1. Airborne Infection

2. Airborne infections: Contracted by inhalation of microorganisms or spores suspended in air on water droplets or dust particles

3. Respiratory tract infections • Infections involving the respiratory tracts • Classified as an upper respiratory tract or a lower respiratory tract infections • Lower respiratory infections, such as pneumonia, tend to be far more serious conditions than upper respiratory infections, such as the common cold

4. URTI • Infections in the: • Nose • Sinuses • Pharynx • Larynx • Middle ear

5. URTI Typical infections • Tonsillitis • Pharyngitis • Laryngitis • Sinusitis (can be cause by fungi) • Otitis media (can be cause by fungi) • Influenza • Common cold

6. Symptoms of URTIs • Cough • Sore throat • Runny nose • Nasal congestion • Headache • Low grade fever • Sneezing

7. Fungal infections of the upper respiratory tracts

8. Fungal infections of the upper respiratory tracts • Fungal Ear infections • Fungal nasal sinusitis • Fungal infections of the oral cavity • Fungal keratitis

9. Fungal Ear Infections“Otomycosis” Otitisexterna & Otitis media

10. Otitisexterna • Fungal infection of the external ear canal • World-wide, but more common in tropical and sub-tropical regions

11. Etiology • Caused mainly by: • Aspergillusfumigatus • Aspergillusniger • Candida albicans • Candida tropicalis

12. Other causes may include • Malassezia species • Pseudallescheriaboydii • Absidia species • Acremonium species • Penicillium species • Rhizopus species • Scopulariopsisbrevicaulis

13. Clinical manifestation • Inflammation • Itching • Scaling • Discomfort • Masses of debris containing hyphae • Pain

14. OtitisExterna

15. Laboratory diagnosis • Direct examination of epithelial debris • Hyphae and in some instances the fruiting structures of the etiologic agent • Culture: • Sabouraud dextrose agar incubated at 30°C (without cycloheximide)

16. Management • Removal of debris and cleaning • Topical azole cream • Gauze packs soaked in amphotercib B + natamycin or imidazole

17. Fungal Paranasal Sinusitis

18. Fubgalparanasalsinusitis • Sinusitis caused by different fungi • Especially in patients with a history of allergic rhinitis or immunosuppression

19. Causative agents • Dematiaceous fungi (phaeohyphomycosis): • Bipolarisspecies • Curvulariaspecies • Alternariaspecies • Non Dematiaceous fungi (haylohyphomycosis): • Aspergillusspecies • Zygomycetes

20. Curvularia geniculata (Atlas of Clinical Fungi, De Hoog et al. 2000)

21. Curvularia lunata

22. Bipolaris

23. Alternaria

24. Zygomycetes

25. Zygomycetes

26. Zygomycetesin tissues

27. Management of Paranasal sinusitis • Surgery • Antifungal (Amphotericin B or Azoles)

28. Oral thrush Oral candidiasis or candidosis

29. Oral candidiasis or candidosis(Oral thrush) • Over growth of C. albicans in the oral cavity • Whitish removable layer cover reddish, eroded, easily bleeding mucosa • May extend to the esophagus • Mainly seen in: • Prolonged use of broad spectrum antibiotics • Impaired T-cell immunity

30. Oral candidiasis

31. Treatment • For healthy adults and children • Eating unsweetened yogurt • Taking acidophilus capsules or liquid • For adults with weakened immune systems • Azoles • Amphotericin B

32. Keratomycosis mycotickeratitis

33. Keratomycosis • Corneal infection caused by either filamentous fungi or yeast • The most important risk factors: • Trauma (generally with plant material) • Chronic ocular surface diseases • Contact lens usage • Surgery • Eye-drops abuse • Immunodeficiencies • Condition related to warm climates

34. Keratitis

35. Epidemiological and clinical differences between the two forms of the infection

36. Laboratory diagnosis • Microscopic examination • Hyphae in corneal scrapings • Fungi are usually deep within the corneal structure, not on the surface. • Extensive debridement may be necessary to obtain satisfactory clinical material (swabs are unsatisfactory)

37. Septatehyphae The fungus was seen in several repeated corneal samplings

38. Management • Drug of choice is Natamycin • Amphotericin B a second alternative • Systemic therapy with azoles • Surgery may be necessary

39. Lower Respiratory Tracts Infections

41. Lower respiratory tracts infections • Generally more serious than upper respiratory infections • The leading cause of death among all infectious diseases • The two most common LRIs: • Bronchitis and pneumonia

42. Pneumonia • Pneumonia is an inflammatory condition of the lung • Especially affecting the microscopic air sacs (alveoli) • Associated with fever, chest symptoms, and a lack of air space (consolidation) on a chest X-ray

43. Causes • Microbial infections: • Bacteria,  • Viruses • Fungi • Parasites • Other causes

44. Typical symptoms • Cough • Chest pain • Fever • Difficulty breathing

45. Diagnosis • X-rays • Sputum examination

47. Classification • Community-acquired • Aspiration • Hospital-acquired • Ventilator-associated pneumonia • Lobar pneumonia • Bronchial pneumonia • By the causative organism

48. Causative agents • Viruses and bacteria (most common) • Fungi and parasites (less common) • Mixed infections with both viruses and bacteria: • Up to 45% of infections in children • 15% of infections in adults • Causative agent is not isolated in approximately half of cases

49. Fungal pneumonia

50. Fungal pneumonia • Uncommon • Occur in individuals with weakened immune systems due to: • AIDS • Immunosuppressive drugs • Other medical problems