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Medical Mycology
              Introduction to Basics
                   Dr.T.V.Rao MD




11/23/2012            Dr.T.V.Rao MD    1
Introduction
•        Mykes (Greek word) : Mushroom
•        Fungi are eukaryotic protista; differ from
         bacteria and other prokaryotes.
       1. Cell walls containing chitin (rigidity & support), mannan &
          other polysaccharides
       2. Cytoplasmic membrane contains ergosterols
       3. Possess true nuclei with nuclear membrane & paired
          chromosomes.
       4. Divide asexually, sexually or by both
       5. Unicellular or multicellular

    11/23/2012                 Dr.T.V.Rao MD                       2
Characteristics of Fungus
• Diverse group of chemo heterotrophs
      – > 90,000 known species
• Saprophytes
      – Digest dead organic matter
• Parasites
      – Obtain nutrients from tissues of organisms
• Molds & mushrooms are multicellular
• Yeasts are unicellular

11/23/2012                 Dr.T.V.Rao MD             3
Fungus Everywhere




11/23/2012         Dr.T.V.Rao MD   4
How the fungus are nourished

• All are chemo heterotrophs
• Absorption of nutrients: powerful
  Exoenzyme
• Grow at lower pH-5 than bacteria
• Grow in high salt and sugar
• Metabolize complex CH2O like lignin in
  wood-wood rot
11/23/2012        Dr.T.V.Rao MD            5
Mycology
• Present as saprophytes in soil, decaying
  plants ,nature.
• Eukaryotes
• Known before bacteria Botanists
• Developing Nations changing trends USA
• More serious and even fatal diseases,

11/23/2012        Dr.T.V.Rao MD              6
FUNGI (Mycology)
 Diverse group of heterotrophs.
  – Many are ecologically important saprophytes (consume dead and
    decaying matter)
  – Others are parasites.
 Most are multicellular, but yeasts are unicellular.
 Most are aerobes or facultative anaerobes.
 Cell walls are made up of chitin (polysaccharide).
 Over 100,000 fungal species identified. Only about
 100 are human or animal pathogens.
  – Most human fungal infections are nosocomial and/or occur in
      immunocompromised individuals (opportunistic infections). 7
  11/23/2012                Dr.T.V.Rao MD
Understanding the Structure of
                 Fungi
• Yeasts and molds have different structural and
  reproductive characteristics
   – Yeast are unicellular, nucleated rounded fungi while
     molds are multicellular, filamentous fungi
   – Yeast reproduce by a process called budding while
     molds produce spores to reproduce
   – Some yeast are opportunistic pathogens in that they
     cause disease in immuno-compromised individuals
   – Yeast are used in the preparation in the variety of
     foods

 11/23/2012               Dr.T.V.Rao MD                 8
Predisposing factors
• Use of
  Antibiotics,
• Use of
  steroids,
• Immunosuppressive
    conditions
11/23/2012           Dr.T.V.Rao MD   9
Fungal Diseases
 • Mycosis- fungal infection
       – < 100 cause human disease
       – Not highly contagious
       – Humans acquire from nature
 • Groups based on degree on tissue
   involvement and mode of entry
 • Cutaneous mycoses-dermatophytes
       – Epidermis, hair & nails
       – Contagious-direct or indirect contact
       – Secrete keratinase that degrades keratin
11/23/2012               Dr.T.V.Rao MD              10
Fungal Morphology
                  Hyphae (threads)                   Yeasts
              making up a mycelium




Many pathogenic fungi
are dimorphic, forming
hyphae at ambient
temperatures but yeasts
at body temperature.


 11/23/2012                          Dr.T.V.Rao MD            11
Structure of Fungi
• Vegetative structures involved in
  catabolism and growth
• Thallus- in molds and fleshy fungi
    – Tubular filaments of cells-hyphae
    – Septate hyphae - cross walls that divide them
      into unicellular units
          • Pores to allow cytoplasm & nuclei to pass
    – Coenocytic hyphae- no septa, continuous
      cells with many nuclei

 11/23/2012                  Dr.T.V.Rao MD              12
Basic structure of Fungus
• Cell wall is rigid
• Contains
        Chitin,Mannan, Polysaccharides,
Cytoplasm contains Sterols.
Contains True Nuclei, Paired chromosome.
Divide
     Sexually, Asexually or by Both
Can have specialized cells

11/23/2012         Dr.T.V.Rao MD           13
Characteristics of fungi
      A. eukaryotic, non- vascular organisms
      B. reproduce by means of spores, usually
      wind-disseminated
      C. both sexual (meiotic) and asexual
      (mitotic) spores may be produced,
      depending on the species and conditions
      D. typically not motile, although a few (e.g.
      Chytrids) have a motile phase.
       E. like plants, fungi have an alternation of
      generations
11/23/2012               Dr.T.V.Rao MD                14
Understanding the Terms in Mycology
• Simplest Unicellular, Budding yeasts,
• Tubular elongations Thread like structures
  called as Hyphae
• Tangled mass is called as Mycelium
• Molding produces filamentous fungi.
• Septate Aseptate
• Grown up Aerial Mycelium
• Grows into media Vegetative mycelium

11/23/2012           Dr.T.V.Rao MD             15
Understanding the Structure of
                 Fungus
• Simplest fungus :- Unicellular budding
  yeast
• Hypha :- Elongation of apical cell
  produces a tubular, thread like structure
  called hypha
• Mycelium :- Tangled mass of hyphae is called
  mycelium. Fungi producing mycelia are
  called molds or filamentous fungi.
• Hyphae may be septate or non-septate
  11/23/2012        Dr.T.V.Rao MD         16
11/23/2012   Dr.T.V.Rao MD   17
CLASSIFICATION
• Depending on cell morphology
 1. Yeasts
 2. Yeast like fungi
 3. Molds
 4. Dimorphic fungi

 11/23/2012     Dr.T.V.Rao MD    18
Yeasts
                      •       Unicellular fungi
                              which reproduce
                              by budding
                      •       On culture -
                              produce
                              smooth, creamy
                              colonies
                              e. g Cryptococcus
                              neoformans
                              (capsulated yeast)
11/23/2012    Dr.T.V.Rao MD                        19
Yeast like fungi
  •      Grow partly as yeasts and partly as
         elongated cells resembling hyphae which
         are called pseudo hyphae.      e.g. Candida
         albicans




11/23/2012              Dr.T.V.Rao MD              20
Molds/ Filamentous fungi
•       Form true mycelia &
        reproduce by formation
        of different types of
        spores.
•       Vegetative/ aerial
        hyphae
        e.g. Rhizopus, Mucor


    11/23/2012          Dr.T.V.Rao MD   21
4. Dimorphic fungi
•      Occur in 2 forms
          Molds (Filaments) – 25 C (soil)
          Yeasts – 37 C (in host tissue)
      Most fungi causing systemic infections are
      dimorphic:
        –    Histoplasma capsulatum
        –    Blastomyces dermatidis
        –    Paracoccidioides brasiliensis
        –    Coccidioides immitis
        –    Penicillium marneffei
        –    Sporothrix schenkii
    11/23/2012                 Dr.T.V.Rao MD       22
Reproduction in fungi
• Sexual - formation of Zygospore, ascospores
      or basidiospores
• Asexual reproduction – budding or
      fission
•     Asexual spores are formed on or in specialized
      structures.
•     Vary in size, shape & colour but these
      characteristics are constant for a particular
      species.
11/23/2012               Dr.T.V.Rao MD            23
Reproduction in fungi
  • Micro
    conidia -
    Small, single
    celled
  • Macro conidia
    – Large, single
         or many celled
11/23/2012            Dr.T.V.Rao MD   24
Systematic classification
• Based on sexual spore formation:
  4 classes
  1. Zygomycetes
  2. Ascomycetes                      reproduce
     sexually
  3. Basidiomycetes
  4. Deuteromycetes (fungi imperfectii)
11/23/2012            Dr.T.V.Rao MD               25
Zygomycetes
• Lower fungi
• Broad, nonseptate
  hyphae
• Asexual spores -
  Sporangiospores:
  present within a swollen
  sac- like structure called
     Sporangium
11/23/2012         Dr.T.V.Rao MD   26
Zygomycetes
• Sexual spores -
  Zygospore: a
  resting, thick
  walled cell in
  between hyphae
  e.g.
  Rhizopus, Mucor
11/23/2012      Dr.T.V.Rao MD   27
Ascomycetes
•      Includes both yeasts & filamentous fungi
•      Narrow, septate hyphae
•      Asexual spores are called conidia borne on
       conidiophore




    11/23/2012                 Dr.T.V.Rao MD        28
Ascomycetes
•     Sexual spores called
      ascospores are present
      within a sac like
      structure called Ascus.
•     Several asci may be
      seen within a fruiting
      body as seen in
      Penicillium, Aspergillus
•     Each ascus has 4 to 8
      ascospores.
11/23/2012             Dr.T.V.Rao MD   29
Basidiomycetes
•      Sexual fusion results in the formation of a club
      shaped organ called base or basidium which bear
                 spores called basidiospores




    11/23/2012           Dr.T.V.Rao MD             30
Deuteromycetes
             or Fungi imperfectii
  • Group of fungi whose sexual
    phases are not identified.
  • Grow as molds as well as yeasts.
  • Asexual stage – conidia
    e.g. Candida, Cryptococcus

11/23/2012         Dr.T.V.Rao MD       31
Vegetative Structures of Fungi

• Arthrospores –
     formed by
     segmentation &
     condensation of hyphae
• Chlamydospores –
    thick walled resting
    spores
    e.g. C.albicans

11/23/2012            Dr.T.V.Rao MD   32
Asexual Spores
• Produced by aerial hyphae: adapted for dispersal
• Progeny genetically identical to parent
• Several types
   – Conidiospores- not enclosed in a sac
      • produced in a chain at end of a conidiophore
      • Several types
   – Sporangiospores
      • Within a sac, sporangium
      • End of sporangiophore
Sexual Spores
• Three phases of development
  – Plasmogamy-haploid nucleus of a donor cell (+)
    penetrates the cytoplasm of a recipient cell (-)
  – Karyogamy- the 2 nuclei fuse to form a diploid
    nucleus
  – Meiosis-diploid nucleus gives rise to haploid
    nuclei
  – Sexual spores, some + , some -,some
    recombinants
  – Sexual spores used to classify fungi into divisions
Fungal Infections/ Mycoses
  • Superficial mycoses:
       – 2 types: surface and cutaneous mycoses
       – Skin, hair & nails.
       – Mild but chronic disease
  • Deep mycoses:
       –     2 types: subcutaneous & systemic mycoses
       –     Caused by soil saprophytes
       –     Infection is accidental
       –     Range from a symptomatic infection to fatal disease


11/23/2012                      Dr.T.V.Rao MD                      35
Superficial: Surface mycoses
• Live exclusively on dead surfaces of
  skin and its appendages
• No contact with living tissue, hence
  no inflammatory response
   1. Tinea versicolor
   2. Tinea nigra
   3. Piedra

11/23/2012               Dr.T.V.Rao MD   36
Superficial: Cutaneous mycoses
  •      Cornified layer of skin & its appendages

  •      Contact with living tissue, hence
         inflammatory & allergic responses seen
       1. Dermatophytes – skin, hair & nails
       2. 3 genera - Trichophyton
                    Microsporum
                    Epidermophyton

11/23/2012               Dr.T.V.Rao MD              37
CHARACTERISTICS OF FUNGI (Continued)
                             Dimorphic Fungi
 Can exist as both multicellular fungi (molds) and yeasts.
 Many pathogenic species.
    – Mold form produces aerial and vegetative hyphae.
    – Yeast form reproduces by budding.
 Dimorphism in pathogenic fungi typically depends on
  temperature:
    – At 37oC: Yeast form.
    – At 25oC: Mold form.
 Dimorphism in nonpathogenic fungi may depend on other
  factors: Carbon dioxide concentration.
   11/23/2012                     Dr.T.V.Rao MD               38
Mycoses
                       • Superficial
                       • Cutaneous
                       • Subcutaneous
                       •Systemic
                       • Opportunistic

11/23/2012     Dr.T.V.Rao MD         39
Deep mycoses
 Subcutaneous mycoses             Systemic mycoses
   1. Mycotic                     1. Cryptococcoses
      Mycetoma                    2. Blastomycosis
   2. Chromoblastomyc             3. Coccidioidomyc
      oses                           oses
   3. Sporotrichosis              4. Histoplasmoses
   4. Rhinosporidiosis
11/23/2012        Dr.T.V.Rao MD                  40
Candidiasis
• Caused by candida sps, forms a
  bridge between superficial & deep
  mycoses as it can cause cutaneous as
  well as systemic infections
• Can also cause opportunistc
   infections

11/23/2012      Dr.T.V.Rao MD        41
Opportunistic infections
  • Pts with debilitating disease, altered physiological
    state
  • Mainly caused by fungi which are common lab
    contaminant on culture media
       –     Aspergillus
       –     Pencillium
       –     Mucor
       –     Rhizopus
  • Produce serious & fatal infections

11/23/2012                 Dr.T.V.Rao MD                   42
Useful Properties of Fungi




     Source of food                                  Antibiotic production
     e.g. mushrooms                                  e.g. Penicillin from
                                                     Penicillium notatum


                      Fermentation - Production of
                      alcohol, bread, cheese
                      e.g. Sacchromyces spps
11/23/2012                    Dr.T.V.Rao MD                            43
Useful Properties of Fungi




               Ergot from Claviceps             Vaccines for Hepatitis B –
             purpurea, used to induce           Sacchromyces cerevisiae
               uterine contractions




11/23/2012                      Dr.T.V.Rao MD                                44
Diagnosis/Treatment
• Grown in medium that selects for fungal
  growth
      – Grow at 25 C and 37 C
• KOH preparations of skin biopsies
      – Dissolves keratin in skin scrapings or biopsies
      – Leaves only fungal cells
• Therapy- amphotericin B or ketoconazole
      – Toxic to humans


11/23/2012                  Dr.T.V.Rao MD                 45
• Programme Created by Dr.T.V.Rao MD
   for Medical and Paramedical Students in
            the Developing World
                  • Email
         • doctortvrao@gmail.com


11/23/2012         Dr.T.V.Rao MD         46

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Introduction to Medical Mycology Basics

  • 1. Medical Mycology Introduction to Basics Dr.T.V.Rao MD 11/23/2012 Dr.T.V.Rao MD 1
  • 2. Introduction • Mykes (Greek word) : Mushroom • Fungi are eukaryotic protista; differ from bacteria and other prokaryotes. 1. Cell walls containing chitin (rigidity & support), mannan & other polysaccharides 2. Cytoplasmic membrane contains ergosterols 3. Possess true nuclei with nuclear membrane & paired chromosomes. 4. Divide asexually, sexually or by both 5. Unicellular or multicellular 11/23/2012 Dr.T.V.Rao MD 2
  • 3. Characteristics of Fungus • Diverse group of chemo heterotrophs – > 90,000 known species • Saprophytes – Digest dead organic matter • Parasites – Obtain nutrients from tissues of organisms • Molds & mushrooms are multicellular • Yeasts are unicellular 11/23/2012 Dr.T.V.Rao MD 3
  • 5. How the fungus are nourished • All are chemo heterotrophs • Absorption of nutrients: powerful Exoenzyme • Grow at lower pH-5 than bacteria • Grow in high salt and sugar • Metabolize complex CH2O like lignin in wood-wood rot 11/23/2012 Dr.T.V.Rao MD 5
  • 6. Mycology • Present as saprophytes in soil, decaying plants ,nature. • Eukaryotes • Known before bacteria Botanists • Developing Nations changing trends USA • More serious and even fatal diseases, 11/23/2012 Dr.T.V.Rao MD 6
  • 7. FUNGI (Mycology)  Diverse group of heterotrophs. – Many are ecologically important saprophytes (consume dead and decaying matter) – Others are parasites.  Most are multicellular, but yeasts are unicellular.  Most are aerobes or facultative anaerobes.  Cell walls are made up of chitin (polysaccharide).  Over 100,000 fungal species identified. Only about 100 are human or animal pathogens. – Most human fungal infections are nosocomial and/or occur in immunocompromised individuals (opportunistic infections). 7 11/23/2012 Dr.T.V.Rao MD
  • 8. Understanding the Structure of Fungi • Yeasts and molds have different structural and reproductive characteristics – Yeast are unicellular, nucleated rounded fungi while molds are multicellular, filamentous fungi – Yeast reproduce by a process called budding while molds produce spores to reproduce – Some yeast are opportunistic pathogens in that they cause disease in immuno-compromised individuals – Yeast are used in the preparation in the variety of foods 11/23/2012 Dr.T.V.Rao MD 8
  • 9. Predisposing factors • Use of Antibiotics, • Use of steroids, • Immunosuppressive conditions 11/23/2012 Dr.T.V.Rao MD 9
  • 10. Fungal Diseases • Mycosis- fungal infection – < 100 cause human disease – Not highly contagious – Humans acquire from nature • Groups based on degree on tissue involvement and mode of entry • Cutaneous mycoses-dermatophytes – Epidermis, hair & nails – Contagious-direct or indirect contact – Secrete keratinase that degrades keratin 11/23/2012 Dr.T.V.Rao MD 10
  • 11. Fungal Morphology Hyphae (threads) Yeasts making up a mycelium Many pathogenic fungi are dimorphic, forming hyphae at ambient temperatures but yeasts at body temperature. 11/23/2012 Dr.T.V.Rao MD 11
  • 12. Structure of Fungi • Vegetative structures involved in catabolism and growth • Thallus- in molds and fleshy fungi – Tubular filaments of cells-hyphae – Septate hyphae - cross walls that divide them into unicellular units • Pores to allow cytoplasm & nuclei to pass – Coenocytic hyphae- no septa, continuous cells with many nuclei 11/23/2012 Dr.T.V.Rao MD 12
  • 13. Basic structure of Fungus • Cell wall is rigid • Contains Chitin,Mannan, Polysaccharides, Cytoplasm contains Sterols. Contains True Nuclei, Paired chromosome. Divide Sexually, Asexually or by Both Can have specialized cells 11/23/2012 Dr.T.V.Rao MD 13
  • 14. Characteristics of fungi A. eukaryotic, non- vascular organisms B. reproduce by means of spores, usually wind-disseminated C. both sexual (meiotic) and asexual (mitotic) spores may be produced, depending on the species and conditions D. typically not motile, although a few (e.g. Chytrids) have a motile phase. E. like plants, fungi have an alternation of generations 11/23/2012 Dr.T.V.Rao MD 14
  • 15. Understanding the Terms in Mycology • Simplest Unicellular, Budding yeasts, • Tubular elongations Thread like structures called as Hyphae • Tangled mass is called as Mycelium • Molding produces filamentous fungi. • Septate Aseptate • Grown up Aerial Mycelium • Grows into media Vegetative mycelium 11/23/2012 Dr.T.V.Rao MD 15
  • 16. Understanding the Structure of Fungus • Simplest fungus :- Unicellular budding yeast • Hypha :- Elongation of apical cell produces a tubular, thread like structure called hypha • Mycelium :- Tangled mass of hyphae is called mycelium. Fungi producing mycelia are called molds or filamentous fungi. • Hyphae may be septate or non-septate 11/23/2012 Dr.T.V.Rao MD 16
  • 17. 11/23/2012 Dr.T.V.Rao MD 17
  • 18. CLASSIFICATION • Depending on cell morphology 1. Yeasts 2. Yeast like fungi 3. Molds 4. Dimorphic fungi 11/23/2012 Dr.T.V.Rao MD 18
  • 19. Yeasts • Unicellular fungi which reproduce by budding • On culture - produce smooth, creamy colonies e. g Cryptococcus neoformans (capsulated yeast) 11/23/2012 Dr.T.V.Rao MD 19
  • 20. Yeast like fungi • Grow partly as yeasts and partly as elongated cells resembling hyphae which are called pseudo hyphae. e.g. Candida albicans 11/23/2012 Dr.T.V.Rao MD 20
  • 21. Molds/ Filamentous fungi • Form true mycelia & reproduce by formation of different types of spores. • Vegetative/ aerial hyphae e.g. Rhizopus, Mucor 11/23/2012 Dr.T.V.Rao MD 21
  • 22. 4. Dimorphic fungi • Occur in 2 forms Molds (Filaments) – 25 C (soil) Yeasts – 37 C (in host tissue) Most fungi causing systemic infections are dimorphic: – Histoplasma capsulatum – Blastomyces dermatidis – Paracoccidioides brasiliensis – Coccidioides immitis – Penicillium marneffei – Sporothrix schenkii 11/23/2012 Dr.T.V.Rao MD 22
  • 23. Reproduction in fungi • Sexual - formation of Zygospore, ascospores or basidiospores • Asexual reproduction – budding or fission • Asexual spores are formed on or in specialized structures. • Vary in size, shape & colour but these characteristics are constant for a particular species. 11/23/2012 Dr.T.V.Rao MD 23
  • 24. Reproduction in fungi • Micro conidia - Small, single celled • Macro conidia – Large, single or many celled 11/23/2012 Dr.T.V.Rao MD 24
  • 25. Systematic classification • Based on sexual spore formation: 4 classes 1. Zygomycetes 2. Ascomycetes reproduce sexually 3. Basidiomycetes 4. Deuteromycetes (fungi imperfectii) 11/23/2012 Dr.T.V.Rao MD 25
  • 26. Zygomycetes • Lower fungi • Broad, nonseptate hyphae • Asexual spores - Sporangiospores: present within a swollen sac- like structure called Sporangium 11/23/2012 Dr.T.V.Rao MD 26
  • 27. Zygomycetes • Sexual spores - Zygospore: a resting, thick walled cell in between hyphae e.g. Rhizopus, Mucor 11/23/2012 Dr.T.V.Rao MD 27
  • 28. Ascomycetes • Includes both yeasts & filamentous fungi • Narrow, septate hyphae • Asexual spores are called conidia borne on conidiophore 11/23/2012 Dr.T.V.Rao MD 28
  • 29. Ascomycetes • Sexual spores called ascospores are present within a sac like structure called Ascus. • Several asci may be seen within a fruiting body as seen in Penicillium, Aspergillus • Each ascus has 4 to 8 ascospores. 11/23/2012 Dr.T.V.Rao MD 29
  • 30. Basidiomycetes • Sexual fusion results in the formation of a club shaped organ called base or basidium which bear spores called basidiospores 11/23/2012 Dr.T.V.Rao MD 30
  • 31. Deuteromycetes or Fungi imperfectii • Group of fungi whose sexual phases are not identified. • Grow as molds as well as yeasts. • Asexual stage – conidia e.g. Candida, Cryptococcus 11/23/2012 Dr.T.V.Rao MD 31
  • 32. Vegetative Structures of Fungi • Arthrospores – formed by segmentation & condensation of hyphae • Chlamydospores – thick walled resting spores e.g. C.albicans 11/23/2012 Dr.T.V.Rao MD 32
  • 33. Asexual Spores • Produced by aerial hyphae: adapted for dispersal • Progeny genetically identical to parent • Several types – Conidiospores- not enclosed in a sac • produced in a chain at end of a conidiophore • Several types – Sporangiospores • Within a sac, sporangium • End of sporangiophore
  • 34. Sexual Spores • Three phases of development – Plasmogamy-haploid nucleus of a donor cell (+) penetrates the cytoplasm of a recipient cell (-) – Karyogamy- the 2 nuclei fuse to form a diploid nucleus – Meiosis-diploid nucleus gives rise to haploid nuclei – Sexual spores, some + , some -,some recombinants – Sexual spores used to classify fungi into divisions
  • 35. Fungal Infections/ Mycoses • Superficial mycoses: – 2 types: surface and cutaneous mycoses – Skin, hair & nails. – Mild but chronic disease • Deep mycoses: – 2 types: subcutaneous & systemic mycoses – Caused by soil saprophytes – Infection is accidental – Range from a symptomatic infection to fatal disease 11/23/2012 Dr.T.V.Rao MD 35
  • 36. Superficial: Surface mycoses • Live exclusively on dead surfaces of skin and its appendages • No contact with living tissue, hence no inflammatory response 1. Tinea versicolor 2. Tinea nigra 3. Piedra 11/23/2012 Dr.T.V.Rao MD 36
  • 37. Superficial: Cutaneous mycoses • Cornified layer of skin & its appendages • Contact with living tissue, hence inflammatory & allergic responses seen 1. Dermatophytes – skin, hair & nails 2. 3 genera - Trichophyton Microsporum Epidermophyton 11/23/2012 Dr.T.V.Rao MD 37
  • 38. CHARACTERISTICS OF FUNGI (Continued) Dimorphic Fungi  Can exist as both multicellular fungi (molds) and yeasts.  Many pathogenic species. – Mold form produces aerial and vegetative hyphae. – Yeast form reproduces by budding.  Dimorphism in pathogenic fungi typically depends on temperature: – At 37oC: Yeast form. – At 25oC: Mold form.  Dimorphism in nonpathogenic fungi may depend on other factors: Carbon dioxide concentration. 11/23/2012 Dr.T.V.Rao MD 38
  • 39. Mycoses • Superficial • Cutaneous • Subcutaneous •Systemic • Opportunistic 11/23/2012 Dr.T.V.Rao MD 39
  • 40. Deep mycoses Subcutaneous mycoses Systemic mycoses 1. Mycotic 1. Cryptococcoses Mycetoma 2. Blastomycosis 2. Chromoblastomyc 3. Coccidioidomyc oses oses 3. Sporotrichosis 4. Histoplasmoses 4. Rhinosporidiosis 11/23/2012 Dr.T.V.Rao MD 40
  • 41. Candidiasis • Caused by candida sps, forms a bridge between superficial & deep mycoses as it can cause cutaneous as well as systemic infections • Can also cause opportunistc infections 11/23/2012 Dr.T.V.Rao MD 41
  • 42. Opportunistic infections • Pts with debilitating disease, altered physiological state • Mainly caused by fungi which are common lab contaminant on culture media – Aspergillus – Pencillium – Mucor – Rhizopus • Produce serious & fatal infections 11/23/2012 Dr.T.V.Rao MD 42
  • 43. Useful Properties of Fungi Source of food Antibiotic production e.g. mushrooms e.g. Penicillin from Penicillium notatum Fermentation - Production of alcohol, bread, cheese e.g. Sacchromyces spps 11/23/2012 Dr.T.V.Rao MD 43
  • 44. Useful Properties of Fungi Ergot from Claviceps Vaccines for Hepatitis B – purpurea, used to induce Sacchromyces cerevisiae uterine contractions 11/23/2012 Dr.T.V.Rao MD 44
  • 45. Diagnosis/Treatment • Grown in medium that selects for fungal growth – Grow at 25 C and 37 C • KOH preparations of skin biopsies – Dissolves keratin in skin scrapings or biopsies – Leaves only fungal cells • Therapy- amphotericin B or ketoconazole – Toxic to humans 11/23/2012 Dr.T.V.Rao MD 45
  • 46. • Programme Created by Dr.T.V.Rao MD for Medical and Paramedical Students in the Developing World • Email • doctortvrao@gmail.com 11/23/2012 Dr.T.V.Rao MD 46