of sebum and
perspiration
5. Youth
6. Heavy exposure
7. Genetic disposition
Trichophytin
- A crude antigen preparation that can
be used to detect immediate or
delayed type hypersensitivity to
dermatophytic antigens
- Many patients who develop chronic,
non-inflammatory dermatophyte
infections have poor cell-mediated
immune responses to dermatophyte
and have elevated IgE levels
 Tinea pedis (Athlete’s foot)
- Most prevalent of all
dermatophytosis
- Occurs as a chronic infection of the
toe webs
- Other varieties: vesicular, ulcerative
and moccasin types with
hyperkeratosis of the sole
- Caused by the ff fungi: T. rubrum,
T. mentagrophytes (most common
cause), and E. floccosum (causes
epidemic Tinea pedis)
- Acute: itching, small red vesicular
lesions
- Chronic: peeling and cracking of
the skin + pain and pruritus
 Tinea unguium (Onychomycosis)
- Nail infection follow prolonged
athlete’s foot
- Nails become yellow, brittle,
thickened and crumbly
- Can be caused by ff fungi: T.
rubrum, T. mentagrophytes, E.
floccosum
- One or more nails of feet or hand
may be involved
 Tinea corporis (Ringworm)
- A dermatophytosis of the body
which usually affects the inside skin
folds
- Circular patches with the advancing
red, vesiculated border and central
scaling and pruritus
- Grows only within dead,
keratinized tissue
- Candida agents are often causative
agents of this infection
- Fungi: T. rubrum, E. floccosum
- Lesions expand centrifugally and
active growth occurs at the
periphery which is the most likely
 region from which to obtain
material for diagnosis
 Tinea cruris (Jock itch)
- Dermatophytosis of the groin
- Common in males
- Dry, itch lesions that often start on
the scrotum and spread to the groin
- Can be caused by ff fungi: T.
rubrum, T. mentagrophytes, E.
floccosum
 Tinea manuum
- Ringworm of the hands or finger
- Dry scaly lesions may involve one
or both hands, single fingers, or two
or more fingers
 Tinea capitis
- Ringworm of the scalp and hair
- Dull, gray, circular patches of
alopecia, scaling, itching
- Ectothrix: fungus on the hair
surface; nimpart greenish to silvery
flourescence under wood light (365
nm)
- Endothrix: fungus inside the hair
shaft; do not fluoresce, they are
weakened and typically break easily
at the follicular opening
- Can be caused by ff fungi: T.
mentagrophytes, M. canis, T.
tonsurans
- Infections begin with hyphal
invasion of the skin of the scalp
which spread down to keratinized
wall of hair follicle
- Patches of alopecia, scaling, and
itching
- T. tonsurans is the chief cause of
“black dot” tinea capitis, produces
spore within hair shaft (endothrix)
- Favus – Acute inflammatory
infection of the hair follicle caused
by T. schoenleinii which leads to the
formation of scutula or crusts
around the follicle
- Kerion - a severe combined
inflammatory and hypersensitivity
reaction induced by zoophilic
species. This can resemble a
pyogenic infection
 Tinea barbae
- Infection of the beard region
- Edematous and erythematous lesion
- Hair do not fluoresce, is weak and
breaks easily
 Dermatophytid
- Patient becomes hypersensitive to
constituents or fungal products and
develops an allergic reaction
- Presence of pruritic vesicular to
bullous lesions
- Found elsewhere on the body most
often on hands
- No fungi present
- Commonly associated with Tinea
pedis
Diagnostic Tests:
 Specimens and microscopic exam
- Consists of scrapings from both the
skin and the nails (T. unguium) plus
hairs plucked from involved areas
- Branching hyphae or chains of
arthroconidia are seen in KOH preps
of skin or nails
 Culture
- Specimens are inoculated onto
Inhibitory Mold Agar (IMA) or
Sabouraud’s dextrose agar (SDA)
slants containing cycloheximide
and chloramphenicol (to suppress
mold and bacterial growth),
incubated for 1-3 weeks at room
temperature (25-30 degrees
Celsius), and further examined in
slide cultures if necessary
Treatment:
- Removal of infected and dead
epithelial structures
- Apply topical antifungal chemicals
or antibiotics
 - Area should be kept dry to avoid lesions that respond to topical treatment
reinfection within weeks and rarely recur
- Avoid sources of infection  Anthropophilic dermatophytes usually
cause relatively mild, chronic lessons
 T. corporis, T. pedis or other related that may require months or years of
infections treatment and frequently recur
- Most effective drugs are
itraconazole and terbinafine
- Miconazole nitrate, tolnaftate, and
clotrimazole (apply for 2-4 weeks)
can be used for smaller lesions
 T. capitis
- Treated for several weeks with oral
administration of griseofulvin or
terbinafine
- Frequent shampoos and miconazole
cream or other topical antifungal
agents may be effective if used for
weeks
- Alternatively, ketoconazole and
itraconazole are quite effective
 Tinea unguium
- Most difficult to treat
- require months of oral itraconazole
or terbinafine as well as surgical
removal of the nail
- relapses are common
- Luliconazole: use to penetrate the
nail plate and demonstrate both end
effectiveness against their
dermatophytes and onychomycosis
REMEMBER!!

 Superficial and cutaneous mycosis are

among the most common of all
communicable diseases
 most superficial and cutaneous fungal
infections are caused buys pieces of
Malassezia, dermatophytes, or Candida.
 The growth of dermatophytes is
inhibited by serum and body
temperature, and these fungi rarely
become invasive
 geophilic and zoophilic dermatophytes
usually cause acute, inflammatory