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FILAMENTOUS FUNGI

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Weight loss. Cough. Hemoptysis. Night sweats. CLINICAL SPECIMENS. SKIN SCRAPINGS. SPUTUM ... 2. Conversion. 3. DNA Probe. Wet Mount. SEROLOGIC TEST ... – PowerPoint PPT presentation

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Title: FILAMENTOUS FUNGI


1
FILAMENTOUS FUNGI
  • PAGE 13

2
SOME DISEASES CAUSED BY FILAMENTOUS FUNGI
  • Chromoblastomycosis
  • Mycetoma
  • Mucormycosis
  • Aspergillosis

3
CHROMOBLASTOMYCOSIS
  • A chronic localized infection of the subcutaneous
    tissue caused by several species of dematiaceous
    fungi

4
Chromoblastomycosis
  • Fonsecaea pedrosoi
  • Cladosporium carrionii
  • Phialophora verrucosa

5
Ecological AssociationChromoblastomycosis
  • Soil
  • Decaying vegetation

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Murifrom Cells(sclerotic bodies)
  • A fungus form resulting from host defenses

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Muriform cells
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Chromoblastomycosis
  • Melanin may be a virulence factor

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Geographic distribution
  • World-wide
  • (usually warmer climates)

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CLINICAL SPECIMENS
  • PUS
  • BIOPSY MATERIAL

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TREATMENT(Difficult)
  • EXCISION
  • TERBINEFINE
  • ITRACONAZOLE
  • POSACONAZOLE

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No Serological Tests Available
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Mycetoma
  • Tumefaction
  • Granules
  • Draining sinus tracts
  • Muscle invasion
  • Bone invasion

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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

28
IDENTIFICATION
  • Colonial morphology
  • Conidia formation
  • Granules
  • Color
  • Size shape
  • Texture
  • Biochemical reactions

29
DEMATIACEOUS HYPHAE
De
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Serological TestPseudalescheria
  • Immunodiffusion

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Therapy
  • Terbinefine
  • Itraconazole
  • Posaconazole

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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

39
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

47
SEROLOGIC TEST
  • IMMUNODIFFUSION

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ASPERGILLOSIS
  • A variety of diseases
  • pulmonary, external ears, eyes, meninges, sinuses
    or blood stream

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CLINICAL TYPES OF PULMONARY DISEASE
  1. ALLERGIC
  2. FUNGUS BALL
  3. INVASIVE

51
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

52
COMMON PATHOGENIC SPECIES
  • A. FUMIGATUS
  • A. NIGER
  • A. FLAVUS

53
GEOGRAPHIC DISTRIBUTION
  • WORLD-WIDE

54
ECOLOGICAL ASSOCIATION
  • UBIQUITOUS
  • SOIL
  • DECAYING VEGETATION
  • FOOD
  • MEDICATION
  • AIR VENTS
  • DISINFECTANTS

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Culture
  • More than 900 species
  • Slow growing
  • Various gross colors
  • Spores
  • Size
  • Shape
  • Texture
  • color

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HISTOPATHOLOGY
  • DICHOTOMOUS BRANCHING
  • WIDE, SEPTATE HYPHAE

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DICHOTOMOUS BRANCHING
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Aspergilloma
Cavity wall
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SEROLOGIC TESTS
  • IMMUNODIFFUSION
  • (antibody)
  • EIA - GALACTOMANNAN
  • (antigen)

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DRUG OF CHOICE
  • VORICONAZOLE
  • AMPHOTERICIN B

66
DIMORPHIC FUNGI(Endemic Mycoses)
  • COMMON CHARACTERISTICS
  • LIMITED GEOGRAPHIC AREA
  • SPECIFIC ECOLOGICAL NICHE
  • SYSTEMIC INFECTIONS
  • MORPHOLOGICALLY DISTINCT

67
DISEASES CAUSED BY DIMORPHIC FUNGI
  • Blastomycosis
  • Histoplasmosis
  • Coccidioidomycosis
  • Paracoccidioidomycosis
  • Sporotrichosis

68
BLASTOMYCOSIS
  • Blastomyces dermatitidis

69
BLASTOMYCOSIS
  • A CHRONIC SUPPURATIVE AND GRANULOMATOUS DISEASE
    OF ANY TISSUE WITH A PREDILECTION FOR LUNGS,
    SKIN, PROSTATE AND BONE.

70
PORTAL OF ENTRY
  • INHALATION
  • INOCULATION
  • (rare)

71
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
  • BRONCHIAL WASHINGS

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

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Virulence Factor
  • BAD1

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Identification
  • 1. Microscopic observation
  • 2. Conversion
  • 3. DNA Probe

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Wet Mount
91
SEROLOGIC TEST
  • IMMUNODIFFUSION
  • COMPLEMENT FIXATION
  • EIA

92
DRUGS OF CHOICE
  • ITRACONAZOLE
  • AMPHOTERICIN B
  • VORICONAZOLE

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END
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