By / Dr Nuha Abou Sekkina

Lecturer of microbiology and immunology,

faculty of medicine, Helwan university
GENERAL MYCOLOGY
 OBJECTIVES
• Discuss general properties of fungi.

• Explain their structure.

• Explain their reproduction.

• Classify morphologically.

• Classify clinically and list examples.

• Explain antifungl drugs.

 MYCOLOGY
• Science of study of fungi.

• Thousand species of fungi exisists. Most of them are

saprophytes. Few are pathogenic.

• Fungi are eukaryotic organisms.

• Their cell wall consists primarily of chitin

• Their cell membrane contains ergosterol, in contrast

to human cell membrane that contains cholesterol.
Difference between fungi & bacteria
I- Morphological classification:

1- Yeasts.

2- Filamentous fungi .

3- Dimorphic fungi.
1- Yeasts:

• Oval or round cells.

• Reproduce by asexual budding.
• May have pseudohyphae.
• E.g. Candida and Crypt. Neoformans.
2- Filamentous fungi :

• Branching filaments (hyphae) which may be septate

or non septate.
• Reproduce by asexual spores (conidia), which may be
unicellula, microconidia or multicellula , macroconidia.

• E.g. the dermatophytes (Microsporum, Trichophyton

and Epidermophyton) and Aspergillus.
3- Dimorphic fungi:

• Occur in 2 forms:

• Yeast form in tissues or when grown at 37⁰C.

• Filamentous form (hyphea) when grown at 22⁰C.

• E.g. Histoplasma, Blastomyces, Coccidioides.

II- Clinical classification:
1- Superficial mycoses.

2- Cutaneous mycoses.

3- Subcutaneouc mycosis.

4- Systemic (endemic) mycoses.

5- Opportunistic mycoses.
1- Superficial mycoses:

• Confined to stratum corneum .

• Without tissue invasion.

• E.g. Pityriasis versicolor

(causing tinea versicolor)
2- Cutaneous mycoses:

• Infections involve skin, nail or hair

• With tissue destruction
• And immunological reaction.
• E.g. dermatophytes and candidiasis.
3- Subcutaneouc mycosis:

• Confined to subcutaneous tissue.

• without dissemination to distant sites.

• E.g.
• mycetoma,
• chromomycosis
• sporotrichosis.
4- Systemic (endemic) mycoses:

• Primary pulmonary lesions.

• Disseminate to any organ

(In immunocompromised patients).

• Caused by dimorphic fungi.

5- Opportunistic mycoses E.g. :

• Systemic candidiasis.
• Cryptococcosis.
• Aspergillosis.
• Mucor mycosis .
• Pneumocystis infections.
III- In addition to mycotic infections there are
two other kinds of fungal diseases:

a- Allergies.

b- Mycotoxicosis.
a- Allergies

• To fungal spores (Aspergillus, Alternaria ).

• They cause type I hypersensitivity reactions ( atopy).

• Manifesting as bronchial asthma, hay fever, urticaria

…….etc.
b- Mycotoxicosis:

Due to food containing fungal toxins e.g.

• Mycotoxicosis, after eating Amanita mushrooms cause

liver necrosis.

• Ergotism , is caused by the mold Claviceps purpura,

which infects grains produce alkaloids (e.g. ergotamine
and lysergic acid diethylamide LSD).

• Other toxins ingested with spoiled grains and peanuts,

aflatoxins which are metabolized in the liver to
epoxide, a potent carcinogen.
Aflatoxins
• Coumarin derivatives produced by Aspergillus flavus.

• They are hepatotoxic, cause tumours in animals and

hepatic carcinoma in man.

• Aflatoxin BI induces a mutation in the p53 tumour

suppressor gene, and loss of growth control in the
hepatocytes.
 ANTIFUNGAL DRUGS

• Selective toxicity is very limited in antifungal

drugs.
• due to the fact that ……………………

• The antifungal drugs bind to ergosterol in the

cell membrane or inhibit its synthesis .

• Others act by inhibiting chitin synthesis in the

cell wall.
EXAMPLES OF ANTIFUNGAL DRUGS

1.Amphotericin B
5. Terbinafine
2.Flucytosine
6. Caspofungin
3.Azoles
7. Topical agents
4.Griseofulvin
SITE OF ACTION OF ANTIFUNGAL DRUGS
1.Amphotericin B:

Mechanism: binds to ergosterol in cell membrane causing

its destruction
Used for: severe systemic & opportunistic mycosis
Route: IVI
Side effects: nephrotoxic
2. Flucytosine:

Mechanism: inhibits fungal DNA synthesis

Used for: with amphotericin B for candidiasis,
cryptococcosis
Route: oral
Side effects: bone marrow suppression, liver
affection, hair loss
3. Azoles (ketoconazole, fluconazole):

Mechanism: inhibit ergosterol synthesis

Used for: wide range systemic & local fungal
infections
Route: oral
Side effects: gynecomastia, impotance
4. Griseofulvin:

Mechanism: Prevent hyphal growth

Used for: For dermatophytes, course takes monthes
Route: oral

5. Terbinafine:

Mechanism: Inhibits ergosterol synthesis

Used for: For dermatophytes
Route: oral, topical
6. Caspofungin:

Mechanism: Block cell wall synthesis

Used for: invasive aspergillosis & candidiasis
Route: IVI

7. Topical agents:

Nystatin…….Candida
Clotrimazole, miconazole…..Candida, Tinea
versicolor