Systemic mycosis Dimorphs Internal organs Cutaneous l l

Systemic mycosis Ø Dimorphs Ø Internal organs Ø Cutaneous l l Primary Secondary Ø Saprophytes

Systemic mycosis Ø Tissue staining l Ø Blastomyces dermatitidis l Ø Yeast, point, blood or bone marrow, wright Paracoccidioides brasiliensis l Ø Yeast, thick wall, linier Histoplasma capsulatum l Ø PAS, H&E, GMS( Gomory Methenamine Silver) Multiple budding Coccidioides immitis l Sphrule

Systemic mycosis Ø PCR Ø SABHI Ø Blood agar Ø 12 week Ø Slide culture Ø Mask, gloves, hood

Blastomycosis Ø Blastomyces dermatitidis Canada, South America, Africa Ø Inhalation of conidia Ø Chronic disease in lung Disseminated Ø Skin Bone Nose Mouth

Blastomycosis Ø Culture l SABHI • • • l Round or oval conidia Unicellular & smooth Shortly conidiophore BHI, Blood agar • • Yeast linier bud Round Big

Histoplasmosis Ø Histoplasma capsulatum Ø America Ø Bird & bat Ø Wind Ø Inhalation Ø Skin

Histoplasmosis Ø 90 -95% without symptom self limitation Ø Clinical manifestation l l l Fever, cough, loose weight, sweat Lung, spleen, kidney, liver, skin, eye, CNS Blood culture is positive Ø Amphotricin-B

Histoplasmosis Ø Culture l SABHI • Hyphae, macro conidia l BHI, Blood agar • Yeast l Point bud

Coccidioidomycosis Ø SW America desert Ø Arthroconidia l Tolerant to dry & salt Ø 60% without symptoms Ø 40% mild Ø Lung blood Bone Skin Brain lymph nod

Coccidioidomycosis Ø Amphotricin-B Ø Culture l SABHI • Rectangular arthroconidia Ø Spherule l l l Endospore Blastomyces Vaseline germtube - C. i + B. d

Paracoccidioidomycosis Ø Ø Ø Ø South America, Brazil Saprophyte Water, soil, plant Inhalation Lung Eating Mouth & gum disseminated systemic Enlargement of lymph nod

paracoccidioidomycosis Ø Co trimaxazol Ø Culture l SABHI • Chlamydioconidia l BHI, Blood agar • Multiple budding l ship's wheel