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Fungal Characteristics and Human Fungal Pathogens Fungal Taxonomy Fungi Fungal Characteristics and Human Fungal Pathogens Fungal Taxonomy Domain Eukarya Kingdom Fungi [True Fungi = Eumycota] – Phylum Zygomycota – Phylum Basidiomycota – Phylum Ascomycota – Phylum Chytridiomycota – Phylum Deuteromycota [Imperfect Fungi] Fungal Taxonomic Names Phylum -mycota Class -mycetes Order -ales Family -aceae Genus Species Fungal Characteristics Heterotrophs Cell wall = chitin, glucan Mainly terrestrial Cell membrane = ergosterol Lack Chlorophyll Nucleus Dark Habitats Membrane bound Multidirectional Diploid chromosomes Spore bearing Cytoplasm Thallus body Similar to plants Types: Different ribosomal synthesis Mushroom Different microtubule protein Moulds Aerobic, multicelled Reproduction Yeast Sexually (meiotic) FA, single cell Asexually (mitotic) Nutritional Status Saphrophytes Scavengers, recycle Non living materials Parasites Feed off living materials Mutualists Symbionic relationship Primarily seen with plants Beneficial Uses of Fungi Yeasts Antibiotics Other Drugs Baking penicillin cyclosporin brewing cephalosporin Steroids Foods Experimental hormones cheeses metabolic (reproductive) Blue pathways Roquefort studied Parasitic Fungi Overview Cause Disease Directly Actual fungal growth in organism Cause Disease Indirectly Allergic reactions Toxin ingestion Exhibit Dimorphism [MÆY shift] Mould form (mycelial, filamentous) Yeast form (or spherule form) Change due to temperature, nutrients, CO2 levels Mould and Yeast Laboratory Methods to Identify Direct Id organism in specimen fluid Hyphae: aseptate, septate Spore: conidiospore, arthrospore, sporangiospore Yeast: size, thickness of walls, capsule +/- Culture Media such as Sabaurouds, BHI, Mycosal Tissue Stains: KOH, Eosin, India ink Serology CF, IFA Flourescence of fungi under UV light Immunity Normal Abnormal Skin Immunocompromised Burn pH HIV FA Chronic Disease Flora GCC turnover Cancers Respiratory DM cilia Post surgical Splenectomized Fungal Infection Locations Superficial Cutaneous Subcutaneous Systemic Lungs Other organ systems Opportunistic Fungal Mould Reproduction Sexual State Meiotic Teleomorph Produce spores (conidia) Asexual State Mitotic Anamorph Produce spores (conidia) Sexual Reproduction of Fungi Sexual Reproduction Sex organs called gametangia Distinguishable male and female Can bear sex cells (gametes) Can bear sex nuclei (gamete nuclei) Homothallic Single mycelium can sexually reproduce Heterothallic Two mycelia are required for sexual reproduction Reproductive Life Cycle Growth of hyphae Transverse fissure Fragmentation Break off Spores Sexual or asexual Disseminate Help in Id of fungus Size, shape, color, number Sexual Spores Zygospore Zygomycetes Sporangium Ascospore Ascomycetes Ascus rupture Basidospore Basidiomycetes Gill house of basidium, pinches off Asexual Spores Sporangiospores From sac head area called sporangium Rupture to release Zygomycetes Conidiospores Free spores, not enclosed in sac Pinched off segments Ascomycetes, Basidiomycetes, Deuteromycetes Types Arthrospores Chlamydospore Blastospore Phialospore Microconidia Macroconidia Porospore Yeast: Sacchromyces Fungal Yeast Reproduction Diploid Cell (via asexual reproduction) Plentiful food Haploid cells fuse to create diploid Mother cell will bud diploid daughter cells Haploid Cell (via sexual reproduction) Starved, Undernourished environment Meiotic division to create 4, 1n daughters 4 daughter spores remain inside “mother” Released when favorable environment Yeast on Sabauroud Agar Phyla include most of the yeasts Phyla include mushrooms, puff balls, shelf fungi, rusts, & smuts Phyla include saphrophytic bread moulds and some pathogens Phyla contain any fungus that has no known sexual repro state Fungal Phyla for aquatic, marine Human Mycoses Fungal Diseases of the Skin Sporotrichosis Sporothrix schenckii Clinical Course Dimorphic fungus Erythematous Reservoir: Papulonodular worldwide, tropical ulcerative Lymphocutaneous Transmission: direct Joints soil innoculation Ostearthritis tenosynovitis DX: Special Stains Pulmonary TX: Antifungals CNS Disseminated Lymphatic organs GI Sporothrix yeast phase Sporothrix infection CANDIDIASIS Candidia albicans Candidiasis of MM Small yeasts Oropharynx Reservoir: soil, food, Vulvovaginal nosocomial Cutaneous Source: Human Invasive Candidiasis commensals Joints GI: liver, pancreas Associated with Urinary immunocompromised Miscellaneous DX: Id organism Chronic TX: Antifungals Includes invasive areas CNS Respiratory Neonatal (thrush) Candidia Candidia infections: histology DERMATOPHYTOSIS Tinea / Ringworm Ubiquitous Tinea capitus Direct contact Tinea corporis Colonize keratin layers Tinea cruris Cause annular lesions with central clearing Tinea pedis DX: ID organism on Tinea unguium selective media or with Tinea favosum skin scrapings TX: Antifungals Trichophytan Microsporum Epidermophytan Trichophyton Microsporum sp. Tinea / Ringworm presentation Trichophytan barbarae Human Mycoses Fungal Infections of the Nervous System CRYPTOCOCCUS Cryptococcus neoformans Encapsulated Local in lungs Acute = ARDS Worldwide Chronic = pneumonia Opportunistic Disseminated Inhalation of spores CNS Æ meningitis Cutaneous Æ ulcers Virulence: GI Æ inflammation liver, Enzymes gall bladder, stomach capsule Bone Æ ostemyelitis DX: Id organism Heart Æinflammation,all Renal Æ abscess TX: Antifungals Eye Æ inflammation, all Cryptococcus neoformans infections Cryptococcus in the brain Human Mycoses Fungal Infections of the Cardiovascular System ZYGOMYCOSIS Rhizomucor, Rhizopus, Absidia Zygomycetes group Rhinocerebral DM Soil, decay Orbital structures Internal Carotid Opportunistic Pulmonary Neutropenic Invades arteries dyspnea causing embolus hemoptysis GI DX: Autopsy, Malnutrition Culture, Histopath Intraabdominal abscess Cutaneous TX: Antifungals Skin trauma, burns Necrotic lesions PX: usually fatal Other areas Bone Heart Rhizomucor, Rhizopus Rhizomucor Rhizopus Human Mycoses Fungal Infections of the Respiratory System ASPERGILLOSIS Aspergillus sp. Allergic Bronchopulmonary Soil, decay Sinuses and lungs Inhalation of spores Pulmonary Opportunistic Within paranchyma Pulmonary Dz Invasive Immunocompromised CNS DX: Id organism in BoneÆ osetomyelitis fluids, culture, HeartÆendocarditis histopathology RenalÆ abscess TX: Antifungals Cutaneous Px: Mortality rate is 50- post op, sx 100% Catheter placement Burn victims Ear Aspergillosis Infections Culture specimen Aspergillus histology Coccidioidomycosis Coccidioides immitis Dimorphic fungi Asymptomatic Acute Western hemisphere in Respiratory: SOB, pain arid regions Skin: rash Inhalation of spores Chronic Pulmonary Nodules Spores transform to Disseminated spherules Skin: ulcerative DX: CF, RADS, Joints: synovitis Meninges: hydrocephalus Isolation, Direct ID Any other organs TX: Antifungals Internal linings GI PX: 90% resolve Urogenital spontaneously unless Endocrine immunocompromised Coccidioidomyces Coccidioides immitis: Spherules Coccidiodes clinical presentation Paracoccidioidomycoses Paracoccidioides brasiliensis South America Asymptomatic Dormant Soil, decayed wood Reappear if immunocompromised Inhalation of MM blastoconidia Ulcerations of mouth and oropharynx DX: Id organism in Pulmonary specimens, culture, Nodular infiltrates Mimic TB histopathology Cutaneous TX: Antifungals Ulcerative Invasive to S.C. PX: good if treated, Disseminated possibility of relapse GI: liver Bones CNS Male genitourinary tract Paracoccidioides KOH Microscopic Yeast Phase Macroscopic BLASTOMYCOSES Blastomyces dermatitidis Dimorphic, heterothallic Asymptomatic ascomycete 50% of infections SC, SE US : Mississippi and Acute Pulmonary Ohio River Valleys Mimics bacterial infections Source Chronic Pulmonary Soil, rotting wood Mimics bronchogenic carcinoma Growth in feces of bats, birds Disseminated Inhalation of conidia Skin: ulcerative DX: Direct Id of fluid specimens, Bones: long bones, lytic Culture, Histopathology Genitourinary TX: Antifungals Male: ducts, glands PX: spontaneous resoluton, Tx Others CNS infections CNS Pericardium GI Adrenal Gland Blastomyces: Yeast Phase HISTOPLASMOSIS Histoplasma capsulatum Dimorphic fungus Subclinical, benign Acute Soil Self limited, flu-like symptoms Pulmonary: pneumonitis, calcification Inhalation of Pericarditis Rheumatological: arthritis microconidia Chronic Pulmonary ~ TB Fibrosing Mediastinitis DX: Direct Id of fungi in Fibrous CT in mediastinum specimen sample, Affects surrounding structures Disseminated histopathology, culture Lymphadenitis Red bone marrow suppression TX: Antifungals Endocarditis CNS: meningitis, cerebritis PX: most are self GI: ulcers limited, Tx if respiratory Skin: rash Genitourinary of males and disseminated Eyes: uveitis, chorioditis Histoplasmosis Histoplasmosis: Disseminated Histoplasmosis Culture Id Clinical Presentation Cytology Human Mycoses Environmental Moulds Environmental Exposure Mycotoxins Allergic Ingestion Prior Exposure Ergotism – Claviceps Re-exposure – Rye products Respiratory signs – Limb gangrene – Alpha adrenergic Coughing blockade Wheezing Aflatoxins – Aspergillus Sinus congestion – Peanut meal Rhinorrhea – carcinogens Itchy nose Zearalenones – Fusarium Sore throat – Estrogen like
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