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MEDICAL MYCOLOGY Arthur F. Di Salvo, MD Reno, Nevada

MEDICAL MYCOLOGY Arthur F. Di Salvo, MD Reno, Nevada. Medical Mycology Outline. HOUR SUBJECT Introduction, Actinomycetes Yeasts, Dermatophytes Filamentous Fungi, Dimorphic Fungi Dimorphic Fungi Opportunistic Fungi . OBJECTIVES.

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MEDICAL MYCOLOGY Arthur F. Di Salvo, MD Reno, Nevada

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  1. MEDICAL MYCOLOGY Arthur F. Di Salvo, MD Reno, Nevada

  2. Medical Mycology Outline HOUR SUBJECT • Introduction, Actinomycetes • Yeasts, Dermatophytes • Filamentous Fungi, Dimorphic Fungi • Dimorphic Fungi • Opportunistic Fungi

  3. OBJECTIVES • To impart sufficient basic science of the medically important fungi to assist you in diagnosing mycotic diseases. • To impart sufficient clinical knowledge to raise your index of suspicion for mycotic diseases.

  4. What is SAID is not HEARD • What is HEARD is not UNDERSTOOD • What is UNDERSTOOD is not RETAINED • What is RETAINED is not IMPLEMENTED

  5. ASK QUESTIONS ANYTIME • During or after lecture

  6. INTRODUCTION

  7. Fairy Ring Mushrooms

  8. What is Mycology?

  9. Mycology is the study of • Beer • Wine • Bread • Cheese • Gourmet mushrooms • Environmental toxins • Biodegradation • Disease

  10. BIOREMEDIATION • Clean up oil spills • Remove cyanide in mining operations • Neutralize dioxins and pesticides • Produce organic acids, sugars • Manufacture other commercial products

  11. A. Classification

  12. What is a Fungus ? • Eukaryotic – a true nucleus • Do not contain chlorophyll • Have cell walls • Produce filamentous structures • Produce spores

  13. Species of Fungi • 100,000 – 200,000 species • About 300 pathogenic for man

  14. Kingdom FungiEukaryocytes Ascomycota Basidiomycota Zygomycota Mitosporic Fungi (Fungi Imperfecti)

  15. KINGDOM CHARACTERISTIC EXAMPLE Monera Prokaryocyte Bacteria Actinomyces Protista Eukaryocyte Protozoa Fungi Eukaryocyte * Fungi Plants Eukaryocyte Plants Moss Animals Eukaryocyte * Arthropods Mammals Man

  16. KINGDOM CHARACTERISTIC EXAMPLE Monera Prokaryocyte Bacteria Actinomyces Protista Eukaryocyte Protozoa Fungi Eukaryocyte * Fungi Plants Eukaryocyte Plants Moss Animals Eukaryocyte * Arthropods Mammals Man

  17. SIZE COMPARISON OF PATHOGENS

  18. Actinomyces(True Bacteria) • Tradition • Clinical infection resembles mycoses • Actinomyces grow on mycotic media • Actinomyces grow slowly (24-48 h) • Gross colonies resemble fungi • (rough,heaped, short aerial filaments) • Resemble mycelia microscopically, with branched mycelia in tissue and smears.

  19. HANDOUT Page 2

  20. What is Medical Mycology ?

  21. MYCOTIC DISEASES(Four Types) • Hypersensitivity • Allergy • Mycotoxicosis • Production of toxin • Mycetismus (mushroom poisoning) • Pre-formed toxin • Infection

  22. Hypersensitivity • FARMER’S LUNG – Moldy hay • MALT WORKER’S DISEASE – Moldy barley • CHEESE WASHER’S LUNG – Moldy cheese • WOOD TRIMMER’S DISEASE – Moldy wood

  23. PATHOGENIC FUNGI • NORMAL HOST • Systemic pathogens - 25 species • Cutaneous pathogens - 33 species • Subcutaneous pathogens - 10 species • IMMUNOCOMPROMISED HOST Opportunistic fungi - 300 species

  24. PARASITIC STATE • Increased metabolic state • Modified metabolic pathways • Modified cell wall structure • Carbohydrate content • Lipid structure • RNA aggregates

  25. PATHOGENICITY OF FUNGI • Thermotolerance • Ability to survive in tissue environment • Ability to withstand host defenses

  26. REVIVED INTEREST IN MYCOLOGY • Increased frequency of mycotic diseases • Increased awareness by physicians • Better trained laboratory personnel • More invasive procedures used on patients • Increased use of immunosuppressive drugs • Increase in immunosuppressive disease 7. Better laboratory diagnostic tools

  27. B. MORPHOLOGY

  28. MORPHOLGY • Yeasts • Hyphae (filamentous fungi, mycelium) • Septate • Coenocytic (non-septate) • Dimorphic • Yeast • Mycelium

  29. Dimorphic Fungi • Yeast Form • Parasitic form • Tissue form • Cultured at 37 C • Mycelial Form • Saprophytic form • Cultured at 25 C

  30. SPORES • SEXUAL • ASEXUAL • Arthrospore • Blastospore • Chamydospore • Conidia • Microconidia • Macroconidia

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