Medical MycologySystemic Mycoses Hugh B. Fackrell Filename; fungi_system.ppt
Fungal Infections • Opportunistic Infections • Superficial fungal infections • Cutaneous Mycoses • Subcutaneous Mycoses • Systemic Mycoses
Systemic or Deep Mycoses • Histoplasmosis • Coccidiomycosis • Blastomycosis • Cryptococcosis
Histoplasmosis before HIV • Before the appearance of HIV, approximately 95% of the cases reported of histoplasmosis capsulati where inapparent, subclinical, or benign and five percent of them where a chronic progressive lung disease with chronic cutaneous or systemic disease, or an acute fulminating fatal systemic disease.
Histoplasmosis After HIV • Now the disease is almost always seen in HIV positive patients or other immunocompromised individuals. • All stages of this disease may mimic tuberculosis. • Histoplasmosis may coexist with actinomycosis, other mycoses, sarcoidosis, or tuberculosis.
Histoplasmosis • Histoplasma capsulatum • Ohio,Mississippi valleys
Coccidiomycosis • SW deserts, San Joaquin • Coccidioides immitus
Blastomycosis • Blastomyces dermatitidi • as histo but rarer. • Canada- Manitoba and St.Lawrence river valley • Disease in horses. • Veternarians at risk.
Cryptococcosis • Cryptococcus neoformans • Sporadic • Pigeons • Meningitis form • fatal
Systemic Mycoses: Disease Patterns • Subacute respiratory infection • Acute infection • Severe disseminated infection
Systemic Mycoses:Subacute Respiratory Infection • Low fever • Non-productive cough • Mild & self limiting
Productive cough purulent sputum pain in chest Weight loss. night sweats X-ray positive one,many lesions consolidation Systemic Mycoses:Acute Infections Differential diagnosis: pneumonia, tumour.
Systemic Mycoses:Severe Disseminated Infections • Acute Infections + • spread to other organs • chronic Differential diagnosis t.b.
Systemic Mycoses:Diagnosis • X-ray • Immunochemical skin test serology • Microscopy Sputum biopsy autopsy
Systemic Mycoses: Transmission Fungal spores inhaled ...pneumonitis..no human to human transmission Primary source bird and bat droppings and roosts. If roosts disturbed- dust, aerosol . Chickens, Pigeons,starlings.
Systemic Mycoses:Treatment Amphotericin B and/or 5-fluorocytosine