1. OPPORTUNISTIC MYCOSES

2. OPPORTUNISTIC MYCOSIS • MOLD • ASPERGILLOSIS • ZYGOMYCOSIS • YEAST • CRYPTOCUCCOSIS • CANDIDIASIS

3. ASPERGILOSIS • Aspergillus • Saprophyte • Recycling • Carbon & Nitrogen • Decaying organic material • 900 species

4. ASPERGILOSIS • Opportunistic • Human & Animal • A.fumigatus • A.flavus • A.niger • Conidia 2-3 μInhalation • Nosocomial infection

5. ASPERGILOSIS • Cystic fibrosis • Immune compromise • Atopic Asthma • Hematological patients

6. ASPERGILOSIS • Increase • Diagnosis • Antifungal therapy

7. ASPERGILOSIS • Allergic • Pulmonary • Cutaneous • Disseminated • Miscellaneous • Iatrogenic

8. Allergic • Asthma • IgE & Eosinophil ( increase) • ABPA • IgE & Eosinophil ( increase) • Alveolitis • Hypersensitivity type III

9. Pulmonary • Invasive • Lymphoma & Leukemia • Secondary infection • Invasive to vessels Infarction & Dead • Non invasive • Cavity Colonization • Fungus ball (Aspergilloma) • Hemaptosis

10. Cutaneous • Rare • 1st • Onychomycosis • Burning • IC • 2nd • Dissemination

11. Disseminated • Brain • Kidney

12. Miscellaneous • Otomycosis • Keratomycosis • Sinusitis

13. Iatrogenic • Materials • Instruments • Aero cells • Air conditioner

14. Pathogenesis & Defense factors • Cell wall • Melanin • Catalase • Fungal metabolites • Super oxide dismutase

15. Cell wall • Interface • Ag & Enzymes • Protection • Cell wall of Conidia • Cell wall of Hyphae

16. Cell wall of Conidia • 2 part • Dense pigmented (out) • DHN (Dihydroxy Naphthalene Melanin) • Translucent (in) • Protection • Phagositosis

17. Cell wall of Hyphae • Component • Β 1-3 glucan • Galactomanan • Chitin • Role • Protection (PMN) • Enzyme (catalase) • Ag (Galactomanan & β1-3 glucan)

18. Galactomanan • Special for A.fumigatus • Serum, Urine, BAL • Monoclonal Ab

19. Melanin • Dihydroxy Phenylalanin (DOPA) • Dihydroxy Naphthalene (DHN) • Free radicals

20. Catalase • Hydrogen peroxide • Expression • Starvation & Sexual reproduction

21. Fungal metabolites • Toxins • Epithelial damage • Gliotoxin • Fumagilin • Helvolic acid

22. Super oxide dismutase • Virulence factor • Surveillance • Neu • Mac

23. Cellular immunity • T cell very important • Gamma INF( first cytokine) • IL4, IL2, TNFα • Cystic fibrosis ABPA • Innate

24. Laboratory diagnosis • Sampling • Sputum, BAL, Serum, Urine • KOH 10% • ELISA • Dichotomous

25. Laboratory diagnosis

26. Laboratory diagnosis

27. Laboratory diagnosis

28. Laboratory diagnosis

29. Serology • ELISA based Ab (galactomann)

30. Treatment • Amphotricin B • 5 flurocytosin

31. Zygomycosis • Phycomycosis • Hyphomycosis • Mucormycosis • Rhizopus • R. oryzea, R. arrhizus • Absidia • A. corymbifera ( 42°- 45°) • Mucor

32. Zygomycosis • Opportunistic • Very dangerous • Acute • Lethal

33. Zygomycosis • Para nasal sinuses • Lung • Eye • Ear • Skin • Alimentary

34. Zygomycosis • Diabetic • Blood cancer • Sever burning • Malnutrition

35. Zygomycosis • Rhinocerbral • Pulmonary • Gastrointestinal • Cutaneous

36. Rhinocerbral • Diabetic • Nose & Para nasal • Discharge • Black & blood • Eye

37. Rhinocerbral

38. Pulmonary • Like the other pulmonary • Pain • Sputum • Aspiration & inhalation • Mucoroma

39. Gastrointestinal • Diahria • Haematemsis • Peritonitis • Stool (blood) • Malnutrition

40. Cutaneous • Burning • Rare

41. Laboratory diagnosis • Sampling • Biopsy • Culture • S • Direct • Ribbon like

42. Laboratory diagnosis

43. Laboratory diagnosis

44. Laboratory diagnosis

45. Laboratory diagnosis

46. Treatment • Control • Amphotricin B • Autopsy

47. YEAST INFECTIONS • Candida • Cryptococcus • Malassezia • Trichosporon • Rhodotorula • Geotricum ( Mold )

48. CANDIDIASIS • Candida species • Yeast like • True hyphae • Reverse dimorph

49. CANDIDIASIS • C.albicans • Normal flora • C.glabrata • C.dubliniensis • C.parapsilosis • Nature ( soil ) • Lactobacillus

50. CANDIDIASIS • Physiologic • Antibiotic • Diabetic