FUNGAL

INFECTIONS OF
HUMANS
CHAPTER 20
LEARNING OBJECTIVES:
After studying Chapter 20, you should be able to:
• Define the terms mycosis, dimorphic, cutaneous,
subcutaneous, and systemic
• Categorize various fungal diseases by body system
• Correlate a particular fungal disease with its major
characteristics, etiologic agent, reservoir(s), mode(s) of
transmission, and diagnostic laboratory procedures
LEARNING OBJECTIVES:
• Briefly explain how fungi cause disease
• Classify a given fungal infection as being a superficial,
cutaneous, subcutaneous, or systemic
• State several diseases caused by dimorphic fungi and
describe their yeast and mould forms
INTRODUCTION
• Fungal infections are also known as mycoses.
• Human mycoses are caused by fungi within 3 fungal
categories:
1. yeast
2. moulds
3. dimorphic fungi (may grow as yeasts or moulds)
HOW DO FUNGI CAUSE DISEASE?
• Direct invasion of tissue, with subsequent displacement
and destruction of vital structures, coupled with toxic
effects of the inflammatory response
CLASSIFICATION OF FUNGAL DISEASE
1) Superficial Mycoses
2) Cutaneous, Hair, and Nail Mycoses (Dermatomycoses)
3) Subcutaneous Mycoses
4) Systemic Mycoses
SUPERFICIAL MYCOSES

• fungal infections of the outermost areas of the human

body, including the outer surfaces of hair shafts and the
outermost, nonliving layer of the skin (the epidermis).
• diagnosed on the basis of clinical appearance
SUPERFICIAL MYCOSES
DISEASE DESCRIPTION PATHOGEN
Black piedra Fungal infection of scalp hair; less Piedraia bortae
common on eyebrows and eyelashes
White piedra Fungal infection of moustache, beard, Trichosporon spp.
pubic, and axilla hair
Tinea versicolor A ringworm infection that affects the Malassezia furfur
skin of the chest or back; less common
on arms, thighs, neck, and face
Tinea nigra An infection of the palms of the hands; Hortaea werneckii
less common on the neck and feet
DERMATOMYCOSES

• fungal infections of the living

layers of skin (the dermis), hair
shafts, and nails—commonly
called tinea infections or
ringworm infections—are caused
by a group of moulds collectively
referred to as dermatophytes.
DERMATOMYCOSES
FUNGAL MODE OF LABORATORY
PATHOGEN RESERVOIRS
INFECTION TRANSMISSION DIAGNOSIS

Dermatomyc Species of -Infected -direct or indirect -microscopic

oses Microsporum, humans contact with lesions examination of KOH
Epidermophyt -Animals of humans or preparations of skin
on, -Soil animals scrapings / hair /
Trichophyton -contact with nail clippings
nonliving things -can be cultured on
various media
SUBCUTANEOUS MYCOSES

• fungal infections of the dermis and underlying tissues

• more severe than superficial and cutaneous mycoses
• results from traumatic implantation of the mould through
the dermis into the subcutaneous tissue
• examples: sporotrichosis, phaeohyphomycosis, and
mycetomas.
SUBCUTANEOUS MYCOSES

• examples: sporotrichosis, phaeohyphomycosis, and

mycetomas.
• often diagnosed through histologic examination of biopsy
specimens
SYSTEMIC MYCOSES

• aka Generalized or Deep-seated mycoses

• the most serious types of fungal infections
• fungal infections of internal organs of the body, sometimes
affecting two or more organ systems simultaneously
SYSTEMIC MYCOSES
FUNGAL MODE OF LABORATORY
PATHOGEN RESERVOIRS
INFECTION TRANSMISSION DIAGNOSIS

Systemic • Aspergillus spp. • Acquired • Passed person to • Immunodiagnostic

Mycoses • Penicillium spp. through person through assays
• Pneumocystis inhalation of aerosols • Molecular Diagnostic
• Scedosporium spores or Procedures
spp. conidia. • Culture with
• members of the • For macroscopic and
Zygomycete family Pneumocystis, microscopic
through observation
aerosols.
FUNGAL INFECTIONS OF THE ORAL REGION
FUNGAL MODE OF LABORATORY
PATHOGEN RESERVOIRS
INFECTION TRANSMISSION DIAGNOSIS
Thrush • C. albicans and • infected • contact with • observation
related species humans secretions or excretions of yeast cells and
of mouth, skin, vagina, pseudohyphae in
or feces of patients or microscopic
carriers; examination of wet
• mother to neonate mounts
during childbirth and by • culture confirmation
endogenous spread
FUNGAL INFECTIONS OF THE GENITOURINARY
SYSTEM
FUNGAL MODE OF LABORATORY
PATHOGEN RESERVOIRS
INFECTION TRANSMISSION DIAGNOSIS
Yeast • C. albicans, • infected • contact with • microscopic
Vaginitis causes about 85% humans secretions or excretions examination of a saline
to 90% of yeast of mouth, skin, vagina, wet mount of vaginal
vaginitis; or feces of patients or discharge material
• other Candida carriers;
spp. • mother to neonate
during childbirth and by
endogenous spread
FUNGAL INFECTIONS OF THE CENTRAL
NERVOUS SYSTEM
FUNGAL MODE OF LABORATORY
PATHOGEN RESERVOIRS
INFECTION TRANSMISSION DIAGNOSIS
Cryptococcosis • Cryptococcus: C. • pigeon nests • inhalation of yeasts • observing
(Cryptococcal neoformans and • pigeon • not transmitted from encapsulated, budding
Meningitis) Cryptococcus gatii • chicken person to person or yeasts in cerebrospinal
• turkey animal to person fluid specimens
• bat droppings examined by an India
• soil ink preparation
contaminated
with bird
droppings.
MICROSPORIDIAL INFECTION
APPROPRIATE THERAPY FOR FUNGAL
INFECTIONS
• the treatment of infectious diseases change frequently
• must be treated using appropriate antifungal drugs
(antimycotic drugs)
THANK
YOU!