MICROBIOLOGY

INTRODUCTION TO MYCOLOGY

● Mycology is a branch of microbiology that deals with the study of fungi.

GENERAL CHARACTERISTICS OF FUNGI
1. ALL fungi are GRAM POSITIVE
2. Saprophytes
○ They live in dead or decaying environment
3. Heterotrophs
○ They obtain nutritional requirements from organic substances.
○ They can survive on different sources of nutrition.
4. Thallophytes
○ They possess root-like structure to obtain nutrition.
5. Chemotrophic organism
○ They obtain their energy from oxidation of electron donors in the environment
6. Natural habitat is environment
7. MOST of them are FACULTATIVE ANAEROBES

Beneficial uses of FUNGI ● Used as food (e.g mushrooms)

● For food production (e.g, yeast for baking, cheese, etc.)
● Fermentation of alcoholic drinks
● Tobacco and rubber manufacturing
● For food disposal → decomposition
● Used for production of antibiotics and other drugs.

HARMFUL EFFECTS OF ● Attack all materials especially wood.

FUNGI ● Spoilage of stored food
● Destroyed crops
● Spontaneous combustion of stacked hay and peat.

MORPHOLOGIC FORMS OF FUNGI

UNICELLULAR ● Round to oval in shape

● Tissue form: Grows at 37 degree Celsius

MULTICELLULAR ● Long filaments

● Filamentous form: grows at 24 degree celsius

Spores 1. Sporangiospores
2. Chlamydospores
3. Arthrospores
4. Blastospores

Specialized spores 1. Zygospores

2. Ascospores
3. Basidiospores
DIFFERENCE BETWEEN FUNGI AND BACTERIA
FEATURES BACTERIA FUNGI

NUCLEUS Prokaryotic Eukaryotic

MITOCHONDRIA ABSENT PRESENT

ENDOPLASMIC ABSENT PRESENT

RETICULUM

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CELL MEMBRANE CHOlesterol ERGOsterol

CELL WALL Peptidoglycan Chitin

Mannan
Glucan

SPORES Endospores for survival Reproduction

REPLICATION Binary fission Binary Fission

Budding

RIBOSOMES 70s 80s

FUNGAL STRUCTURES

Cell wall Rigid structures ● Activate COMPLEMENT leading to inflammation.

- 80-90% of the following ○ To differentiate rashed caused by fungal infection from the
- Carbohydrates ones caused by ALLERGIC REACTION → rashes in fungal
- Chitin ( N-acetylglucosamine) infection are more reddish, can be painful and itchy → due
- Mannan ( Mannose) to complement.
- Glucan (D- Glucose) ● Surface components mediate attachment of the host cells.
- Some fungi contain MELANIN pigment that is
called DEMATIACEOUS FUNGI
- Impart brown or black color.
- Diagnostic and associated with VIRULENCE.

Capsule (tightly - Stained by india ink

attached) and Slime - Mainly by polysaccharides
Layer (Loosely - Cause cells to adhere and clump together
attached) - May influence the growth of fungi

Cell membrane Bilayered → composed of: ● Protects the cytoplasm

- Phospholipids ● Regulates intake and secretion of solutes
- Steroids (Zymosterol and Ergosterol) ● Facilitates synthesis of cell wall and capsular materials
- Ergosterol is the component found in all
antifungal agents.

MORPHOLOGIC FORMS OF FUNGI

Yeast ● Grows as a SINGLE CELLS (UNIcellular) ● Fission formation

● It is ROUND, spherical to OVAL shape
● At 37 degree C they grow and produce
ASEXUALLY by the process of :
○ Fission formation
○ Blastoconidia formation or Budding
○ Sometimes this elongates and multiplies forming a
sausage-like appearance → PSEUDOHYPHAE
● Blastoconidia formation (BUDDING)
○ Conidia formation through a budding process

Molds ● Multicellular, hyphal or mycelial colony or form ● Components:

of growth ○ Hyphae is a one strand filament
● Can grow as long filaments / thread like ■ Septate hyphae: W/DIVISION
structure. ■ Non-septate hyphae (Coenocytic hyphae): NO
DIVISION
○ Mycelium (Mat): Mass of Hyphae
■ Vegetative it means the function is to absorb
nutrients.
■ Aerial it means the function is to carry the conidial
reproduction.

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 MICROBIOLOGY

TYPES OF REPRODUCTION
- Many fungi can have both states especially ASCOMYCOTA
- Most have either one or the other

Sexual Reproduction ● Typically occurs when mating compatible strains ● The sexual (perfect, meiotic) state is referred to as
of species are stimulated by pheromones to TELEOMORPH.
undergo plasmogamy, nuclear fusion and
meiosis → exchange of genetic information

Asexuall ● Spores reproduce clonally ● The asexual (imperfect, mitotic) state of fungus is termed as
Reproduction ANAMORPH

PARASEXUAL REPRODUCTION
- Culminates genetic exchange through mitotic recombination.
- If you see a specialized spore among an imperfect fungus then its name will be change from Histoplasma capsulatum to Ajellomyces
capsulatum.

KARYOGAMY - If there is the fusion of nuclei

PLASMOGAMY - If there is the fusion of the cytoplasm

Mycoses is the infection caused by fungi

PATHOGENESIS OF FUNGAL INFECTION

1. HIGHLY virulent
2. Disruptions in the protective barriers of skin and mucus membrane
3. Defects in the host immune system
4. toxins.

Fungi (Dysbiosis) → invasion of barriers → recognition of fungal antigens by innate immune system → pro-inflammatory cytokines → Th17 and Th1
dysregulation → loss of mucosal hemostasis, inflammation and dysbiosis.

FUNGAL PROPERTIES FOR PATHOGENESIS

1. Ability to proliferate in the mammalian host.

2. Withstand the defenses of the host
3. Genetic switching of metabolic process
4. Surface adhesin
5. Enzymes
6. Cell wall components

MECHANISM OF FUNGAL INFECTION

1. Mycotoxicosis
2. Hypersensitivity disease
3. Colonization - invasion
4. Fungal infection

CLASSIFICATION OF FUNGI

ZYFOMYCETES ● VEGETATIVE HYPHAE is sparsely spectate ● Sexual reproduction: ZYGOSPORES

Example: ● Asexual reproduction:SPORANGIA
- Rhizopus
- Mucor

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ASCOMYCETES ● Conidia is a term that refers to asexual spores of ● Sexual reproduction: Sac or Ascus → Ascospores
filamentous fungi. It is a structure in aerial ● Asexual reproduction: Conidia
mycelium that is responsible for fungal
reproduction. → DERIVED from hypha
(conidophore)
● Septate hyphae
● Example:
- Blastomyces
- Histoplasma
- Microsporum
- Trichophyton
- Saccharomyces

BASIDIOMYCETES ● Hyphae with complex septa ● Sexual reproduction: basidiospores supported by basidium.
● Examples:
- Mushrooms
- Filobasidiella
- Neoformans
- Anamorph
- Cryptococcus neoformans

DEUTEROMYCETES ● Artificial grouping of imperfect fungi ● NO SEXUAL REPRODUCTION DISCOVERED

● (+) ASEXUAL conidia
● Example:
- C. immitis
- P. brasillensis
- C. albicans

TABLE FOR THE CLASSIFICATION OF FUNGI

SEXUAL ASEXUAL PARASEXUAL

ZYGOSPORES SPORANGIOSPORES→ produced by sporangia grow a H.capsulatum

new organism Ajellomyces capsulatum

ASCOSPORES CHLAMYDOSPORES

BASIDIOSPORES ARTHROSPORES

BLASTOSPORES

DIMORPHIC FUNGI

Tissue or Yeast phase Assumed by fungi at body temperature of 37 degree celsius

Mycelial or Assumed the mold form at room temperature of 24 degree celsius

Filamentous phase

LABORATORY DIAGNOSIS

Wet Preparation ● Uses KOH or NaOH as clearing agent.

● KOH or NaOH functions to lyses the tissue deeply so that you
can see the structures clearly.

Calcofluor White Stain ● Shows fungal elements in exudates and small skin scales
Direct Microscopic under fluorescent microscope
Examination

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Nigrosin or India Ink ● Stains the capsule

Wright Stain or Giemsa Stain ●

Sabouraud dextrose agar ● Utilizes Chloramphenicol or Gentamycin to inhibit the

(Peptone and glucose) bacteria
● Cycloheximide to inhibit saprophytic molds.
● Growth and maintenance of clinically important fungal
pathogens.

Potato Dextrose Agar ● Enhances the production of conidia

(Potato extract and infusion, dextrose, agar)
Culture
Blood Agar ●

Corn Meal Agar ●

Inhibitory mold agar ● For recovery of pathogenic fungi from clinical specimen.
(Tryptone, beef extract, yeast extract, starch dextrin,
chloramphenicol, gentamicin and saline butter)

Brain heart infusion agar ● Growth of fastidious pathogenic fungi such as:
(Brain heart infusion, glucose, L-cysteine HCL, agar) - H, capsulatum
- B. dermatitidis

Periodic acid shift

Gomori methenamine silver stain

Histologic Stains
Calcofluor white

Fluorescent Antibody stain For rapid diagnosis of fungal cell wall

DNA Probe Test ● Identify the colonies growing in culture at an early stage of growth.
● Available for coccidiomycoses, histoplasmosis, blastomycoses and cryptococcus.

Immunologic ● For detection of antigen or antibody.

● Complement-fixation, agglutination, and precipitation test.
● Immunologic test
○ Useful only for systemic and opportunistic mycoses
○ C-F is frequently used in suspected cases of coccidioidomycosis, blastomycoses and histoplasmosis.

Wood’s Light ● Used in determining the prognosis of the ● Examples

patient. - T. capitis: yellowish green in color
● If there is a fungal infection, it may fluoresce - P. versicolor: golden yellow
under the wood’s lamp. - Pseudomonas → bacteria that can fluoresce under the
wood’s lamp.

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TREATMENT

Aflatoxins Sterigmatocystin Zearalenone Amanita toxin

Fungi Aspergillus flavus A versicolor, bipolaris spp Fusarium spp. Amanita phalloides or
A. parasiticus A nidulans death cap mushroom

Foods Nuts Grains Reddish kernels Mushroom

Corn Coffee
Cassava Cheeses
Rice Spices
Wheat beers
beans

Factors for toxin Humidity Moist weather

production Temperature

Effects Liver cancer Liver and kidney damage Estrogenic → enlarged Hepatorenal damage
→ icterus and petechiae vulva, abortion in pigs

CLASS DRUGS INDICATIONS ADVERSE EFFECT

ECHINOCANDINS CASPOFUNGIN - Invasive aspergillosis - GI upset

- Candidiasis - flushing

Amphotericin B - Systemic - Nephrotoxic

- Serious mycosis - Arrhythmias
- Hypotension
- Fever
- Anemia

Nystatin - Oral and vaginal

candidiasis

Allylamines Terbinafine - ONYCHOMYCOSIS - GI upset

- Headache
- Hepatotoxicity
- Tast

Imidazoles Ketoconazole - DERMATOPHYTOSIS - Decreased in libido

Miconazole - Gynecomastia
Clotrimazole - Impotence due to
testosterone synthesis
Triazole Fluconazole - Cryptococcal inhibition (esp
suppression in AIDS Ketoconazole
- Liver dysfunction
Itraconazole - Systemic mycoses

Voriconazole - Invasive aspergillosis

Flucytosine - Systemic mycoses - Bone marrow

suppression

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Griseofulvin - DERMATOPHYTOSIS - Teratogenic

- Carcinogenic
- Confusion
- Headaches
- Disulfiram-like reaction
- Increase GYP450

TARGET CELLS CLASS DRUG ACTION

CELL WALL ECHINOCANDIN Caspofungin - It inhibits β glucan synthesis.

CELL MEMBRANE POLYENES Amphotericin B - Binds to ergosterol causing disruption and leakage of
cytoplasmic components
Nystatin

ALLYLAMINES Terbinafine - Inhibits squalene epoxidase

AZOLES Imidazoles - Inhibits the 14 α- demethylase

Triazoles

Nuclei Acids Flucytosine - Converted into 5-HU inhibits the nucleic acid synthesis

Microtubules Griseofulvin - It inhibits microtubule assembly disrupting mitosis

ADDITIONAL NOTES

THREE METHODS OF ASEXUAL REPRODUCTION

THALLIC -
REPRODUCTION

BUDDING - Produces blastoconidia or blastospores

GERM TYPE - Becomes pseudohyphae

FUNGAL REPRODUCTION

MEIOTIC Involving fusion of 2 nuclei

reproduction

TELOMORPH Sexual state of the fungus

HETEROTHALLIC Reproduction occurs within a single mycelia

- Molds copulate at the tips and grow toward each other in response to sex hormones

SPORANGIA Releases sporangiospores after zygote formation occurs

Alimentary Toxic - Due to the consumption of overwintered - Characterized by:

Aleukia (ATA) grains infected by fusarium - Leukopenia agranulocytosis, necrotic angina, a
hemorrhagic rash, sepsis, exhaustion of the bone

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marrow, bleeding from the nose, throat, and gums, and

fever.

Balkan Neuropathy - A chronic tubulointerstitial disease associated with a high frequency of urothelial atypia, occasionally culminating
in tumors of the renal pelvis and urethra

SUPERFICIAL AND CUTANEOUS MYCOSES

Superficial mycoses ● Confined at the outermost layer of the skin, hair, mucosa and DOES NOT INVADE LIVING TISSUE
● NO DISCOMFORT
● Can cause cosmetic problems
● Limited STRATUM CORNEUM
● NO CELLULAR RESPONSE FROM THE HOST
● NO PATHOLOGICAL changes elicited
● These infections are often so innocuous that patients are often unaware of their condition

SKIN INFECTIONS

PITYRIASIS TINEA ● Caused by Malassezia furfur (Pityrosporum orbiculare)

VERSICOLOR VERSICOLOR ● Commonly known as “An-an”
● LIPOPHILIC yeast → requires fatty acid supplement
● Found as normal flora in the skin
● Lesion may occur as frequently on the upper torso, arms and abdomen as
discrete hyper or hypo pigmented macular lesion
● They scale vert easily, giving the affected area dry or chalky appearance.
● Sometimes lesion appeared to be elevated and folliculitis may occur if hair
follicles were involved.
● BOTH sexes are equally affected
● World wide distribution and may affect all races

Laboratory diagnosis

1. Specimen: Skin scrapings

2. Methods:
a. 10% KOH preparation
i. Shows characteristic of “spaghetti and meatballs appearance”
ii. Short fragment of hyphae
iii. Cluster or yeast
iv. BOTH budding yeast cells and hyphae can be demonstrated
b. Culture

1. Vitiligo
2. Chiosama of pregnancy
Differential 3. Tinea circinata (ringworm)
diagnosis 4. Seborrheic dermatitis
5. Pityriasis rosea
6. Erythrasma
7. Secondary syphilis
8. Pinta

1. Irregular well demarcated patches of discoloration may be raised.

2. Fawn. reddish, yellow brown/ dark crown patches on the skin.
Clinical 3. May or may not be scaling
manifestations 4. Common sites: **
a. Chest
b. Trunk
c. Abdomen
d. Shoulder

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e. Face
f. Neck

1. Topical agents Imidazole (Ketoconazole shampoo)

2. Oral treatment Ketoconazole

Management and Itraconazole
treatment
3. Alternative Zinc pyrithione shampoo
Propylene glycol 50% in water twice a day
Miconazole

TINEA NIGRA EXOPHIAL ● Usually a single lesion

WERNICKII ● Sharply marginated
● Brown-black non-scaly macule
● Common sites:
○ Palmar and plantar areas of stratum corneum
● There is NO INFLAMMATORY REACTION and it is NOT SCALY
● ETIOLOGIC AGENT: Hortae Werneckii (Exophial Werneckii)

Clinical diagnosis ● H. werneckii (E.werneckii)

○ Dimorphic
○ Initially grows as yeast with many cells → budding
○ YEAST CELLS
○ Older colonies → septate hyphae
○ A dematiaceous fungi producing melanin

Laboratory ● Microscopic examination with 10-20% KOH pigmented Septate Hyphae and budding Yeast Cells with
diagnosis Melanized Cell Walls, from skin scraping a dematiaceous fungi producing Melanin
● Culture:
○ Sabouraud’s Dextrose Agar – dematiaceous yeast colony in 3 weeks become velvety

Differential 1. Melanoma
diagnosis 2. Junctiona; nevus
3. Pigmented Addison’s disease
4. Straining due to dyes

Keratoltic solution - Salicylic acid

Management and
Treatment Antifungal drugs - Azole cream
- Terbinafine
- Whitfield ointment

HAIR INFECTION

WHITE PIEDRA Trichosporon ● Infection of the hair caused by yeast-like organism Trichosporon beigelii
beigelii ● Common sites
○ Scalp
○ Mustache
○ Beard
○ Groin
○ Axilla
● Relapse is common
● The development of soft, pasty, cream-colored lesion growth along infected
hair shaft characterized this condition.
● The initial growth occurs beneath the epidermis of the hair.
● The infected hair shafts consist of MYCELIUM that rapidly fragments to

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ARTHROCONIDIA.

Clinical Diagnosis - Sleeve-like collarette around the hair shaft

Laboratory Diagnosis 1. Direct microscopic examination of the hair

2. Culture
a. Asexual phase of fungus

Probable factors 1. Corticosteroids

2. Tropics and excessive sweating
3. Genetic predisposition
4. Poor nutritional state

Treatment 1. Shaving or cutting the infected hair

2. Topical fungicides
a. Bichloride mercury (1:200_
b. Benzoic and salicylic acid combinants
c. 3% sulfur ointments

BLACK PIEDRA Piedra Horate ● Hard black nodules formed around the scalp hair (carbonaceous; can house
and asci)
● Thick walled closely septate hyphae with chlamydoconidia
● Growth is DIMORPHIC-hyphae and blastoconidia
● Associated with poor hygiene
● Presents as small, dark, hard mass/nodules held together by a cement-like
substances around the hair shaft
● Pigmented (brown to reddish-black) molds
● In Sexual Phase, fungi contain Asci and Ascospores

Laboratory diagnosis - Asci and Ascospores

- Direct microscopic examination of affected hair
- Cultures:
- Sabouraud’s Dextrose Agar

Treatment 1. Hair cut

2. Proper and regular washing
3. Topical fungicides
4. Bichloride of mercury
5. Benzoic acid/ Salicylic acid combinations

DIFFERENCE BETWEEN BLACK AND WHITE

FEATURES BLACK PIEDRA WHITE PIEDRA

ETIOLOGY Piedra hortae T. beigelii

EPIDEMIOLOGY Tropical areas Temperate areas

LOCATION Scalp hair Beard, axilla and groin

SOURCE Soil Environment

LESION Gritty, hard brown-black encrustations Softer granules, red or light brown
Hard to remove Easy to remove
Hair breakage No hair breakage

DIFFERENTIAL Nits of pediculosis Nits of pediculosis

DIAGNOSIS

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DIAGNOSIS (+) asci with ascospores (-) asci

CYCLOHEXIMIDE NOT INHIBITED INHIBITED

TREATMENT Shaving Shaving

antifungals Antifungals

CUTANEOUS MYCOSES

DERMATOPHYTOSIS

● Superficial fungal infection of the skin, hair and nails

● May STIMULATE IMMUNE RESPONSE
● NO LIVING TISSUE INVOLVED
○ Generally restricted to the keratinized layers of the integument and its appendages
● Also referred to as “Keratinophilic fungi/ Dermatophytes → tinea, ringworm
● May give rise to hypertensive state known as “dermatophytid” or “id reaction”
● Three genera which are distributed according to its geographical distribution

Microsporum —
HAIR
Trichophyton SKIN NAILS

Epidermophyton —

TAKE NOTE
- MICROSPORUM : both microconidia and MACROconidia pero mas madami ang macro which is use for diagnostic
- TRICHOPHYTON- both MICROconidia and macroconidia
- EPIDERMOPHYTON- does not involved the hair
- MICROSPORUM- does not involved the nails
- Elastic proteases and other enzyme
- When hair is infected, the fungal invasion can either be Ectothrix (outside), Endothrix (inside), or Favic (honeycomb-hyphae,
arthroconidia, and empty spaces pattern resemble air bubbles

TRICHOPHYTON ARTHRODERMA ● Infect the skin, hair and nails

● MICROCONIDIA and macroconidia
●

T. mentagrophytes - Grape like cluster on terminal

T. rubrum - Tear drop shaped microconidia

Types of Trichophyton
T. tonsurans - Clavate microconidia
- Elongated and attached to hyphae

T. schoenleinii (favic - Lead to formation of scutula (crust around

chandelier) the follicle → favus (POKNAT)

MICROSPORUM NANNIZIA ● Infects the skin and hair

● MACROCONIDIA and microcondia
● Fluorescence under wood’s lamp

M. canis - Thick walled macroconidia

- Macroconidia have curled or hooked spink
tips
- Spindle in shaped
- Rough walls
- 5- 15 cells
Types of Microsporum

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M. gypseum - Thinner walled macroconidia

- Blunt edge
- Rough walls

M. audounii - Thick walled chlamydospores

- 4-6 cells per macroconidia

EPIDERMOPHYTON ● Involves skin and nails

● NO MICROCONIDIA
● Numerous MACROCONIDIA → smooth walled club-shaped in clusters
● Described as FUSEAUX IN BANANA BUNCH
● E. floccosum

GENERAL CHARACTERISTICS OF MACROCONIDIA AND MICROCONIDIA OF DERMATOPHYTES

GENUS MACROCONIDIA MICROCONIDIA

MICROSPORUM Numerous, thick walled and rough Rare

EPIDERMOPHYTON Numerous, smooth walled Absent

TRICHOPHYTON RARE, thin walled, smooth Abundant

CLINICAL FEATURES OF DERMATOPHYTE INFECTION

AFFECTED AREAS CLINICAL MANIFESTATIONS

Tinea corporis Non-hair Clinical patches with advancing red, M. canis

(ring worm) Smooth skin vesiculated border and central scaling, pruritic T. mentagrophytes

Tinea pedis Interdigital spaces on Acute: itchy, red vesicular T. rubrum

feet of persons Chronic: Itchy, scaly, fissures T. mentagrophytes
wearing shoes E. floccosum

Tinea cruris (jock Groin Erythematous scaly lesion on intertriginous T. rubrum

itch) areas T. mentagrophytes
Pruritic E. floccosum

Tinea capitis Scalp hair Circular bald patches with short hair stubs or M. canis
- Endothrix- broken hair within hair follicles M. tonsurans
trichophyton spp.
fungus inside the Microsporum: infected hair fluorescens
hair shaft
- Exothrix-
Microsporum
spp. fungus on
surface of the
hair

Tinea barbae Beard hair Edematous T. rubrum

Erythematous T. mentagrophytes

Tinea unguim Nail Nails thickened or crumbing distally T. rubrum

(Onychomycosis) Discolored T. mentagrophytes
Usually associated with T.pedis E. floccosum

Types of T. capitis

Epidemic Antropophilic ● Caused by M. audoinii

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● Chronic, non-inflammatory and difficult to cure

● Occurs in children and contagious

Non-endemic Zoophilic ● Caused by T. mentagrophytes or M. canis

● Occurs primarily in children
● Transmitted by pets
● May induced a severe combined inflammatory and hypersensitivity reaction
called kerion

Black dot ● Caused by T.tonsurans

● Occurs in adults and is chronic infection
● Characterized by hair breakage

Favus Fungal scarring

TABLE CLASSIFICATIONS **

ANTHROPOPHILIC ZOOPHILIC GEOPHILIC

1. M. Audouinii 1. M. canis 1. M. cookie

2. T. mentagrophytes 2. M. equinum 2. T. gypsum
3. Var. interdigitae 3. M. gallinae 3. M. fulvum
4. T. rubrum 4. Mt. equinum 4. M. namum
5. T. tonsurans 5. T. mentagrophytes
6. T. violaceum 6. Var. mentagrophytes
7. E. floccosum

Tinea pedis Athlete's foot ● Occurs as chronic Treatment Differential diagnosis

infection of toe webs Azoles 1. Contact dermatitis
● Itching between toes and 2. Psoriasis
vesicles → discharge thin
fluid → skin becomes
macerated and peels →
cracking the skin.
● T. rubrum is the most
frequent organism
associated with the
disease.

Tinea unguium Onychomycosis ● Pale thickening Differential diagnosis

dystrophy of 1 or more 1. Psoriasis
nails. 2. Lichen planus
● May follow prolonged 3. Candidiasis
tinea pedis. 4. Hereditary nail dystrophies
● Nails may be yellow,
brittle, thickened and
crumbly.
● Associated with T.
rubrum.

Tinea corporis ● Annular lesion of ringworm.

● With scaly, central cleaning.
● Surrounded by red advancing border.
● May be dry or vesicular
● Associated with T. rubrum.
● Etiology:
○ Etiology:
- T. rubrum
- M. canis
- T. mentagrophytes

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Tinea cruris Jock itch ● Occurs in the groin area. Treatment Differential diagnosis
● Commonly involves Azoles 1. Seborrheic dermatitis
males. 2. Candidiasis
● Present as dry, itchy 3. Erythrasma
lesion 4. Psoriasis
● Starts on the scrotum
and spreads to the groins

Tinea manus ● Involves hands and fingers

● Dry scaly lesion of one or both hands, single or more fingers
● Associated with T. rubrum

Tinea barbae ● Involves the beard

● Associated with T. rubrum and T. verrucosum

Tinea Capitis ● Pattern: ectothrix, endothrix and favic.

● ringworm of the scalp and scalp hair, bearded region.
● Dull gray, circular patches of alopecia, scaling and itching
● Microsporum causes ectothrix infection

Tinea tonsurans ● Chief cause of black dot capitis

● Endothrix infection

Tinea favosa ● Chorionic, progressive inflammatory injection on the scalp.

(favus) ● Caused by trichophyton schoenleinii
● Characterized by permanent hair loss and inflammation of the scalp
● Scalp is covered by matted hair with dense, yellow follicular cup-shaped crust with unpleasant odor.

Tinea imbricata ● Chonic superficial mycosis produced by Trichophyton concentricum

(tolekau) ● Found in the tropica regions of Far East, South Pacific, SOuth and Central America and Africa.
●

Zoophilic ● Produce kerion which is a combined inflammatory and hypersensitivity reaction.

dermatophytes ● Has a good response to treatment

Dermatophytid or Id reaction ● Hypersensitivity to fungal antigens or products of the fungus → allergic

reaction
● There is NO presence of fungi on the lesion
● Secondary to bacteria
● Usually present as vesicles
● Located elsewhere on the body but most often in the hands.

COMPARISON OF HAIR INFECTION

ECTOTHRIX ENDOTHRIX

- NATURAL HAIR INVASION by dermatophyte characterized by the - NATURAL HAIR INVASION by the
formation of arthroconidia on the OUTSIDE OF THE SHAFT dermatophyte characterized by the
- The cuticle is DESTROYED formation of arthroconidia within the shaft
- Infected hair usually FLUORESCES a bright greenish yellow color under only.
the wood’s lamp - Hair cuticle remains intact
- M. canus, M. gypseum, M. equinum and T. Verrucosum - Infected hair DO NOT FLUORESCES
under the wood’s lamp.
- ALL ARE ANTHROPOPHILIC such as T.
tonsurans & T. violaceum

Additional notes (PPT)

- Endothrix: Trichophyton spp.
- Ectothrix: Microsporum spp.

Reviewer by: Maria Clarisse R. Baldonado, RPm 14

 MICROBIOLOGY

- Anatomic location:
- Tinea pedis: foot
- Tinea capitis: hair
- Tinea corporis: body
- Tinea cruris groin (jock itch)

SUMMARY TABLE:
FUNGI DISEASE UNIQUE FEATURE

Malassezia furur Tinea versicolor/ pityriasis ● Lipophilic fungi

versicolor ● Hypo or hyper pigmented skin lesion
Seborrheic dermatitis ● “Spaghetti and meatball appearance”

Exophiala werneckii Tinea nigra ● Brown to black macules in palms and

soles
● Dematiaceous fungi
● Annelloconidia - 2 celled yeast

Trichosporon beigelii White Piedra ● Beard. Axilla and groin hairs

● Soft granules white or light brown

Piedraia hortae Black piedra ● Scalp hair black to brown encrustations

FUNGI PARTS ECOLOGICAL CONIDIA HAIR UNIQUE FEATURES

INVOLVED GROUP INVASION

M. gypseum Skin. hair Geophilic Micro & macro Ectothrix Club shaped
Thin walled with 4- 6 cells

M. audouinii Skin. hair Anthropophilic RARE micro and Ectothrix Salmon pink colony reverse
macro

M. canis Skin. hair Zoophilic Micro & macro Ectothrix Spindle shaped macroconidia with
rough thick walls
8-15 cells

T. mentagrophytes Skin. hair and Anthropophilic Micro & macro Endothrix “EN GRAPPE” microconidia
nails

T. rubrum Skin. hair and Anthropophilic Micro & macro Endothrix EN THYRSE microconidia or
nails TEAR DROP microconidia

T. shoenleinii Skin. hair and Anthropophilic NO MICRO and Endothrix “FAVIC CHANDELIER” or antler r
nails MACRO nail hyphae

T. floccosum Skin, nails Anthropophilic MACRO NONE Club shaped macroconidia with
smooth walls in clusters
FUSEUX

Reviewer by: Maria Clarisse R. Baldonado, RPm 15