1 Medical Mycology Opportunistic Mycoses Hugh B Fackrell
1 Medical Mycology Opportunistic Mycoses Hugh B. Fackrell Filename: Fungi_opport. ppt 9/5/2021
2 Mycoses & Mytoxicosis l Mycoses l fungal infections Mycotoxicosis- intoxicaton 9/5/2021
3 Fungal Diseases Mycoses -Colonization of the host l Mycotoxicosis l Hypersensitivity l 9/5/2021
4 Fungal Infections l Opportunistic Infections Superficial fungal infections l Cutaneous Mycoses l Subcutaneous Mycoses l Systemic Mycoses l 9/5/2021
5 Host Defense Factors l l l Intact skin long chain fatty acids p. H Bacterial antagonism stratum corneum desiccated epithelial cell turnover rate (0. 5 kg/yr) l l Mucous membranes ciliated antimicrobials Immunological competence 9/5/2021
6 Fungal Entry l Rarely cause disease in healthy person – many host defenses l Commensal – Candida albicans – Malasseza fufur l Underlying disorder – trauma – immunological deficiency – debilitating conditions 9/5/2021
7 Disease Mechanisms of Fungi l Endogenous l Opportunistic – Iatrogenic ( indwelling lines catheters) l Exogenous l Opportunistic – inhalation l Superficial – Trauma hygiene l Cutaneous – trauma l Subcutaneous – trauma l Systemic – inhalation 9/5/2021
8 Fungal Dissemination l Breach in host defenses – endocrinopathies – immune disorders – iatrogenic Must repair defect 9/5/2021
9 Opportunistic Mycoses *Pneumocystosis Candidiasis l Aspergillosis l Zygomycosis – Mucormycosis – Phycomycosis l 9/5/2021
10 Pneumocystosis Pneumocystis carinii - Thought to be a protozoan but recent RNA analysis shows it is a fungus. Infections occur world wide, if symptoms occur - mild respiratory. Childhood. l Respiratory Infection l – interstitial pneumonitis with plasma cell infiltrates 9/5/2021
11 Pneumocystosis Occurence Primarily AIDS l Hospitalized infants who were premature and malnourished l Elderly l Cancer and organ transplant patients who are being treated with immunosuppressive drugs. l 9/5/2021
12 Pneumocystosis Treatment Trimethoprim - sulfamethoxazole l Aerosolized pentamidine (particularly for AIDS patients) l 9/5/2021
13 Pneumocystosis Laboratory Diagnosis Sputum, lavage, Transbronchial aspirate, Brush biopsy, Open biopsy l Microscopic - Stain appearance, Fluorescent antibody l 9/5/2021
14 Pneumocystis microscopy CDC Website 9/5/2021
15 Pneumocystosis Microscopy CDC Website 9/5/2021
16 Pneumocystis microscopy Fluorescent antibody CDC Website 9/5/2021
17 Candidiasis l Candida albicans - normal flora of the mouth, gut, vagina. – Acute purulent inflammation with white patches. – Heavy discharge in the mouth, vulvo-vaginal area, or glans penis. l chronic mucocutaneous candidiasis – in skin- moist areas axilla, perineum, nails. l Disseminated candidiasis – Systemically in gut, renal, pulmonary. 9/5/2021
18 Candidiasis Usually indigenous flora (endogenous) but can be infectious (exogenous). l Typical opportunist: – normal flora disruption – Birth control pills - vaginitis. – Pregnancy – Diabetes – malignancy – drugs corticosteroids Immunosuppressive drugs. Broad spectrum oral antibiotics(gut) 9/5/2021 l
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20 Chronic Mucocutaneous Candidiasis 9/5/2021
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22 Disseminated Candidiasis: Kidney 9/5/2021
23 Disseminated Candidiasis 9/5/2021
24 Candidiasis Laboratory Diagnosis 9/5/2021
25 Treatment, Prevention & Control Oral: nystatin, amphotericin B, gentian violet l Enteritis: Ketoconazole l Vaginitis: nystatin amphotericin B l – suppositories l Systemic: amphotericin B + 5 fluorocytosine 9/5/2021
26 Aspergillosis l Granulomatous lesions Secondary to other chronic diseases – tuberculosis, l malignancy, steroid therapy, immunocompromised. l 9/5/2021
27 Aspergillus 9/5/2021
28 Aspergillus 9/5/2021
29 Diseases caused by Aspergillus Mycotoxicoses – contaminated food l Hypersensitivity pneumonitis – (allergic bronchopulmonary disease) l Secondary colonization – no invasion of surrounding tissue l Systemic mycoses – invasion of multiple organs l 9/5/2021
30 Aspergillosis Laboratory Diagnosis Tissue specimens directional branching of septate hyphae l Confirmation Difficult – repeated specimens – hard to isolate – ubiquitous l 9/5/2021
31 Zygomycosis Mucormycosis l Phycomycosis l 9/5/2021
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