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Medical Mycology. Comparison of fungi and bacteria. Role of fungi in nature. There are approximately 70,000 recognized species of fungi. Most are beneficial to humankind. production of food antibiotics and immunosuppressive drugs used as model systems in molecular biology.
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Role of fungi in nature • There are approximately 70,000 recognized species of fungi. • Most are beneficial to humankind. • production of food • antibiotics and immunosuppressive drugs • used as model systems in molecular biology
Medical Mycology • the subject on pathogenic fungi • Some fungi act as the plant and animal pathogens in the agricultural industry. • About 300 species of fungi cause human infections.
曲霉菌 假丝酵母菌 表皮癣菌 小孢子癣菌 毛癣菌 Mucor 毛霉菌 Cryptococcus neoformans 新型隐球菌 皮炎芽生菌 荚膜组织胞浆菌 巴西副孢子菌
Cellular Morphology • Yeasts: unicellular organisms • mycelia (molds): multicellular • Dimorphic fungi
A. Yeast cells propagating by blastoconidia / budding B. Yeast dividing by binary fission C. Development of pseudohyphae
amold is multicellular microbes composed of two parts:sporeandhypha. Hypha • spore
Dimorphic fungi • Some fungi exist in both yeast and mycelial forms. These fungi are called dimorphic fungi. • Yeast form:a parasitic or pathogenic form. This form is usually seen in tissue of patients. Can be cultured at 37 ℃. Conversion to yeast form appears to be essential for pathogenicity. • Mycelial form:a saprophytic form. This is the form existing in nature. Can be cultured at 25 ℃.
Culture & Colony morphology • Sabouraud culture medium. • Optimal pH 4-6. • Optimal temperature 22-28℃, 37 ℃ for certain pathogenic fungi. • Aerobic.
Resistance • Fungi have strong resistance to dryness, sunlight, UV light and many chemical agents, but much sensitive to wet heat.
Drugs • The antibiotics to treat fungal infectious diseases are quite different compared to those to cure bacterial infectious diseases: amphotericin B (两性霉素B), anticandine (制霉菌素), miconazole (咪康唑), ketoconazole (酮康唑) etc.
Major clinical manifestations of fungal diseases: ◇Hypersensitivity:an allergic reaction to molds and spores. ◇Mycotoxicosis: poisoning of human and animals by food contaminated with mycotoxins. ◇Infectious diseases: caused by exogenous pathogenic fungi or endogenous fungi (opportunistic infections). ◇Inducing tumors:Some mycotoxins can induce tumors (e.g., aflatoxin causes liver cancer) (黄曲霉素).
Anti-fungus Immunity & fungal Infectious diseases
In general, humans have a high level of innate immunity to fungi and most of the fungal infections are mild and self-limiting. • For the exogenous pathogenic fungi, the infections are classified according to where the infections take place: • A. Superficial mycoses • B. Cutaneous mycoses • C. Subcutaneous mycoses • D. Systemic mycoses
Superficial mycoses: • Infections are limited to the hair or the outermost layers of skin.
B.Cutaneous mycoses: • Fungi invade the keratinized layers (角化层) of skin, hair and nails and the diseases are limited in these layers. • The fungi causing these diseases are termed dermatophytes (皮肤癣真菌). • The diseases are referred to as tinea (癣病).
All tinea are caused by members of three genera: • Trichophyton (毛癣菌) • Epidermophyton (表皮癣菌) • Microsprum (小孢子癣菌) • Unlike the superficial mycoses, cellular immune responses may be evoked
C.Subcutaneous mycoses: The infections involve the dermis, subcutaneous tissue, muscle and fascia.
D. Systemic mycoses: the infections originate primarily from the lung and then spread to many other organs
Cryptococcus neoformans • Oval, budding yeast surrounded by characteristic thick polysaccharide capsule.
C. neoformans with capsule is negatively stained by India Ink
Disease • Cryptococcosis • Acute or chronic infections in the lung, bone and skin, and meningitis • meningitis can last several months and are highly fatal • No human to human transmission • Infection follows inhalation of pigeon or chicken droppings containing the microbe
Opportunistic mycoses • Patients or individuals with immune deficiency are easily suffering from opportunistic mycoses caused by fungi belonging to normal flora.
Candida albicans can be found in 40-80% of normal human beings. It is present in mouth, intestine and vagina. • Candida albicans is dimorphic fungus. • Candida albicans can show germ tubes with special shape, which used as a diagnostic feature of the microbe.