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Medical Mycology Opportunistic Mycoses

Medical Mycology Opportunistic Mycoses. Hugh B. Fackrell Filename: Fungi_opport.ppt. Mycoses & Mytoxicosis. Mycoses fungal infections Mycotoxicosis- intoxicaton . Fungal Diseases. Mycoses -Colonization of the host Mycotoxicosis Hypersensitivity. Fungal Infections.

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Medical Mycology Opportunistic Mycoses

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  1. Medical MycologyOpportunistic Mycoses Hugh B. Fackrell Filename: Fungi_opport.ppt

  2. Mycoses & Mytoxicosis • Mycoses fungal infections • Mycotoxicosis- intoxicaton

  3. Fungal Diseases • Mycoses -Colonization of the host • Mycotoxicosis • Hypersensitivity

  4. Fungal Infections • Opportunistic Infections • Superficial fungal infections • Cutaneous Mycoses • Subcutaneous Mycoses • Systemic Mycoses

  5. Intact skin long chain fatty acids pH Bacterial antagonism stratum corneum desiccated epithelial cell turnover rate (0.5 kg/yr) Mucous membranes ciliated antimicrobials Immunological competence Host Defense Factors

  6. Fungal Entry • Rarely cause disease in healthy person • many host defenses • Commensal • Candida albicans • Malasseza fufur • Underlying disorder • trauma • immunological deficiency • debilitating conditions

  7. Endogenous Opportunistic Iatrogenic ( indwelling lines catheters) Exogenous Opportunistic inhalation Superficial Trauma hygiene Cutaneous trauma Subcutaneous trauma Systemic inhalation Disease Mechanisms of Fungi

  8. Fungal Dissemination • Breach in host defenses • endocrinopathies • immune disorders • iatrogenic Must repair defect

  9. Opportunistic Mycoses • Pneumocystosis • Candidiasis • Aspergillosis • Zygomycosis • Mucormycosis • Phycomycosis

  10. Pneumocystosis Pneumocystis carinii - Thought to be a protozoan but recent RNA analysis shows it is a fungus. • Infections occur world wide, if symptoms occur - mild respiratory. Childhood. • Respiratory Infection • interstitial pneumonitis with plasma cell infiltrates

  11. Pneumocystosis Occurence • Primarily AIDS • Hospitalized infants who were premature and malnourished • Elderly • Cancer and organ transplant patients who are being treated with immunosuppressive drugs.

  12. Pneumocystosis Treatment • Trimethoprim - sulfamethoxazole • Aerosolized pentamidine (particularly for AIDS patients)

  13. Pneumocystosis Laboratory Diagnosis • Sputum, lavage, Transbronchial aspirate, Brush biopsy, Open biopsy • Microscopic - Stain appearance, Fluorescent antibody

  14. Pneumocystis microscopy CDC Website

  15. Pneumocystosis Microscopy CDC Website

  16. Pneumocystis microscopyFluorescent antibody CDC Website

  17. Candidiasis • Candida albicans - normal flora of the mouth, gut, vagina. • Acute purulent inflammation with white patches. • Heavy discharge in the mouth, vulvo-vaginal area, or glans penis. • chronic mucocutaneous candidiasis • in skin- moist areas axilla,perineum,nails. • Disseminated candidiasis • Systemically in gut, renal, pulmonary.

  18. Candidiasis • Usually indigenous flora (endogenous) but can be infectious (exogenous) . • Typical opportunist: • normal flora disruption • Birth control pills - vaginitis. • Pregnancy • Diabetes • malignancy • drugs corticosteroids Immunosuppressive drugs. Broad spectrum oral antibiotics(gut)

  19. Chronic Mucocutaneous Candidiasis

  20. Disseminated Candidiasis: Kidney

  21. Disseminated Candidiasis

  22. CandidiasisLaboratory Diagnosis

  23. Treatment, Prevention & Control • Oral: nystatin, amphotericin B, gentian violet • Enteritis:Ketoconazole • Vaginitis:nystatin amphotericin B • suppositories • Systemic: amphotericin B + 5 fluorocytosine

  24. Aspergillosis • Granulomatous lesions • Secondary to other chronic diseases • tuberculosis, • malignancy, steroid therapy, immuno-compromised.

  25. Aspergillus

  26. Aspergillus

  27. Diseases caused by Aspergillus • Mycotoxicoses • contaminated food • Hypersensitivity pneumonitis • (allergic bronchopulmonary disease) • Secondary colonization • no invasion of surrounding tissue • Systemic mycoses • invasion of multiple organs

  28. AspergillosisLaboratory Diagnosis • Tissue specimens directional branching of septate hyphae • Confirmation Difficult • repeated specimens • hard to isolate • ubiquitous

  29. Zygomycosis • Mucormycosis • Phycomycosis

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