Medical Mycology Systemic Mycoses

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Medical MycologySystemic Mycoses

• Hugh B. Fackrell
• Filename fungi_system.ppt

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Fungal Infections

• Opportunistic Infections
• Superficial fungal infections
• Cutaneous Mycoses
• Subcutaneous Mycoses
• Systemic Mycoses

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Systemic or Deep Mycoses

• Histoplasmosis
• Coccidiomycosis
• Blastomycosis
• Cryptococcosis

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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.

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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.

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Histoplasmosis

• Histoplasma capsulatum
• Ohio,Mississippi valleys

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Coccidiomycosis

• SW deserts, San Joaquin
• Coccidioides immitus

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Valley Fever
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Blastomycosis

• Blastomyces dermatitidi
• as histo but rarer.
• Canada- Manitoba and St.Lawrence river valley
• Disease in horses.
• Veternarians at risk.

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Cryptococcosis

• Cryptococcus neoformans
• Sporadic
• Pigeons
• Meningitis form
• fatal

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Systemic Mycoses Disease Patterns

• Subacute respiratory infection
• Acute infection
• Severe disseminated infection

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Systemic MycosesSubacute Respiratory Infection

• Low fever
• Non-productive cough
• Mild self limiting

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Systemic MycosesAcute Infections

• Productive cough
• purulent sputum
• pain in chest
• Weight loss.

• night sweats
• X-ray positive
• one,many lesions
• consolidation

Differential diagnosis pneumonia, tumour.
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Systemic MycosesSevere Disseminated Infections

• Acute Infections
• spread to other organs
• chronic

Differential diagnosis t.b.
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Systemic MycosesDiagnosis

• X-ray
• Immunochemical
• skin test
• serology
• Microscopy
• Sputum
• biopsy
• autopsy

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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.

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Systemic MycosesTreatment

• Amphotericin B
• and/or
• 5-fluorocytosine