DEEP / SYSTEMIC MYCOSES

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DEEP / SYSTEMIC MYCOSES

• Dr. A.Aziz Djamal MSc.DTMH.SpMK(K)

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There are two types

• Cosmopolitant Aspergillus, Candida and
• 
  Cryptococcosis.
• 2. Exotic type In a specific area
  Penicillium
• marneffei

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Deep / Systemic Mycoses

• A Group of Fungi that cause a variety of systemic
  / deep seated infection each ranging in severity
  from subclinical to progressive , debilitating
  diseases

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• Several Deep Mycoses
• Aspergillus.
• Candida
• Cryptococcus
• Penicillicium marneffei.
• Coccidioides.
• Paracoccidioides.
• Mucormycoses.
• Paehypomycoses
• Blastomycoses.
• Pseudallescheriasis.
• Fusariosis

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Aspergillus

• Common species
• Aspergillus fumigatus
• Aspergillus flavus

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Aspergillus Characteristic
Typically asexual
sporulationSeptate hyphaePalliadesVesicleMicro
conidia
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Aspergillus systemic diseases

• Sinusitis Unilateral,non-invasive, maxillary
  sinus.
• Pulmonary aspergilloma Free and mobile Fungus
  ball in residual lung cavity/tb ,interwoven
  hyphae, haemoptysis.
• Invasive Pulmonary aspergillosis With or
  Without Deep Lesion. Fatal opportunistic
  infection in certain group of netrophenia,
  extrapulmonary. AIDS.

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Diagnoses

• 1.Sinusitus aspergillus Direct examination or
• histological biopsy examination.
• 2. Pulmonary aspergilloma Sputum culture.
• Precipitin specific to A. fumigatus or A.
  flavus
• 3. Invasive Pulmonary Aspergillosis Clinical
• outcome, Immune status and fungus
• isolation.

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Systemic Candidiasis

• Only on Predisposed patient /
• Opportunistic.
• Local or systemic predisposing factors.
• Persoption not exogenous infection.

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Clinical Manifestation Oesophagitis
colitis Pulmonary candidosis (
haematagenous or direct contact) Kidney
Eye Chronic Liver and Spleen Absces in
leukemia Meningitis in premature baby.
Endocarditis in heart surgery / valve prothesis
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Cryptococcoses

• Causative Agent Cryptococcus neoformans
• var. neoformans
  ( cosmopolitant)
• var gattii (
  Exclusive in tropic )

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Cryptococcus neoformans

• Yeast 4-6 micrometer
• characteristic capsule ext 25 micrometer.
• capsule complex polysaccharide polymer
• Glucoronoxylomannan ( GXM)

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Mostly in Impaired immunity patient 20-25 of
AIDS patients in South east Asia. Mostly var
neoformans 99 Aerial transmission-lung-meningit
is
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Others Histoplasma capsulatum
Blastomyces dermatitidis and
Coccidioides immitis
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Candida cause systemic infection 1. C.
albicans.2. C. parapsilosis.3. C.
tropicalis.4. C. krusei.5. C. gulliermondii.6.
C. kefyr.7. C. lusitaniae8. C. zeylanoides.9.
C. glabrata.