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Questions and Answers
What is the primary role of the ascus in Ascomycota during sexual reproduction?
What is the primary role of the ascus in Ascomycota during sexual reproduction?
Which of the following correctly describes superficial mycoses?
Which of the following correctly describes superficial mycoses?
Which organism is primarily responsible for causing pityriasis versicolor?
Which organism is primarily responsible for causing pityriasis versicolor?
What distinguishes systemic fungi from other types of fungi?
What distinguishes systemic fungi from other types of fungi?
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What is the significance of Sabouraud's agar as a mycological medium?
What is the significance of Sabouraud's agar as a mycological medium?
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Which class of fungi includes dermatophytes that cause conditions like ringworm?
Which class of fungi includes dermatophytes that cause conditions like ringworm?
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What type of fungal infections are categorized as subcutaneous mycoses?
What type of fungal infections are categorized as subcutaneous mycoses?
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Which of the following statements about opportunistic fungi is true?
Which of the following statements about opportunistic fungi is true?
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Which among the following statements accurately reflects the classification of mycoses?
Which among the following statements accurately reflects the classification of mycoses?
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What is a primary characteristic that differentiates superficial mycoses from cutaneous mycoses?
What is a primary characteristic that differentiates superficial mycoses from cutaneous mycoses?
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Which of the following is NOT a common method for diagnosing fungal infections?
Which of the following is NOT a common method for diagnosing fungal infections?
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In treating superficial mycoses, which class of medication is typically utilized?
In treating superficial mycoses, which class of medication is typically utilized?
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What is the predominant sterol found in fungal cell membranes that differentiates them from mammalian cells?
What is the predominant sterol found in fungal cell membranes that differentiates them from mammalian cells?
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Which of the following antifungal treatments is most likely used for cutaneous mycoses?
Which of the following antifungal treatments is most likely used for cutaneous mycoses?
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Which feature is NOT characteristic of fungi in comparison to bacteria?
Which feature is NOT characteristic of fungi in comparison to bacteria?
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What is a significant difference between the cell walls of fungi and bacteria?
What is a significant difference between the cell walls of fungi and bacteria?
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Which of the following statements is true concerning obligate and facultative aerobes in fungi?
Which of the following statements is true concerning obligate and facultative aerobes in fungi?
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Which of the following best describes the eukaryotic structure of fungal cells?
Which of the following best describes the eukaryotic structure of fungal cells?
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Which organism is primarily associated with subcutaneous phaeohyphomycosis?
Which organism is primarily associated with subcutaneous phaeohyphomycosis?
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What is the primary characteristic feature of phaeohyphomycosis observed in tissue?
What is the primary characteristic feature of phaeohyphomycosis observed in tissue?
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Which treatment is considered the drug of choice for subcutaneous phaeohyphomycosis?
Which treatment is considered the drug of choice for subcutaneous phaeohyphomycosis?
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What type of infection can result from Cladophialophora bantiana?
What type of infection can result from Cladophialophora bantiana?
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Which of the following statements about chromoblastomycosis is true?
Which of the following statements about chromoblastomycosis is true?
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Which characteristics differentiate actinomycotic mycetoma granules from mycotic lesions?
Which characteristics differentiate actinomycotic mycetoma granules from mycotic lesions?
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What is a common treatment option for rhinosporidiosis?
What is a common treatment option for rhinosporidiosis?
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Which method is NOT used for the laboratory diagnosis of fungal infections?
Which method is NOT used for the laboratory diagnosis of fungal infections?
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What factor complicates the development of antifungal medications?
What factor complicates the development of antifungal medications?
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Which of these fungi groups is responsible for producing deadly toxins?
Which of these fungi groups is responsible for producing deadly toxins?
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In the context of fungal infections, which organism is indicated as the causative agent of rhinosporidiosis?
In the context of fungal infections, which organism is indicated as the causative agent of rhinosporidiosis?
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What is the general habitat associated with the transmission of Rhinosporidium seeberi?
What is the general habitat associated with the transmission of Rhinosporidium seeberi?
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Which of the following antifungal agents is NOT typically used for treating fungal infections?
Which of the following antifungal agents is NOT typically used for treating fungal infections?
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Which microbial feature is important in distinguishing various fungal groups?
Which microbial feature is important in distinguishing various fungal groups?
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How are polyps caused by rhinosporidiosis typically characterized?
How are polyps caused by rhinosporidiosis typically characterized?
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What is the primary mode of entry for fungi causing subcutaneous mycoses?
What is the primary mode of entry for fungi causing subcutaneous mycoses?
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Which of the following is NOT a characteristic of sporotrichosis caused by Sporothrix schenckii?
Which of the following is NOT a characteristic of sporotrichosis caused by Sporothrix schenckii?
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What is the treatment recommendation for sporotrichosis after the lesions clear?
What is the treatment recommendation for sporotrichosis after the lesions clear?
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Which subcutaneous mycosis is primarily associated with involvement in lymphatics and lymph nodes?
Which subcutaneous mycosis is primarily associated with involvement in lymphatics and lymph nodes?
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What is a common environmental source of Sporothrix schenckii?
What is a common environmental source of Sporothrix schenckii?
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Which statement about subcutaneous mycoses is incorrect?
Which statement about subcutaneous mycoses is incorrect?
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What type of fungus is Sporothrix schenckii classified as?
What type of fungus is Sporothrix schenckii classified as?
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What characteristic lesion typically appears at the site of a thorn injury in sporotrichosis?
What characteristic lesion typically appears at the site of a thorn injury in sporotrichosis?
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Which occupational group is most frequently associated with sporotrichosis?
Which occupational group is most frequently associated with sporotrichosis?
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What is the preferred treatment option for troublesome cases of sporotrichosis?
What is the preferred treatment option for troublesome cases of sporotrichosis?
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Study Notes
Cutaneous and Subcutaneous Mycoses
- Mycology is the study of fungi
- Approximately 80,000 fungal species have been described, but fewer than 400 are medically important.
- Less than 50 species cause more than 90% of fungal infections
- Fungi are beneficial in breaking down and recycling organic matter
- Fungi contribute to food and beverages (cheese, bread, beer)
- Fungi produce bioactive secondary metabolites like antibiotics (penicillin) and immunosuppressants (cyclosporine)
- Fungi are eukaryotes, with a higher biological complexity than bacteria
- Fungal cells have a nucleus, nuclear membrane, endoplasmic reticulum, mitochondria, and a secretory apparatus
- Most fungi are obligate or facultative aerobes
- Fungi reproduce both sexually and asexually
- Some fungi are unicellular; others become multicellular via branching filaments
- Fungi absorb nutrients; they lack chlorophyll
- The fungal cell wall is different from bacteria and plant cells chemically
- The main sterol in fungi is ergosterol, while in mammals it is cholesterol
- Fungi are typically haploid, although diploid nuclei are formed during sexual reproduction
- Fungal cells are typically surrounded by a rigid cell wall
- The cell wall is made up of polysaccharides (mannan, glucan, and chitin) and structural proteins
- Fungal infections are termed mycoses
- Mycoses can be classified as superficial, cutaneous, subcutaneous, or systemic (Table 45-1)
- Systemic mycoses often exhibit subcutaneous manifestations and vice versa
- Most patients with opportunistic infections have compromised host defences
Fungal Structure
- Fungal cells have a nucleus, nucleolus, nuclear membrane, linear chromosomes, cytoskeleton (actin microfilaments and tubulin-containing microtubules), ribosomes, and other organelles (e.g., mitochondria, endoplasmic reticulum and Golgi apparatus)
- Fungal cells have a rigid cell wall (external to cytoplasm membrane).
- Fungi differ from bacterial and plant cells in their sterol composition/make up.
Yeasts and Molds
- Fungi grow as yeasts or molds
- Mold growth is by multicellular filamentous colonies
- Colonies are composed of branching cylindrical tubules called hyphae, with diameters from 2μm – 10μm
- Intertwined hyphae form a mycelium
- Hyphae may be divided into cells with cross-walls or septa (like compartments), appearing at regular intervals during growth
- Some medically significant molds, like zygomycetes, have hyphae that are not septated
- Other fungi have septate hyphae
- Aseptate (coenocytic) hyphae have multinucleated cytoplasm
- Fungi grow through the development of hyphae (like extensions of the cell)
- These extended hyphae form an interwoven mass referred to as the mycelium.
- A portion of the mycelium (vegetative mycelium) absorbs nutrients
- The aerial mycelium produces spores for reproduction
- Mycelium is like a root
- Aerial mycelium bears reproductive structures (conidia or spores)
- The hyphae are rigid to support the interwined network which is a mold
Types of Hyphae
- Vegetative hyphae penetrate the medium for nutrient absorption
- Aerial hyphae extend above the surface to provide support or to reproduce.
- Reproductive hyphae carry spores for reproduction.
- Mycelium is a collection of hyphae
Asexual Spores on Aerial Mycelia
- Sporangiospores develop in a sporangium on sporangiophore
- Conidia form on conidiophore, developing from the hyphae directly or on specialized structures
- Arthrospores are conidia formed when the hyphae break down into septate segments
- Chlamydospores are thick-walled spores produced within the hyphae
- Blastospores are produced by budding
- Phialospores are formed on the outside of specialized conidiophores
- Macroconidia: Larger in size compared to microconidia
- Microconidia: Smaller in size compared to macroconidia
Yeasts
- Yeasts are single cells, typically spherical or egg-shaped, with diameters of 3–15 μm.
- Yeasts reproduce via budding.
- Some yeasts produce buds that, rather than detaching, become elongated, producing a chain of elongated cells, called pseudohyphae.
Yeast vs. Hyphae
- Pseudohyphae differ from hyphae in recurring bud-like constructions and in being less rigid
- Yeasts colonize mucosal surfaces and spread to other locations (especially in immuncompromised hosts)
- Pseudohyphae have enhanced nutrient scavenging capabilities, and motility.
- Hyphae invade host tissues and breach endothelial cell layers. They are capable of lysing macrophages and neutrophils and exhibit thigmotropism and antigenic variation.
Reproduction
- Fungi reproduce sexually or asexually
- Asexual reproduction produces conidia, which arise either from condiophores or directly from existing hyphae
- Sexual reproduction produces ascospores
Spores
- Spores are readily dispersed
- Spores are resistant to harsh environments
- Spores can germinate when conditions for growth are favorable
- Spores can derive from asexual or sexual reproduction
Fungal Groups
- Fungi are classified into four phyla: Chytridiomycota, Zygomycota, Ascomycota, and Basidiomycota.
- Ascomycota includes more than 60% of known fungi and about 85% of human pathogenic fungi
- Zygomycota or Basidiomycota are the remaining pathogenic fungi
Zygomycota
- Sexual reproduction results in zygospores
- Asexual reproduction occurs via sporangia
- Vegetative hyphae are sparsely septate
Ascomycota
- Sexual reproduction involves a sac (ascus) where karyogamy and meiosis occur
- Asexual reproduction is via conidia
- Molds have septate hyphae.
Basidiomycota
- Sexual reproduction forms four basidiospores on a club-shaped basidium
- Hyphae are complex and septate.
Culturing
- Fungi readily grow on simple sources of nitrogen and carbohydrates.
- Sabouraud's agar is used because it doesn't support bacterial growth
Fungal Medical Significance
- Various fungi (yeasts, molds, and fleshy fungi) have medical, veterinary, or agricultural importance due to causing infections
- Fungal infections in humans, animals and plants are called mycoses
Grouping of Medically Important Fungi
- Grouping fungi by the tissues they parasitize and diseases produced
- Superficial fungi: dermatophytes (e.g., ringworm, athlete's foot)
- Subcutaneous fungi cause infections in the skin and extend to subcutaneous tissue (e.g., sporotrichosis, chromoblastomycosis, phaeohyphomycosis, mycetoma)
- Opportunistic fungi found in the environment or normally in the flora, producing disease in compromised situations
- Systemic fungi are highly virulent and cause progressive systemic diseases (e.g., histoplasmosis)
Superficial Mycoses
- Superficial mycoses involve infection of the outermost body areas (hair, nails and epidermis)
Pityriasis Versicolor
- A chronic superficial infection of the stratum corneum
- Caused by Malassezia globosa, M restricta, or other members of the M furfur complex
- Characterized by discrete, serpentine, hyper or hypopigmented maculae mainly on the back.
- Treated with selenium sulfide or azoles
Tinea Nigra
- A superficial, chronic, and asymptomatic infection of the stratum corneum
- Caused by Hortaea (Exophiala) werneckii
- Characterized by a dark-colored discoloration, often on the palms (especially in young women).
- Treated with keratolytics, salicylic acid, or azole antifungals
Piedra
- Nodular infections of hair shafts
- Black piedra is caused by Piedraia hortai
- White piedra is caused by Trichosporon species
- Treated by hair removal and topical antifungals.
Cutaneous Mycoses
- Cutaneous mycoses are fungal skin infections
- Caused by fungi that infect only superficial keratinized tissues (skin, hair, and nails)
- Dermatophytes are the most important ones of these (Microsporum, Trichophyton, Epidermophyton)
Dermatopytoses
- Dermatophytoses are among the most prevalent fungal infections
- The infections are not usually life-threatening but can be troublesome
- Acquired by contact with contaminated soil or infected animals/humans
- Geophilic, zoophilic, or anthropophilic, depending on whether the habitat is soil, animals or humans, respectively.
Epidemiology & Immunity
- Dermatophytes infections begin with trauma/contact
- Susceptibility may be enhanced by factors such as moisture, warmth, skin chemistry, youth, and heavy exposure
- The incidence is higher in hot/humid climates and crowded living conditions
- Transmission from soil/infected animal
- Trichophytin is a crude antigen preparation used to detect hypersensitivity
Tinea Pedis (Athlete's Foot)
- Usually occurs as a chronic infection of toe webs
- Other types include vesicular, ulcerative, and moccasin
- Itching between toes, small vesicles developing, thin fluid discharge, maceration and peeling, secondary bacterial infection
- Peeling/cracking are the principal manifestations, accompanied by pain and pruritus
- Chronic infections
Tinea Unguium (Onychomycosis)
- Nail infection following prolonged tinea pedis
- Manifestations: brittle, thickened, crumbly nails
Tinea Corporis, Tinea Cruris, and Tinea Manus
- Dermatophytosis affects glabrous skin
- Annular lesions (ringworm) with a clearing, scaly center and red advancing border.
- Usually in dry or vesicular form
- Fungal metabolites, enzymes, and antigens cause erythema/vesicle formation/pruritus
- Lesions expand outward
- Tinea cruris (jock itch), infects the groin, may spread to scrotum
- Tinea manus (hand ringworm), involves fingers/hands
Tinea Capitis and Tinea Barbae
- Tinea capitis (scalp ringworm), an infection of scalp/hair follicles
- Infection begins with hyphal invasion of the skin and subsequent spread down the keratinized wall of hair follicle
- Infection above hair root, causes dull gray circular patches with alopecia, scaling and itching.
- Tinea barbae involves the bearded region
Treatment (General)
- Treatment involves removal of infected and dead epithelial structures
- Topical antifungal chemicals or antibiotics are used
- The area should be kept dry, sources of infection avoided
Treatment (Specific)
- Scalp infections: griseofulvin for 4–6 weeks, but azoles, ketoconazole, itraconazole, and terbinafine are quite effective
- Tinea corporis, pedis: itraconazole, terbinafine; topical preparations (miconazole, tolnaftate, clotrimazole, for 2-4 weeks)
Subcutaneous Mycoses
- Fungi reside commonly in soil/vegetation
- Enter skin/subcutaneous tissue via trauma from contaminated material/material
- Lesions become granulomatous and slowly expand
- Extension via lymphatics; usually confined to subcutaneous tissue but can become systemic
- Sporotrichosis, chromoblastomycosis, phaeohyphomycosis, mycetoma, lobomycosis, rhinosporidiosis
Sporothrix schenckii
- Thermally dimorphic fungus
- Grows as mold (ambient temperatures), or budding yeast at 35-37 degrees Celsius in tissue or vitro
- Causative agent for sporotrichosis
- Associated with vegetation/plant materials
- Acquired through traumatic inoculation
- Chronic granulomatous infection with secondary spread to draining lymphatics and lymph nodes
Sporotrichosis
- Chronic infection of cutaneous, subcutaneous, lymphatic tissue
- Commonly seen in gardeners, forest workers, and manual laborers
- Causative agent is Sporothrix schenckii
- Found in soil, decaying woods, thorns, infected animals
Chromoblastomycosis
- Subcutaneous fungal infection caused by traumatic inoculation of certain dematiaceous fungi
- Fungal agents: Phialophora verrucosa, Fonsecaea pedrosoi, Rhinocladiella aquaspersa, Fonsecaea compacta, Cladophialophora carrionii
- Chronic with gradual development of granulomatous lesions
Phaeohyphomycosis
- Infections characterized by darkly pigmented septate hyphae
- Forms from various species of dematiaceous molds, typically exogenous
- Geographic distribution: tropical countries
- Can develop as solitary encapsulated cysts, sinusitis, brain abscesses,
- Treated with itraconazole or flucytosine; amphotericin B and surgery for brain abscesses
Mycetoma
- A chronic, granulomatous, progressive inflammatory disease of the subcutaneous tissue
- Causative agents: true fungi (eumycetes) or higher bacteria (actinomycetes)
- Characterized by the formation of grains that contain aggregates of causative organisms and drain through multiple sinuses
Madura Foot
- A type of mycetoma, originally reported from Madurai.
- Chronic infection draining through sinuses on the skin
Rhinosporidiosis
- Chronic granulomatous disease characterized by the development of friable polyps (usually in the nose, mouth, eyes, rarely genitalia, or other mucous membranes)
- Distribution mainly from India and Sri Lanka, although first identified in Argentina.
- Causative agent: Rhinosporidium seeberi (cannot be cultured) believed to be transmitted in dust or water, with fish as the likely natural host
Treatment (Specific, Mycetoma)
- Treatments for mycetoma, including surgery, antifungal therapy (amphotericin B, miconazole, ketoconazole, itraconazole, flucytosine), topical nystatin, and topical potassium iodide.
Laboratory Diagnosis
- Tissue samples, aspiration fluid, pus, biopsy material, skin scrapings, and swabs are collected
- KOH mounts of specimens or histopathological examination of tissue sections stained by methanamine silver stain are used
- Cultivating organisms in culture and physiological/serological tests to assist with diagnosis
Summary (Main Points)
- Fungi are diverse saprophytic eukaryotes with chitin cell walls
- Some fungi are unicellular and others multicellular; many fungal spores are microscopic, whilst some are large.
- Reproductive types are significant for fungal group identification
- Medically important fungi belong to Zygomycota, Ascomycota, Basidiomycota
- Members of certain groups produce deadly toxins
- Important differences in fungal cells, e.g., ergosterol, are targets for antifungal medications. Similarities between human/fungal cells pose difficulty in finding ideal targets.
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Description
Test your knowledge on the fascinating world of fungi, focusing on Ascomycota, mycoses, and their roles in different environments. This quiz covers topics such as sexual reproduction in fungi, types of mycoses, and specific fungi responsible for certain infections. Perfect for students and enthusiasts of mycology!