Fungal diseases

(MYCOSES)
OWNER: PROF. HOLLY GRACE ESPIRITU, RMT, MS MICRO
PRESENTED BY: ROCHELLE D. DARLUCIO-YABUT, RMT, MPH
OUR LADY OF FATIMA UNIVERSITY
COLLEGE OF MEDICAL LABORATORY SCIENCE
LESSON INTENDED LEARNING OUTCOMES:

 After the discussion, the students are expected to:

 1. Understand Dermatophytes in terms of Morphology,

Identification, prevention and Control and its Pathology.
 CLASSIFICATION (SITE OF INFECTION)

 1. Superficial - no tissue invasion, very rare

 2. Cutaneous/Dermatomycoses- no tissue invasion,
superficial infection of skin, nails, and hair
 3. Subcutaneous – localized infection of the skin,
subcutaneous tissue
 4. Systemic/ deep mycoses- involves many deep
organ. RES, CVS,CNS
 5. Opportunistic fungi- low immunity
Cutaneous mycoses
( Dermatomycoses)
 CUTANEOUS MYCOSES ( DERMATOMYCOSES)
 Keratin Loving (degrades keratin)

• Infect only the epidermis , hair and nail

• Do not invade underlying tissue
• MOT- human to human Animal to animal
• Usual Habitat
a. geophilic-soil
b. zoophilic-animals
c. anthropophilic- human

 Tinea – (latin for “worm” or “ringworm”

 tinea corporis (ringworm of the body)
 tinea cruris (ringworm of the groin, or “jock itch”)
 tinea capitis (ringworm of the scalp and hair)
 tinea barbae (ringworm of the beard)
 tinea unguium (ringworm of the nail)
 tinea pedis (ringworm of the feet, or “athlete’s foot”)
 Manifestation

• A. ectothrix
• B. endothrix
• C. wood’s lamp
• D. scutula
 Manifestation

Ectothrix
 forming a sheath of spores
on the outside of a hair as well
as growing within the hair
shaft.

Endothrix
 whose spores and
sometimes mycelia
characteristically invade the
interior of the hair shaft.
Three genera:

 a. Trichophyton- hair, skin and nails (endothrix or

ectothrix)
 b. Microsporum- hair and skin (ectothrix)
 c. Epidermophyton- skin and nails
 Detection of Clinical Materials
1. SKIN SCRAPING FROM BORDER OF ACTIVE LESION
A. hyphae – threadlike lines running through skin or nail cells
B. DIFFERENTIATION FROM ARTIFACTS
a. cell walls, branches or septate
b. chlamydospores of older hyphae

2. HAIR, ECTOTHRIX
 Microsporum- mosaic pattern around hair

 Trichophyton –parallel cell arrangement around hair

3. HAIR, ENDOTHRIX
 Trichophyton-arthroconidia in rows
 Favus hyphae- T. schoenleinii
 CULTURE OF CLINICAL SPECIMENS

 Mycosel
 DTM
 cornmeal
 Slide culture
 Colony characteristic
 Microsporum canis (zoophilic)
Large muti celled spindle shaped rough
walled macroconidia
 3-15 celled
 Terminal end,
 sometimes curved
 with a terminal knob.
 Microconidia –few
pyriform to clavate microconidia are also
present
Colony pigmentation
 Microsporum gypseum (geophilic)
 produces a single inflammatory skin or
scalp lesion.
 Macroconidia
 Symmetrically ellipsoidal, thin-walled 4-
 6 celled macroconidia. terminal or distal
ends of most macroconidia are slightly
rounded.

 microconidia
 Numerous clavate shaped are also
present
Microsporum gypseum (geophilic)
Microsporum gypseum (geophilic)
 Microsporum audouinii (anthropophilic)
anthropophilic fungus causing non-
inflammatory infections of scalp and skin
especially in children

MOT-infected hairs on hats, caps ,

upholstery combs and barbers
clippers
 Microscopically:
Conidia are absent or bizarre if present
atypical vegatative hyphae with terminal
chlamydospore, racquet hyphae and
favic chandeliers
Microsporum audouinii (anthropophilic)
Microsporum audouinii (anthropophilic)

scalp infection of
6 years duration
showing minimal
hair loss and
scaling
 Epidermophyton floccosum

 Invades skin and nails but never

hair.
 Tinea cruris and Tinea pedis

May become epidemic among

personnel using common shower or
gym facilities, e.g. athletic teams,
troops, ship crews and inmates of
institutions.
Epidermophyton floccosum
 Epidermophyton floccosum

tinea cruris

Tinea pedis

Submammary tinea corporis

 I.Trichophyton

 Predominant spore forms are microconidia

 Infected hair do not fluoresce under Wood’s lamp
Arthroderma- sexual form of Trichophyton
 T. rubrum
 T. verrucosum
 T. mentagrophytes spp. Complex
 T. tonsurans
Trichophyton rubrum
 Common cause of tinea ungium
(nail) slender clavate to pyriform microconidia.

 Hair perforation test –negative

 Urease- none, weak or delayed
>5 days
 clavate- or peg-shaped
microconidia

Macroconidia: absent but maybe present in some

strains, pencil-shaped or closterospore-like projections
maybe seen
Trichophyton rubrum
Trichophyton rubrum
 Trichophyton mentagrophytes
Invaded hairs show an ectothrix infection
but do not fluoresce under Wood's ultra-
violet light.
 Common cause of Tinea pedis (athletes
foot)
 Microconidia are found primarily in clusters
described as grapelike (“en grappe”).

 Other test:
 Urease (+)
Can be differentiated from T. rubrum by in
vitro hair penetration +
Trichophyton mentagrophytes
Trichophyton mentagrophytes

infection in a Guinea pig showing hair

loss and skin scaling of the nose.

Infection of a laboratory technician's finger by T.

mentagrophytes var.
mentagrophytes following contact with mice.
Trichophyton rubrum FEATURES Trichophyton
mentagrophytes
Tear-shaped single and microconidia Spherical ; grape like
lateral along hyphae cluster, spiral hyphae

Few, smooth-walled, macroconidia Few smooth-walled, cigar

pencil-shaped attached shaped, connected to
directly to hyphae hyphae with definite
narrow attachment

Abundant, wine red Red pigment in culture Scant red pigment

medium
None or weak, delayed urease 1-3 days

Grows on surface of hair; no Hair-baiting test Penetrates hair shaft

penetration
 Trichophyton tonsurans
 endothrix hair invasion
• “Black dot”,
 • Common cause of Tinea capitis
• Colonies are raised or with sunken centers
and a folded surface with yellowish color in
the depression, velvety to powdery.
• Colony: slow growing.wrinkled.may not
grow w/o thiamine
• Microconidia: various size and shapes,
flattened base.
 aged microconidia: ballon forms
Macroconidia: absent or rare, distorted
Trichophyton tonsurans
Trichophyton tonsurans
Trichophyton tonsurans
 Trichophyton verrucosum
 Zoophilic fungus causing ringworm in cattle. Infections
in humans result from direct contact with cattle or
infected fomites
 usually highly inflammatory involving the scalp, beard
or exposed areas of the body.
 Invaded hairs show an ectothrix infection and
fluorescence under Wood's ultra-violet light has been
noted in cattle but not in humans.
Macroconidia: rat tail or string
All strains require thiamine for growth and many bean shape
strains also require inositol.
 Growth is enhanced at 37OC.
 Trichophyton verrucosum

All strains of T. verrucosum produce typical chains of

chlamydoconidia when grown in brain heart infusion broth
clavate to pyriform microconidia with para-amino benzoic acid (P.A.B) and agar at 37OC.
Trichophyton verrucosum
Trichophyton verrucosum
Trichophyton verrucosum
 Trichophyton schoenleinii
 An anthropophilic fungus causing favus in
humans which is a chronic, scarring form of
tinea capitis characterized by saucer-shaped
crusted lesions or scutula and permanent
hair loss.
 Invaded hairs remain intact and fluoresce
a pale
 greenish yellow under Wood's ultra-violet
light. Very slow growers (30 days or
more), small wrinkled waxy.
 Conidia: absent
 Favic chandeliers and chlamydospore
Microscopic morphology of T. schoenleinii showing
formation characteristic antler "nail head" hyphae also known
as 'Favic chandeliers
Trichophyton schoenleinii
Trichophyton schoenleinii
Trichophyton schoenleinii
 Trichophyton violaceum

 • Infect scalp and body

 “black dot” tinea capitis
• Invaded hairs show an endothrix infection and do
not fluoresce under Wood's ultra-violet light.
 • Heaped, folded globious wavy surface with
violet
 color.”port wine” verrucous (warty)
 • Microconidia and macroconidia absent.
• Swollen or distorted hyphae containing
cytoplasmic granules and presence of
chlamydospores.
Trichophyton violaceum
Trichophyton violaceum
“Black dot” endothrix tinea capitis