SOME DISEASES CAUSED
BY FILAMENTOUS FUNGI
• Chromoblastomycosis
• Mycetoma
• Mucormycosis ****
• Aspergillosis ****
CHROMOBLASTOMYCOSIS
A chronic localized infection of the
subcutaneous tissue caused by several
species of dematiaceous fungi
Chromoblastomycosis
Fonsecaea pedrosoi
Cladosporium carrionii
Phialophora verrucosa
Ecological Association
Chromoblastomycosis
• Soil
• Decaying vegetation
Sclerotic Bodies
A fungus form resulting from host
defenses
SCLEROTIC BODIES
Chromoblastomycosis
Melanin may be a virulence factor
Geographic distribution
World-wide
(usually warmer climates)
CLINICAL SPECIMENS
• PUS
• BIOPSY MATERIAL
TREATMENT
• EXCISION
• TERBINEFINE
• ITRACONAZOLE
• POSACONAZOLE
No Serological Tests Available
sporptrichosis
Sporothrixis schinkii
• Tissue form cigar body
shape yeasts at37
• There is always a history of
rose thorn trauma
Dimorphic fungi
• Invitro shape is rose like
hyphi at 22C
ͦ
• The patients could be a
farmer or rose grower or
flower decorator
SPOROTRICHOSIS
Mycetoma
• Tumefaction
• Granules
• Draining sinus tracts
• Muscle invasion
• Bone invasion
Mycetoma agents
• Madurella mycetomatis
• Phialophora jeanselmei
• Pseudallescheria boydii
GEOGRAPHIC
DISTRIBUTION
WARM CLIMATES
(SE United States, South America,
Africa)
ECOLOGICAL ASSOCIATION
SOIL
Clinical Specimens
Mycetoma
•
Pus
• Tissue
IDENTIFICATION
• Colonial morphology
• Conidia formation
• Granules
– Color
– Size shape
– Texture
• Biochemical reactions
D
e
DEMATIACEOUS HYPHAE
Serological Test
Pseudalescheria
Immunodiffusion
Therapy
Terbinefine
Itraconazole
Posaconazole
Mucormycosis
An acute infection characterized by
inflammation and vascular invasion
and thrombosis.
Portal of entry
• Inhalation
• Ingestion
• Surface contamination (burns)
Mucormycosis
*Rhizopus species
Mucor species
Absidia species.
GEOGRAPHIC
DISTRIBUTION
WORLDWIDE
ECOLOGICAL NICHE
UBIQUITOUS
• FOOD
• SOIL
• ORGANIC DEBRIS
UNCONTROLLED DIABETIC
Rapidly fatal
MUCORMYCOSIS
CLINICAL SIGNS
Ketoacidosis
Nasal stuffiness
Proptosis
Eschar
CHARACTERISITICS OF
MUCOR INFECTION
• AFFINITY FOR ARTERIAL INVASION
• NASAL OR SINUS INFECTIONS
• DIRECT EXTENSION TO THE BRAIN
THROUGH CRIBIFORM PLATE
• RAPIDLY FATAL
WIDE, NON-SEPTATE, RIBBON-LIKE
TREATMENT
MUCORMYCOSIS
• Control diabetes (or other underlying
condition)
• Biopsy
• Culture
• Surgery (Debridement)
• Amphotericin B
SEROLOGIC TEST
IMMUNODIFFUSION
ASPERGILLOSIS
A variety of diseases:
pulmonary, external ears, eyes,
meninges, sinuses or blood stream
CLINICAL TYPES OF
PULMONARY DISEASE
1. ALLERGIC
2. FUNGUS BALL
3. INVASIVE
Difficult to diagnose
1.
Clinical symptoms are not specific
2.
Radiography not specific (except fungus ball)
3.
Blood cultures seldom positive
4.
Serology seldom positive (early)
5.
Need invasive procedures for early detection
COMMON PATHOGENIC
SPECIES
• A. FUMIGATUS
• A. NIGER
• A. FLAVUS
GEOGRAPHIC
DISTRIBUTION
WORLD-WIDE
ECOLOGICAL ASSOCIATION
UBIQUITOUS
• SOIL
• DECAYING VEGETATION
• FOOD
• MEDICATION
• AIR VENTS
• DISINFECTANTS
Culture
• More than 900 species
• Slow growing
• Various gross colors
• Spores
– Size
– Shape
– Texture
– color
HISTOPATHOLOGY
• DICHOTOMOUS BRANCHING
• WIDE, SEPTATE HYPHAE
DICHOTOMOUS BRANCHING
Aspergilloma
Cavity
wall
SEROLOGIC TESTS
1. IMMUNODIFFUSION
(antibody)
2. EIA - GALACTOMANNAN
(antigen
)
DRUG OF CHOICE
VORICONAZOLE
AMPHOTERICIN B
DIMORPHIC FUNGI
(Endemic Mycoses)
COMMON CHARACTERISTICS
• LIMITED GEOGRAPHIC AREA
• SPECIFIC ECOLOGICAL NICHE
• SYSTEMIC INFECTIONS
• MORPHOLOGICALLY DISTINCT
BLASTOMYCOSIS
Blastomyces dermatitidis
BLASTOMYCOSIS
A CHRONIC SUPPURATIVE AND
GRANULOMATOUS DISEASE OF ANY TISSUE
WITH A PREDILECTION FOR LUNGS, SKIN,
PROSTATE AND BONE.
PORTAL OF ENTRY
INHALATION
INOCULATION
(rare)
CLINICAL FORMS
1. SYSTEMIC
USUALLY PULMONARY
2. CUTANEOUS
PRIMARY
SECONDARY
Pulmonary Symptoms
• Anorexia
• Weight loss
• Cough
• Hemoptysis
• Night sweats
CLINICAL SPECIMENS
• SKIN SCRAPINGS
• SPUTUM
• PUS
• BIOPSY MATERIAL
• URINE
• BRONCHIAL WASHINGS
ECOLOGICAL ASSOCIATION
ORGANIC DEBRIS
(SOIL, ROTTED WOOD,
DECAYED VEGETATION)
Virulence Factor
BAD1
Identification
• 1. Microscopic observation
• 2. Conversion
• 3. DNA Probe
Wet Mount
SEROLOGIC TEST
• IMMUNODIFFUSION
• COMPLEMENT FIXATION
• EIA
DRUGS OF CHOICE
•ITRACONAZOLE
•AMPHOTERICIN B
•VORICONAZOLE
END