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Medical Mycology Opportunistic Mycoses

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Opportunistic Mycoses Hugh B. Fackrell Filename: Fungi_opport.ppt Mycoses & Mytoxicosis Mycoses fungal infections Mycotoxicosis- intoxicaton Fungal Diseases Mycoses ... – PowerPoint PPT presentation

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Title: Medical Mycology Opportunistic Mycoses


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
Host Defense Factors
  • 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

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

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
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20
Chronic Mucocutaneous Candidiasis
21
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22
Disseminated Candidiasis Kidney
23
Disseminated Candidiasis
24
CandidiasisLaboratory Diagnosis
25
Treatment, Prevention Control
  • Oral nystatin, amphotericin B, gentian violet
  • EnteritisKetoconazole
  • Vaginitisnystatin amphotericin B
  • suppositories
  • Systemic amphotericin B 5 fluorocytosine

26
Aspergillosis
  • Granulomatous lesions
  • Secondary to other chronic diseases
  • tuberculosis,
  • malignancy, steroid therapy, immuno-compromised.

27
Aspergillus
28
Aspergillus
29
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

30
AspergillosisLaboratory Diagnosis
  • Tissue specimens directional branching of
    septate hyphae
  • Confirmation Difficult
  • repeated specimens
  • hard to isolate
  • ubiquitous

31
Zygomycosis
  • Mucormycosis
  • Phycomycosis
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