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Primary systemic mycosis

Primary systemic mycosis. Primary systemic mycosis. Blastomycosis Blastomyces dermatitidis Coccidioidomycosis Coccidioides immitis Paracoccidioidomycosis Paracoccidioidoes brasiliensis Histoplasmosis Histoplasma capsulatum. Systemic mycosis caused by dimorphic Onygenales.

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Primary systemic mycosis

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  1. Primary systemic mycosis

  2. Primary systemic mycosis • Blastomycosis • Blastomycesdermatitidis • Coccidioidomycosis • Coccidioidesimmitis • Paracoccidioidomycosis • Paracoccidioidoesbrasiliensis • Histoplasmosis • Histoplasmacapsulatum

  3. Systemic mycosis caused by dimorphic Onygenales • Related dimorphic fungi • Most of them restricted to particular endemic areas • Primary pathogens • Inhalation from dust • In most cases exposure: • No clinical disease • Positive skin test (14 days)

  4. Systemic mycosis caused by dimorphic Onygenales • Acute reactions: • Asymptomatic or • Symptomatic, which may heal or develop into chronic lung disease • Endogenous reactivation • Occasionally disseminate to: • Skin • CNS • Visceral organs • Drug of choice Amphotericin B

  5. Summary

  6. Blastomycosis Skin lesions resulting from the dissemination of the fungus from the lungs

  7. Coccidioidomycosis Extension of pulmonary coccidioidomycosis showing a large superficial ulcerated lesion Chronic cutaneous granulomatous lesions of the face, neck and chin

  8. Paracoccidioidomycosis Ulcerated lesion on the nasal mucosa Extensive destruction of facial features Ulcerated lesion on the pharyngeal mucosa

  9. Laboratory diagnosis 1. Clinical material: • Skin scrapings • Respiratory specimens • CSF • Pleural fluid and blood • Bone marrow • Urine • Tissue biopsies from various visceral organs 2. Direct Microscopy: • 10% KOH, PAS, Silver or Gram stain 3. Culture: • SDA + BHIA at 37°C

  10. Blastomycosis Tissue sections showing large, broad-base, unipolar budding yeast-like cells

  11. Broad based budding and thickened cell walls and globose shape are characteristic of the yeast form of Blastomycesdermatitidis Blastomycesdermatitidis One-celled conidia formed on short conidiophores.

  12. Coccidioidomycosis Tissue section showing typical endosporulating spherules ofC. immitis

  13. Coccidioides immitis showing typical single-celled, hyaline, rectangular to barrel-shaped, alternate arthroconidia

  14. Paracoccidioidoesbrasiliensis Multiple, narrow base, budding yeast cells"steering wheels" of P. brasiliensis

  15. Paracoccidioidoes brasiliensis Multiple, narrow base, budding yeast cells "steering wheels" of P. brasiliensis

  16. PAS stain showing Histoplasma capsulatum yeast cells in liver specimen

  17. Histoplasma capsulatum Macroconidia and microconidia Rough-walled macroconidia

  18. End

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