SOME DISEASES CAUSED BY FILAMENTOUS FUNGI

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SOME DISEASES CAUSED BY FILAMENTOUS FUNGI

• Chromoblastomycosis
• Mycetoma
• Mucormycosis
• Aspergillosis

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CHROMOBLASTOMYCOSIS

• A chronic localized infection of the subcutaneous
  tissue caused by several species of dematiaceous
  fungi

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Chromoblastomycosis

• Fonsecaea pedrosoi
• Fonsecaea compactum
• Phialophora verrucossum

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Ecological AssociationChromoblastomycosis

• Soil
• Decaying vegetation

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Sclerotic Bodies

• A fungus form resulting from host defenses

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SCLEROTIC BODIES
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Chromoblastomycosis

• Melanin may be a virulence factor

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Geographic distribution

• World-wide

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CLINICAL SPECIMENS

• PUS
• BIOPSY MATERIAL

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TREATMENT

• EXCISION
• TERBINEFINE
• ITRACONAZOLE

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No Serological Tests Available
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Mycetoma

• Tumefaction
• Granules
• Draining sinus tracts

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Mycetoma agents

• Madurella mycetomatis
• Phialophora jeanselmei
• Pseudallescheria boydii

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GEOGRAPHIC DISTRIBUTION

• WARM CLIMATES
• (SE United States, South America, Africa)

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ECOLOGICAL ASSOCIATION

• SOIL

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Clinical SpecimensMycetoma

• Pus
• Tissue

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IDENTIFICATION

• Colonial morphology
• Conidia formation
• Granules
• Color
• Size shape
• Texture
• Biochemical reactions

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DEMATIACEOUS HYPHAE
De
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Serological TestPseudalescheria

• Immunodiffusion

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Therapy

• Terbinefine
• Itraconazole

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Mucormycosis

• An acute infection characterized by inflammation
  and vascular invasion and thrombosis.

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Portal of entry

• Inhalation
• Ingestion
• Surface contamination (burns)

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Mucormycosis

• Rhizopus species
• Mucor species
• Absidia species.

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GEOGRAPHIC DISTRIBUTION

• WORLDWIDE

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ECOLOGICAL NICHE

• UBIQUITOUS
• FOOD
• SOIL
• ORGANIC DEBRIS

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UNCONTROLLED DIABETIC

• Rapidly fatal

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MUCORMYCOSIS

• CLINICAL SIGNS
• Ketoacidosis
• Nasal stuffiness
• Proptosis
• Eschar

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CHARACTERISITICS OF MUCOR INFECTION

• AFFINITY FOR ARTERIAL INVASION
• NASAL OR SINUS INFECTIONS
• DIRECT EXTENSION TO THE BRAIN THROUGH CRIBIFORM
  PLATE
• RAPIDLY FATAL

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WIDE, NON-SEPTATE, RIBBON-LIKE
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TREATMENT

• MUCORMYCOSIS
• Control diabetes (or other underlying
  condition)
• Biopsy
• Culture
• Surgery (Debridement)
• Amphotericin B

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SEROLOGIC TEST

• IMMUNODIFFUSION

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ASPERGILLOSIS

• A variety of diseases
• Pulmonary, external ear, eyes, meninges, sinuses
  or blood stream

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CLINICAL TYPES OF PULMONARY DISEASE

1. ALLERGIC
2. FUNGUS BALL
3. INVASIVE

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Difficult to diagnose

1. Clinical symptoms are not specific
2. Radiography not specific (except fungus ball)
3. Blood cultures seldom positive
4. Serology seldom positive (early)
5. Need invasive procedures for early detection

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COMMON PATHOGENIC SPECIES

• A. FUMIGATUS
• A. NIGER
• A. FLAVUS

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GEOGRAPHIC DISTRIBUTION

• WORLD-WIDE

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ECOLOGICAL ASSOCIATION

• UBIQUITOUS
• SOIL
• DECAYING VEGETATION
• FOOD
• MEDICATION
• AIR VENTS
• DISINFECTANTS

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Culture

• More than 100 species
• Slow growing
• Various gross colors
• Spores
• Size
• Shape
• Texture
• color

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HISTOPATHOLOGY

• DICHOTOMOUS BRANCHING
• SEPTATE HYPHAE

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DICHOTOMOUS BRANCHING
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Aspergilloma
Cavity wall
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SEROLOGIC TESTS

• IMMUNODIFFUSION
• (BANDS)
• GALACTOMANNAN
• (EIA)

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DRUG OF CHOICE

• VORICONAZOLE
• AMPHOTERICIN B

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DIMORPHIC FUNGI(Endemic Mycoses)

• LIMITED GEOGRAPHIC AREA
• SPECIFIC ECOLOGICAL NICHE
• SYSTEMIC INFECTIONS
• MORPHOLOGICALLY DISTINCT

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BLASTOMYCOSIS

• Blastomyces dermatitidis

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BLASTOMYCOSIS

• A CHRONIC SUPPURATIVE AND GRANULOMATOUS DISEASE
  OF ANY TISSUE WITH A PREDILECTION FOR LUNGS,
  SKIN, PROSTATE AND BONE.

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PORTAL OF ENTRY

• INHALATION
• INOCULATION
• (rare)

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CLINICAL FORMS

• SYSTEMIC
• USUALLY PULMONARY
• CUTANEOUS
• PRIMARY
• SECONDARY

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Pulmonary Symptoms

• Anorexia
• Weight loss
• Cough
• Hemoptysis
• Night sweats

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CLINICAL SPECIMENS

• SKIN SCRAPINGS
• SPUTUM
• PUS
• BIOPSY MATERIAL
• URINE

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ECOLOGICAL ASSOCIATION

• ORGANIC DEBRIS
• (SOIL, ROTTED WOOD, DECAYED VEGETATION)

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Virulence Factor

• BAD1

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Wet Mount
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SEROLOGIC TEST

• IMMUNODIFFUSION
• COMPLEMENT FIXATION
• EIA

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DRUGS OF CHOICE

• ITRACONAZOLE
• AMPHOTERICIN B
• VORICONAZOLE

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