FILAMENTOUS FUNGI

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FILAMENTOUS FUNGI

• PAGE 13

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SOME DISEASES CAUSED BY FILAMENTOUS FUNGI

• Chromoblastomycosis
• Mycetoma
• Mucormycosis
• Aspergillosis

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CHROMOBLASTOMYCOSIS

• A chronic localized infection of the subcutaneous
  tissue caused by several species of dematiaceous
  fungi

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Chromoblastomycosis

• Fonsecaea pedrosoi
• Cladosporium carrionii
• Phialophora verrucosa

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Ecological AssociationChromoblastomycosis

• Soil
• Decaying vegetation

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Sclerotic Bodies

• A fungus form resulting from host defenses

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SCLEROTIC BODIES
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Chromoblastomycosis

• Melanin may be a virulence factor

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Geographic distribution

• World-wide
• (usually warmer climates)

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CLINICAL SPECIMENS

• PUS
• BIOPSY MATERIAL

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TREATMENT

• EXCISION
• TERBINEFINE
• ITRACONAZOLE
• POSACONAZOLE

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No Serological Tests Available
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Mycetoma

• Tumefaction
• Granules
• Draining sinus tracts
• Muscle invasion
• Bone invasion

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Mycetoma agents

• Madurella mycetomatis
• Phialophora jeanselmei
• Pseudallescheria boydii

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GEOGRAPHIC DISTRIBUTION

• WARM CLIMATES
• (SE United States, South America, Africa)

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ECOLOGICAL ASSOCIATION

• SOIL

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Clinical SpecimensMycetoma

• Pus
• Tissue

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IDENTIFICATION

• Colonial morphology
• Conidia formation
• Granules
• Color
• Size shape
• Texture
• Biochemical reactions

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DEMATIACEOUS HYPHAE
De
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Serological TestPseudalescheria

• Immunodiffusion

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Therapy

• Terbinefine
• Itraconazole
• Posaconazole

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Mucormycosis

• An acute infection characterized by inflammation
  and vascular invasion and thrombosis.

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Portal of entry

• Inhalation
• Ingestion
• Surface contamination (burns)

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Mucormycosis

• Rhizopus species
• Mucor species
• Absidia species.

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GEOGRAPHIC DISTRIBUTION

• WORLDWIDE

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ECOLOGICAL NICHE

• UBIQUITOUS
• FOOD
• SOIL
• ORGANIC DEBRIS

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UNCONTROLLED DIABETIC

• Rapidly fatal

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MUCORMYCOSIS

• CLINICAL SIGNS
• Ketoacidosis
• Nasal stuffiness
• Proptosis
• Eschar

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CHARACTERISITICS OF MUCOR INFECTION

• AFFINITY FOR ARTERIAL INVASION
• NASAL OR SINUS INFECTIONS
• DIRECT EXTENSION TO THE BRAIN THROUGH CRIBIFORM
  PLATE
• RAPIDLY FATAL

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WIDE, NON-SEPTATE, RIBBON-LIKE
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TREATMENT

• MUCORMYCOSIS
• Control diabetes (or other underlying
  condition)
• Biopsy
• Culture
• Surgery (Debridement)
• Amphotericin B

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SEROLOGIC TEST

• IMMUNODIFFUSION

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ASPERGILLOSIS

• A variety of diseases
• pulmonary, external ears, eyes, meninges, sinuses
  or blood stream

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CLINICAL TYPES OF PULMONARY DISEASE

• ALLERGIC
• FUNGUS BALL
• INVASIVE

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Difficult to diagnose

• Clinical symptoms are not specific
• Radiography not specific (except fungus ball)
• Blood cultures seldom positive
• Serology seldom positive (early)
• Need invasive procedures for early detection

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COMMON PATHOGENIC SPECIES

• A. FUMIGATUS
• A. NIGER
• A. FLAVUS

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GEOGRAPHIC DISTRIBUTION

• WORLD-WIDE

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ECOLOGICAL ASSOCIATION

• UBIQUITOUS
• SOIL
• DECAYING VEGETATION
• FOOD
• MEDICATION
• AIR VENTS
• DISINFECTANTS

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Culture

• More than 900 species
• Slow growing
• Various gross colors
• Spores
• Size
• Shape
• Texture
• color

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HISTOPATHOLOGY

• DICHOTOMOUS BRANCHING
• WIDE, SEPTATE HYPHAE

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DICHOTOMOUS BRANCHING
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Aspergilloma
Cavity wall
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SEROLOGIC TESTS

• IMMUNODIFFUSION
• (antibody)
• EIA - GALACTOMANNAN
• (antigen)

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DRUG OF CHOICE

• VORICONAZOLE
• AMPHOTERICIN B

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DIMORPHIC FUNGI(Endemic Mycoses)

• COMMON CHARACTERISTICS
• LIMITED GEOGRAPHIC AREA
• SPECIFIC ECOLOGICAL NICHE
• SYSTEMIC INFECTIONS
• MORPHOLOGICALLY DISTINCT

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DISEASES CAUSED BY DIMORPHIC FUNGI

• Blastomycosis
• Histoplasmosis
• Coccidioidomycosis
• Paracoccidioidomycosis
• Sporotrichosis

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BLASTOMYCOSIS

• Blastomyces dermatitidis

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BLASTOMYCOSIS

• A CHRONIC SUPPURATIVE AND GRANULOMATOUS DISEASE
  OF ANY TISSUE WITH A PREDILECTION FOR LUNGS,
  SKIN, PROSTATE AND BONE.

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PORTAL OF ENTRY

• INHALATION
• INOCULATION
• (rare)

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CLINICAL FORMS

• SYSTEMIC
• USUALLY PULMONARY
• CUTANEOUS
• PRIMARY
• SECONDARY

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Pulmonary Symptoms

• Anorexia
• Weight loss
• Cough
• Hemoptysis
• Night sweats

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CLINICAL SPECIMENS

• SKIN SCRAPINGS
• SPUTUM
• PUS
• BIOPSY MATERIAL
• URINE
• BRONCHIAL WASHINGS

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ECOLOGICAL ASSOCIATION

• ORGANIC DEBRIS
• (SOIL, ROTTED WOOD, DECAYED VEGETATION)

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Virulence Factor

• BAD1

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Identification

• 1. Microscopic observation
• 2. Conversion
• 3. DNA Probe

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Wet Mount
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SEROLOGIC TEST

• IMMUNODIFFUSION
• COMPLEMENT FIXATION
• EIA

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DRUGS OF CHOICE

• ITRACONAZOLE
• AMPHOTERICIN B
• VORICONAZOLE

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