Mycology

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Eukaryotic organism Posses at least one nucleus nuclear membrane, endoplasmic reticulum, and mitochondria Lacks the property of photosynthesis

two basic morphological forms

Yeasts

are unicellular fungi which reproduce asexually by blastoconidia formation (budding) or fission multi-cellular fungi which reproduce asexually and/or sexually

Hyphae

**Dimorphism is the condition where by a fungus can exhibit either the yeast form or the hyphal form, depending on growth conditions

Morphology
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Thallus- vegetative portion of a fungus Hypha- filamentous or thread like of a thallus
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Non septate- without partition Septate- with partition Pectinate- with comblike lateral projection Spiral- with terminal cells

Mycelium- mass of countless hyphae synonymous to mold Spores ( conidia )- reproduction

Asexual spore- resistant to adverse growth condition

Thallospores- derived from the cells of the thallus or body of the fungus
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Blastophores- buds from yeast Chlamydospores arthrospores

Conidia- macroconidia, microconidia

Asexual spore

Ascospores- results from asexual production involving saclike structure called ascus Basidiospores- spores produces from the surface of a special structure called basidium Oospores- formed when two asexually formed spores unite

Fungal metabolism

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All fungi are free living they are not obligate intracellular parasites do not contain chlorophyll and cannot synthesize macromolecules from carbon dioxide and energy derived from light rays. Therefore all fungi are heterotrophs, living on preformed organic matter

important aspects of fungal metabolism are:

The synthesis of chitin, a polymer of N-acetyl glucosamine, and other compounds, for use in forming the cell wall. These induce immune hypersensitivity .

The synthesis of ergosterol for incorporation into the plasma membrane. This makes the plasma membrane sensitive to those antimicrobial agents which either block the synthesis of ergosterol or prevent its incorporation into the membrane or bind to it, e.g. amphotericin B.

The synthesis of proteins on ribosomes that are different from those found in bacteria. This makes the fungi immune to those antimicrobial agents that are directed against the bacterial ribosome, e.g., chloramphenicol.

The ability of certain metabolites to alter morphology of yeast and/or be assimilated by yeast with concomitant clinical identification affects.

Synthesis of toxin

Ergot alkaloids- these are produced by Claviceps purpurea and cause an alpha adrenergic blockade Psychotropic agents - these include psilocybin, psilocin and lysergic acid diethylamide (LSD)

Aflatoxins - these are carcinogens produced by Aspergillus flavus when growing on grain. When these grains are eaten by humans or when they are fed to dairy cattle and they get into the milk supply, they affect humans.

Clinical Techniques in Mycology

A. Visualization of fungi in tissue preparations

Treatment with 10% potassium hydroxide Positive stain with
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a. Lactophenol cotton blue b. Grocott silver stain c. Hematoxylin d. Eosin

3.

Negative stain with India ink

Fluorescence of fungi under ultraviolet light Culture of fungi on

1. Sabouraud's agar (favors fungal growth because of low pH) 2. Mycosel agar (selective for pathogenic fungi because of chloramphenicol and cycloheximide in medium)

Visualization of cultured fungi (25oC and 37oC)
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Identification of yeast by
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Colonial morphology Cellular morphology

Biochemical tests Behavior in broth and serum (germ tube formation) Behavior on cornmeal agar (pseudohyphae formation)

Classification of fungi

Class myxomycetes- no known pathogen Class zygomycetes

Ascomycotina –sexually reproduce involving the ascus Basidiomycotina- sexually reproduce involving the basidium Deuteromycotina- only asexual spore

Mycoses
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Superficial Cutaneous Subcutaneous Systemic or deep mycoses Mycoses due to opportunistic fungi

Superficial Mycoses

Tinea versicolor- caused by Malassezia furfur AKA pitysporum orbiculare Tinea nigra- caused by exophiala werneckii, cause dark pigmented patches on the skin Tinea nodosa (black piedra)- caused by piedraia hortae which characteristically form hard nodules along parasitized hair

White piedra- caused by trichosporon beiglelii, development of soft oval nodules adhering to the hair

Disease

Etiological Agent

Symptoms

Identification of organism

Pityriasis versicolor

Malassezia furfur

hypopigmented macules

"spaghetti and meatballs" appearance of organism in skin scrapings

Tinea nigra

Exophiala werneckii

black macules

black, 2-celled oval yeast in skin scrapings

Black piedra

Piedraia hortai

black nodule on hair shaft

black nodule on hair shaft composed of spore sacs and spores

White piedra

Trichosporum beigelii

creme-colored nodules on hair shaft

white nodule on hair shaft composed of mycelia that fragment into arthrospores

Tinea versicolor

Tinea nigra

Black piedra

Cutaneous mycosis

infections that extend deeper into the epidermis, as well as invasive hair and nail diseases. These diseases are restricted to the keratinized layers of the skin, hair and nails The agents causing these diseases are termed dermatophytes. The diseases are referred to as ringworm or tinea.

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Tinea capitis, tinea favosa- microsporum and tricophyton. Tinea barbae Tinea corporis- face and trunk Tinea cruris- affecting groin Tinea axilliaris Tinea pedis Tinea manuum Tinea unguim

Disease Tinea capitis

Etiological Agent Microsporum sp. Trichophyton sp. Epidermophyton sp.

Symptoms ringworm lesion of scalp

Indentification of organism Presence/absence and shape of microand macroconidia in scrapings from lesion

Tinea corporis

Microsporum sp. Trichophyton sp. Epidermophyton sp

ringworm lesion of trunk, arms, legs

Presence/absence and shape of microand macroconidia in scrapings from lesion

Tinea manus

Microsporum sp. Trichophyton sp. Epidermophyton sp

ringworm lesion of hand

Presence/absence and shape of microand macroconidia in scrapings from lesion

Tinea cruris "jock itch"

Microsporum sp. Trichophyton sp. Epidermophyton sp

ringworm lesion of groin

Presence/absence and shape of microand macroconidia in scrapings from lesion

Tinea pedis"athlete's foot"

Microsporum sp. Trichophyton sp. Epidermophyton sp

ringworm lesion of foot

Presence/absence and shape of microand macroconidia in scrapings from lesion

Tinea unguium

Microsporum sp. Trichophyton sp. Epidermophyton sp

infection of nails

Presence/absence and shape of microand macroconidia in scrapings from lesion

Ectothrix

Microsporum sp. Trichophyton sp. Epidermophyton sp

infection of hair shaft surface

Mycelium and spores on hair shaft

Endothrix

Microsporum sp. Trichophyton sp. Epidermophyton sp

infection of hair shaft interior

Mycelium and spores in hair shaft

Tinea capitis

Tinea fovosa

Tinea barbae

Tinea corporis

Tinea cruris

Tinea cruris 2

Tinea pedis

Tinea manuum

Tinea unguim

Subcutanoues mycoses

infections involving the dermis, subcutaneous tissues, muscle and fascia These infections initially involve the deeper layers of the dermis, subcutaneous tissue or bone

Sporotrichosis- sphorothrix schenkii, starts with the subcutaneous nodule followed by the chain of draining ulcers Chromoblastomycosis- granulomatous verrucose ulcerative infection, painless unless complicated by bacteria
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Phialophora verrucosa Cladosporium carrionii Fonsecaea pedrosi Fonsecaea compactum

Mycetoma
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Pseudallescheria boydii Madurella grisea Madurella mycetomatis

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Draining sinus tracts at site of inoculation White, brown, yellow or black granules in exudate that are fungal colonies

Disease

Etiological Agent

Symptoms

Identification of Organism

Sporotrichosis

Sporothrix schenckii

Nodules and ulcers along lymphatics at Budding yeast in tissue exudate that site of inoculation converts to mold with "rosette pattern" of conidiation on culture at 25oC.

Chromoblastomycosis

Fonsecaea pedrosoi Fonsecaea compacta Wangiella dermatitidis

Warty nodules that progress to "cauliflower-like" appearance at site of inoculation

Copper-colored spherical yeast called "Medlar bodies" in tissue

Mycetoma

Pseudallescheria boydii Madurella grisea Madurella mycetomatis

Draining sinus tracts at site of inoculation

White, brown, yellow or black granules in exudate that are fungal colonies

keratomycosis

sporotrichosis

Systemic mycoses

infections that originate primarily in the lung and may spread to many organ systems. Unlike most other fungi, the five systemic mycotic agents are inherently virulent. Each species has biochemical and structural

Systemic mycosis
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Coccidiodes immitis- coccidiomycosis Histoplasma capsulatum- agent of histoplasmosis which involves the lungs, spleen, lymph glands, kidneys and brain - KOH is not useful in the diagnosis but buffy coat, bone marrow and lymph nodes biopsy or mucosal scrappings

Cryptococcus neoformans- subacute or chronic infection that involves the CNS Blastomyces dermatidis- chronic granulomatous and suppurative condition that involves the lungs and the pleurae that simulates tuberculosis Candida albicans- infection that involves nails, vulvo-vagina, CNS, pericardium, lungs

Nocardia asteroides- chronic granulomatous condition of the lungs and the CNS Aspergillus- associated with prolongs antibiotic therapy

histoplasmosis

cryptococcosis

cryptococcosis

candidiasis

candidiasis

nocardia

aspegillus

Opportunistic mycosis
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infections in patients with immune deficiencies who would otherwise not be infected Opportunistic mycoses are seen in those people with impaired host defenses such as occurs in
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AIDS Alteration of normal flora Diabetes mellitus Immunosuppressive therapy Malignancy

Disease

Etiological Agent

Symptoms

Identification of organism

Candidiases

Candida albicans

Creamy growth on various areas of body

Budding yeast, septate hyphae, pseudohyphae in tissue. Germ tubeformation in serum

Aspergillosis

Aspergillus fumigatus

"Fungus ball" in tissue

Morphology of asexual fruiting structure

Zygomycosis

Rhizopus sp. Absidia sp. Mucor sp.

Various

Morphology of asexual fruiting structure and mycelium