Hypersensitivity

 Air born spores

 Fungal elements
 Act as antigenic stimulants
 Immunological state of individual
 Induce hypersensitivity
 Production of immunoglobulin
 Sensitized lymphocytes
Hypersensitivity Cont.
 As Hypersensitivity pneumonitis
 Include rhinitis
 Bronchial asthma
 Various form of atopy
Colonization and resultant diseases
 Fungi are free living organisms
 Human have high level of immunity
 Most infection are mild
 Or self limiting
 Host immunity to fungal diseases
 Skin, mucosal surface
 Fatty acids, PH, normal flora
 Humoral factors such as transferrin
Classification of fungal diseases
 Superficial mycoses
 Outermost layers of skin, hair
 Cutaneous mycoses
 Epidermis, invasive hair, skin, nail
 Subcutaneous mycoses
 Dermis, muscle and fascia
 Systemic mycoses
 Lung and spread other organs
Fungal diseases Cont.
 Opportunistic mycoses
 Agents with low pathogenic
 Disease under certain conditions
 Host debilitations
 Change in the normal flora
 Cytotoxic drugs, steroids
 Immunosuppressive drugs and so on
 Candida species, Aspergillus,
Cryptococcus
Superficial Mycoses
 Cosmetic problems
 Easily diagnosed and treated
 2 involves skin (stratum corneum)
 Pityriasis versicolor
 Tinea nigra
 2 involves hair (cuticle)
 Black piedra
 White piedra
Pityriasis versicolor
 Malassezia furfur (P. orbiculare)
 A lipophilic yeast

 Related to P. ovale

 Area rich in sebaceous gland

 Normal flora of skin

 Infected area

 Upper torso, arm, abdomen

Clinical syndroms
 Hyper or hypopigmented lesions
 May cause hair and skin folliculitis

 Dandruff

 Fungmia in patients receiving IV

lipid therapy

Pityriasis folliculitis
 Laboratory diagnosis
 Direct microscopic examination
 Skin scraping
 KOH, alkali stain
 Fungal elements

 Classical spaghetti appearance

 Short hyphae and yeast cell
Culture media
 Not necessary but may be
 Required for fungmia

 Epidemiological study

 Treatment failure

 Growth require lipid such as olive oil

 Sabouraud dextrose agar

Tinea nigra
 Etiological agent
 Exophiala werneckii

 Dimorphic fungi

 Produce melanin pigments

 Clinical syndroms

 Grey to black demarcated lesion

 Palm of hand and soles of feet

Laboratory diagnosis
 Direct microscopic examination
 KOH, Alkali stain
 Skin scraping
 Darkly pigmented yeast-like cell
 Hyphal fragmented
 Culture
 SDA
 Black to brown yeast and hyphae
Black piedra
 Causative agent and disease
 Piedraia hortae
 Hard brown to black nodules
 Along hair shaft
 Ascospores on direct microscopic
White piedra
 Trichosporon beigelii
 Hair of scalp
 Moustache and beard
 Clinical future
 Soft white to creamy yellow
granules
 Form sleeve-like collarette
 Along hair shaft
Laboratory diagnosis
 Direct microscopic examination
 Culture on SDA without actidione
 Mycelium fragmented into arthroconidia

 Treatment of superficial mycoses

 Skin infection
 Topical keratolytic agents
 Azoles compounds
 Oral antifungal for generalized Tinea.
 versicolor
Treatment Cont.

Hair infection
 Shaving

 Proper personal hygiene