Introduction Medical Mycology

1. Introduction Medical Mycology Prof. Dr. Asem Shehabi Faculty of Medicine University of Jordan

2. General Fungi-1 • Fungi are eukaryotic microorganisms.. Larger than bacteria occur as Yeasts(unicellular cells; 0.5-4 um) or Molds/ filamentous Fungi.. composed of various cellular structures; spores, filaments/Hyphae.. cells up 20um).. • Nest branchingfilament/ Multicellular fungi • Masses of Hyphae are called mycelium. • In molds, the mycelia often spread to fill the available space, limited by available nutrients.

3. Hypha Cell-Yeast Cell

4. General Fungi-2 • Essentially Aerobic .. Mostly found in Nature living in association with plants ..often as harmful organisms..free saprophytes on dead organic substances. • Fungi have chemoheterotrophic metabolisms, obtaining nutrients through chemical absorption.. Certain Fungi .. Producer Antibiotics.. Decompose organic materials.. plants. • Molds Reproduction by various spores, hyphae.. apical extension of cells.. • YeastMostly reproduce asexually by budding, although a few reproduce by binary fission. • Baker's yeast/ Saccharomycescerevisiae.. Sugar- Fermentation.. Important in Production Bread.. Vitamins Medical drugs like Insulin.

6. 1-Aminata Toxic Mushroom 2-Non-Toxic Mushroom in Nature

7. Fungi cell Structures • About 100 Fungi types are opportunistic pathogens.. Yeast part normal flora.. Oral cavity-intestine-Vagina.. Few types true pathogens • They are not susceptible to antibacterial drugs , phages • Fungi Cell wall: Mostly Polysaccharides (chitin, glucan, mannan), lipid-phosphate-protein, protease, melanin . Their Plasma membranes containing Ergosterol, Cytoplasm contains microtubules composed of tubulin/Specific Protein..Mitochondria, Lipids & phosphate granules • Pathogenic Yeasts produce often elongated Oval cell & Pseudohyphe on body mucosal cells ..Pathogenic Mold:single and multiply filaments.. cell fragments in infected tissue. • Antifungal drugs: Nystatin, Fluconazol, Amphotericin B, Casbofungin.. All react with ergosterol forming compmlex molecules.. damage cell membrane.

9. Budding Yeast/Germ Tubes

10. Capsulated Yeast / Cryptococcus neoformans (India ink test)

11. FilamentsFungi/ Molds • Molds form multicellular filaments/ hyphae .. non-septate/ septatehyphae.. spores of different sizes.. color.. arrangement .. A mass of hyphae and spores represent Aerial & Vegetative Mycelium • Dimorphic Pathogenic fungigrow as Yeasts or Yeast-like structure in vivo at 37°C, but as Molds at 25°C • Lab Identification: Direct smear .. Culture on Sabourauds dextrose agar/ blood agar.. Slow or rapid growth (2-30 days).. Morphology & reproduction of spores/yeast cells/ Filments (Hyphae).. Colors of Micro/Macro Conidia.. Arrangement of spores on septet or non-septet hyphae.

12. Human Mycosis-1 • Dermatophytosis /Superficial Mycoses/ Cutaneous Mycoses/ Ringworm/Tinea .. • Involve superficial keratinize.. Dead tissues.. skin, hair, Nails.. Caused by Dermatophytes: Trichophyton - Microsporium -, Epidermophyton species • Worldwide distribution.. Spores, Hyphae fragments.. Common in nature, skin human, animals. • Tineaversicolor / Pityriasisversicolor.. Yeast • Clinical Features: Erythematic Skin lesions..Rare inflammation.. Allergic reaction.. Common under stress conditions.. Fever, Unknown Factors.

13. Human Mycosis-2 • Skin spots commonly affect the back, underarm, upper arm, chest, lower legs, and neck. Occasionally it can also be present on the face. • The yeasts can often be seen under the microscope within the lesions with typically round yeasts & filaments. Light to Dark patches on skin.. Difficult to culture. • Hair:Tineacapitis, Hairshaft /hair follicles. Scalp, Endo-Exothrix, Common in Children.. Rare Adults.. Infection Outbreaks . • Nail:Tineaunguium &Tineapedis.. Feet fingers, Feet interspace, moist skin lesions, Common in Adults, develop Chronic • Causative agents:Dermatophytes.. Trichophyton - Microsporium -, Epidermophyton species.

14. Tinea corporis- Pityriasis versicolor

15. Tinea unguium – Tinea Tineacapitis

16. Microconidia-Macroconidia

17. Penicillinums-Trichophyton spp.

18. Yeast /Candida species • Candidiasis/ Candidiosis: C. albicans (50-70%).. Less C. glabrata, C. tropicalis., C. Krusei.. & Others spp. • Part normal body Flora.. Mouth, Vagina, Skin, Intestine, Urinary tract. • Opportunistic Pathogens.. mostly endogenous infection, arising from overgrowth of the fungus .. intensive use of antimicrobial drugs.. Inhibiting normal flora.. Underlining diseases, compromised host, Radiation, Toxic drugs • Exogenous infection .. catheters or prosthetic devices.. Respiratory tubes.. person-to-person transmission, • Common Nosocomial Infection. • Clinical Features: Oral mucosa.. Thrush .. Throat- Pharynx, Lung , Candidiasis ,vaginal Candidiasis.. discharge & Irritation, Candidemia, meningitis.

19. Candida Pseudohyphae ( Chlamydo-Blastospores)

20. Candida Trush

21. Other Yeast Infection • Encapsulated C. neoformans..Large Capsule..cause a chronic- subacute- acute pulmonary.. May spread to blood, CNS.. causes ..systemic or meningitic disease.. Often isolated from pigeon, Birds excreta. • C. neoformans has a world-wide distribution.. now one of the most significant opportunistic pathogens in humans.. immunodifficient ..AIDS patients..

22. Mold infection:Aspergillosis • Aspergillus speciesare common in nature.. Spores spread with dust particles..Inhalation. . Few develop Allergy or clinical disease • A. fumigatus, A. flavus, A. niger. • Human Aspergillosis : Mycotoxicosis due to ingestion of contaminated foods with fungal toxin ..Peanuts, Rice, • A. flavus .. Produce Aflatoxins.. Liver cirrhosis..Death 2) Allergic BronchopulmonaryAspergillosis: Presence of conidia or transient growth of the organism in body Respiratory tract.. Sinuses.. often associated with Allergic reaction ..Eosinophilia.. Asthma.. 3) Pulmonary lesions in preformed cavities .. debilitated tissues.. Common in Tuberculosis & Lung carcinoma, Localized Lesions, ..Eye , Sinuses, External Otitis infection …Surgery & Antifungal Treatment

23. 1-Aspergillus niger growth2- Wet preparation, Aspergillus