DIMORPHIC FUNGI Part 2 Dr Hams M A

DIMORPHIC FUNGI Part (2) Dr. Hams M. A. Mohamed

3 -COCCIDIOIDOMYCOSIS Cause: Coccidioides imitis Pathogenesis Inhalation of arthroconidia (spores) Present in soil (mycelial phase) Arthrospore lower airway disease

Coccidioidomycosis 2. Chronic Pulmonary Infection/Acute Progressive 5% Asymptomatic Symptomatic nodule cavity chronic pneumonia scarring cavities bronchiectasis empyema/B-P fistula

Disseminated lesion to knee

Coccidioidomycosis u. Dogs: Lamness, abcesses u. Lymphadenopathy, meningitis u. Cattle: lymphadinits specialy broncial, mediastinal lymph nodes

COCCIDIOIDES IMITIS A) Laboratory Diagnosis 1. Direct Examination - sputum - tissue biopsy- skin KOH Calcofluor Histopathology (GMS, PAS) - Spherule (yeast) form at 37 C i. immature spherule (5 -30 µ) *ii. mature spherule (30 -100 µ) iii. endospores (2 -5 µ) From culture at 25 C: Barrel shape arthroconidia

At 25 C At 37 C

Mould cocci Phase contrast Alternating barrel-shaped arthroconidia

COCCIDIOIDES IMITIS A) Laboratory Diagnosis (cont. ) 2. Culture (250 C) Mould form (mycelial phase) while colony, rapid growth septate hypae (2 -4 µ) arthroconidia- alternating barrel-shaped AT 37 C: : WAXY, CREAMY , COLONIES

COCCIDIOIDES IMITIS A) Laboratory Diagnosis Exoantigen test 4. Serology Percipitation test C. F. T ELISA 5 - Allergic test (Coccidioidin, spheruline antigen)

COCCIDIOIDES IMITIS Treatment Amphotericin B Azoles Fluconazole Itraconazole Non-meningeal disease FLU/ITRA Meningitis - Fluconazole - AMB (IT) + azole + IV AMB

Sporotrichosis u Sporotrichosis is an infection caused by a fungus called Sporothrix schenckii. The fungus lives throughout the world in soil, plants, and decaying vegetation. Cutaneous (skin) infection is the most common form of infection and usually occurs after handling contaminated plant material, when the fungus enters the skin through a small cut or scrape. OR by inhalation

Diagnosis u Direct microscopic examination: u At 37 C FROM TISSUES: budding yeast have cigar shape with asteroid bodies surround by splendro-hoeppli oesinophilic material. u At 25 C: branching hyphae have conidephore carry conidia like flower

Sporotricosis At 37 C At 25 C

Culture At 25 C: COLONIES Leathery to velvety, and have a finely wrinkled surface. The colour is white initially and may change color over time to become cream to dark brown

u At 37 C: smooth white or off-white colonies. 3 - Allergic test: sporotrichine

Morphological classification of Dimorphic fungi Fungus Blastomycosis Coccidioides Histoplasma Paracoccidioides Sporothrix