أسئلة ريتين الثامنة ميكرو دمياط (قبل التعديل)
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Questions and Answers

What is the primary anatomical site that dermatophytes invade?

Dermatophytes primarily invade the epidermis, hair, and nails, but not the dermis.

Which fungal infections are particularly concerning for immunocompromised patients?

Fungal infections such as candidiasis and aspergillosis are particularly concerning for immunocompromised patients.

What are the two parts of specimens collected for fungal infection examination?

The two parts are one for microscopy and the other for culture.

What is the role of KOH in the examination of fungal specimens?

<p>KOH is used to dissolve keratin and aid in the visualization of fungal cells under the microscope.</p> Signup and view all the answers

Name one class of antifungal agents that inhibit cell wall synthesis and provide an example.

<p>Echinocandins inhibit cell wall synthesis; an example is Caspofungin.</p> Signup and view all the answers

Why is the incubation of cultures at both 25°C and 37°C important?

<p>Cultures are incubated at both temperatures to reveal the dimorphism of certain fungi.</p> Signup and view all the answers

What is the significance of Candida in the human microbiome?

<p>Candida is part of the normal flora but can cause infections when the immune system is compromised.</p> Signup and view all the answers

What are some complications that can arise after antibiotic and corticosteroid therapy?

<p>Complications include increased susceptibility to fungal infections such as cryptocomosis and candidiasis.</p> Signup and view all the answers

What is mycology and where are most fungi commonly found?

<p>Mycology is the study of fungi. Most fungi are commonly found in soil and water.</p> Signup and view all the answers

Describe the composition of fungal cell walls and membranes.

<p>Fungal cell walls are rigid and composed of chitin, glucans, and mannans, while the cell membranes contain ergosterol.</p> Signup and view all the answers

What are the differences between vegetative and aerial hyphae?

<p>Vegetative hyphae anchor the colony and absorb nutrients, while aerial hyphae project above the reproductive structure.</p> Signup and view all the answers

What are sporangiospores and where do they develop?

<p>Sporangiospores are endogenous spores that develop within a sporangium.</p> Signup and view all the answers

Explain the term mycosis and its implications.

<p>Mycosis refers to infections caused by fungi due to their invasion of tissues and organs.</p> Signup and view all the answers

What is the role of melanin production in fungi?

<p>Melanin production in fungi protects them from phagocytosis, temperature extremes, and UV radiation.</p> Signup and view all the answers

Define mycotoxicosis and provide an example.

<p>Mycotoxicosis is due to accidental consumption of food contaminated by fungal toxins, such as aflatoxicosis from Aspergillus flavus.</p> Signup and view all the answers

What are the two phases of fungi and their growth conditions?

<p>Fungi have a parasitic phase that occurs at 37°C in host tissues, and a saprophytic phase that occurs at 22-25°C in ordinary media.</p> Signup and view all the answers

What is the primary opportunistic pathogen responsible for human infections as outlined?

<p>Aspergillus fumigatus.</p> Signup and view all the answers

Describe the appearance of oral thrush.

<p>Oral thrush appears as discrete white patches on the tongue and buccal mucosa.</p> Signup and view all the answers

What are the typical locations for skin infections caused by Aspergillus?

<p>Infection typically occurs in moist, warm areas such as the axilla, groin, and submammary fold.</p> Signup and view all the answers

How does Aspergillus fumigatus cause Aspergilloma in patients?

<p>Aspergilloma occurs when the fungus forms a ball in a preexisting lung cavity, often due to tuberculosis.</p> Signup and view all the answers

What specimen type is used for identifying infections caused by Candida albicans?

<p>Specimens are obtained according to the site of infection, using techniques like direct microscopy and culture on SDA.</p> Signup and view all the answers

What is one key characteristic feature identified in the culture of Aspergillus fumigatus?

<p>Aspergillus fumigatus cultures display smooth, white, creamy colonies with a yeast odor.</p> Signup and view all the answers

What is the significance of germ tube formation in the identification of Candida albicans?

<p>Germ tube formation indicates the presence of Candida albicans when grown in human serum at 37°C.</p> Signup and view all the answers

In the clinical case presented, what key risk factor does the patient have that may contribute to his current health condition?

<p>The patient has rheumatoid arthritis and is on corticosteroids, which suppress his immune system.</p> Signup and view all the answers

What are the two reproductive methods of yeast-like fungi?

<p>Yeast-like fungi reproduce by budding or fission.</p> Signup and view all the answers

Describe the significance of thermotolerance in fungi.

<p>Thermotolerance protects fungi from temperature extremes and enhances their survival in host tissues.</p> Signup and view all the answers

What cultural method allows for the identification of Aspergillus species from a specimen?

<p>Culture on SDA shows white, creamy colonies with a distinct yeast odor.</p> Signup and view all the answers

What type of spores are formed by filamentous fungi and what is their origin?

<p>Filamentous fungi produce conidiospores, which are exogenous spores formed from hyphal branches.</p> Signup and view all the answers

What role does a capsule play in fungal pathogenesis?

<p>A capsule protects fungi from phagocytosis and enhances their ability to invade host tissues.</p> Signup and view all the answers

What are the common sites for superficial Aspergillosis lesions in humans?

<p>Common sites include mucous membranes, the skin in moist areas, and nails.</p> Signup and view all the answers

What is the typical presentation of an Aspergilloma in a patient?

<p>An Aspergilloma presents as a fungus ball in a preexisting lung cavity.</p> Signup and view all the answers

Explain the difference between mycotoxicosis and mycetismus.

<p>Mycotoxicosis results from ingesting food contaminated with fungal toxins, while mycetismus is due to consuming mushrooms containing preformed toxins.</p> Signup and view all the answers

How does mucosal candidiasis typically manifest in patients?

<p>It appears as discrete white patches on the tongue and buccal mucosa.</p> Signup and view all the answers

What is the role of phospholipases in fungal infections?

<p>Phospholipases help fungi invade host tissues by breaking down cell membranes.</p> Signup and view all the answers

Describe the impact of biofilm formation by fungi on human health.

<p>Biofilm formation allows fungi to adhere to surfaces and resist antifungal treatments, leading to persistent infections.</p> Signup and view all the answers

Explain the method used to observe Cryptococcus in CSF samples.

<p>India ink preparation reveals capsulated blue yeast cells when viewed under microscopy.</p> Signup and view all the answers

In the context of invasive Aspergillosis, what does hematogenous spread imply?

<p>Hematogenous spread implies that the fungus disseminates through the bloodstream to various organs.</p> Signup and view all the answers

What environmental factor contributes to hypersensitivity reactions to fungal spores?

<p>Environmental exposure to fungal spores, such as in damp or moldy conditions, contributes to hypersensitivity reactions.</p> Signup and view all the answers

Identify one significant factor in the clinical case that increases the patient's risk for fungal infection.

<p>The patient's use of corticosteroids significantly increases his risk of infection.</p> Signup and view all the answers

What distinguishes the microscopic appearance of Candida albicans from other fungi?

<p>Candida albicans is characterized by the presence of pseudohyphae and budding yeast cells.</p> Signup and view all the answers

What are two mechanisms by which antifungal drugs can inhibit yeast cell function?

<p>Antifungal drugs can inhibit cell wall synthesis via echinocandins and disrupt ergosterol synthesis through azoles.</p> Signup and view all the answers

Identify two fungal infections that primarily affect immunocompromised patients.

<p>Cryptococcosis and candidiasis are two fungal infections that primarily affect immunocompromised individuals.</p> Signup and view all the answers

What role does Sabouraud dextrose agar play in fungal culture and identification?

<p>Sabouraud dextrose agar supports the growth of fungi while chloramphenicol and cycloheximide prevent bacterial and yeast contamination.</p> Signup and view all the answers

What type of specimen preparation is recommended for fungal infection examination?

<p>Specimen preparation includes one part for microscopy and another for culture.</p> Signup and view all the answers

How does the presence of fungal spores in the environment contribute to human infections?

<p>Fungal spores inhaled from the environment can lead to lung infections and exacerbate existing local mycoses.</p> Signup and view all the answers

Why is the use of KOH important in preparing specimens for fungal microscopy?

<p>KOH dissolves keratin and cellular material, allowing for better visibility of fungal structures under a microscope.</p> Signup and view all the answers

Explain why dimorphic fungi are particularly important in clinical mycology.

<p>Dimorphic fungi can exist in both yeast and mold forms, complicating diagnosis and treatment and primarily affecting the lungs.</p> Signup and view all the answers

What is the impact of corticosteroid therapy on fungal infections?

<p>Corticosteroid therapy can increase susceptibility to fungal infections due to immune suppression.</p> Signup and view all the answers

Study Notes

Microbiology - General Mycology

  • Mycology is the study of fungi
  • Fungi are found in soil and water
  • Fungi are eukaryotic organisms with rigid cell walls made of chitin, glucans, mannans, and complex polysaccharides.
  • Their cell membranes contain ergosterol
  • Fungi can be obligate aerobes or facultative anaerobes
  • They grow in a wide range of temperatures and pH
  • Fungi can be classified as yeasts, yeast-like fungi, filamentous fungi, or dimorphic fungi

Yeast and Yeast-Like Fungi

  • Unicellular, round to oval fungi
  • Reproduce by budding or fission
  • Examples include Cryptococcus neoformans and Candida
  • Buds fail to detach in Candida giving a pseudohyphae

Filamentous Fungi (Hyphae)

  • Tubular, branched hyphae
  • Septated or aseptated
  • Form a mycelium when hyphae branch
  • Vegetative hyphae anchor the colony and absorb nutrients
  • Aerial hyphae project above the reproductive structure
  • Examples include Aspergillus

Dimorphic Fungi

  • Exist either as yeast or filamentous form
  • Parasitic in host tissue
  • Saprophytic in soil
  • Grow in enriched or ordinary media

Reproduction of Fungi

  • Asexual: Offspring arises from one single parent cell, only by mitosis
    • Sporangiospores: Endogenous spores in sporangium
    • Conidiospores: Exogenous spores, arthrospores
  • Sexual: Offspring arise by Meiosis
    • Ascospores= Spores formed within a sac (ascus)
    • Basidiospores = Spores formed on a basidium

Pathogenesis of Fungi

  • Toxin production: Physiological alteration; fungi increase metabolic activity to invade tissue
  • Capsule: Protective barrier
  • Enzyme production: Phospholipases
  • Thermotolerance
  • Melanin production: Protect fungi from phagocytosis, temperature, and UV extremes
  • Biofilm formation
  • Hypersensitivity: Due to environmental exposure to fungal spores
  • Infection (Mycosis) due to fungal invasion of tissue and organs
  • Toxicosis: Two types: mycotoxicosis and mycetismus
    • Mycotoxicosis: Accidental consumption of food contaminated by toxins (e.g., aflatoxicosis, Aspergillus flavus, liver cancer).
    • Mycetismus: Ingesting mushrooms with preformed toxins

Harmful Effects of Fungi

  • Plant diseases
  • Food spoilage; mycotoxins
  • Beneficial effects: antibiotics, health benefits, pigments, and enzymes

Diseases Caused by Fungi (Human Mycosis)

  • Superficial mycoses: Infection limited to outermost layers (e.g., skin & hair).
  • Cutaneous mycoses: Infection involving epidermis, hair and nails (e.g., dermatophytes).
  • Subcutaneous mycoses: Infection in subcutaneous tissue, dermis, muscles, and fascia.
  • Opportunistic mycoses: Infections in immunocompromised patients (e.g., diabetics, cancer patients, patients on immunosuppressive treatments).
  • Systemic mycoses: Infection of multiple organs, primarily lung, due to local mycosis (e.g., Histoplasmosis).

Diagnosis of Fungal Diseases

  • Specimens - parts differ according to site infection.
  • Examination types: microscopy (KOH, Lactophenol blue, Gram stain) or culture
  • Direct Microscopy: KOH 10-20%, gentle heating, lectophenol cotton blue, used for cellular material, and Indian Ink
  • Histopathology: Tissue biopsy for identification
  • Culture: Sabouraud dextrose agar (SDA) + chloramphenicol + cycloheximide, used to prevent bacterial contamination. Incubated at 25°C and 37°C to reveal dimorphism for at least 3 weeks.

Antifungal Agents

  • Fungi are eukaryotic cells
  • Most antifungal agents are toxic to host cells.
  • Mechanism of action:
    • Cell wall synthesis inhibition (e.g., echinocandins, caspofungin)
    • Ergosterol synthesis inhibition (e.g., azoles, fluconazole, voriconazole)
    • Cytoplasmic membrane function alteration (e.g., polyenes, amphotericin B)
    • Nucleic acid synthesis inhibition (e.g., flucytosine)

Opportunistic Mycoses

  • Caused by commensal and saprophytic fungi in immunocompromised individuals
  • Examples: Cryptococcosis, Candidiasis, Aspergillosis

Clinical Cases Examples

  • Specific examples given are for Cryptococcosis, Candidiasis, & Aspergillosis, showing etiology, clinical presentations, and diagnosis of fungal diseases, including Candida, Cryptococcus, Aspergillus (A. fumigatus).

  • Case example: A 49-year-old patient with rheumatoid arthritis, on corticosteroids, presented with fever, fatigue, chest pain, cough and hemoptysis . Culture revealed green colonies with dichotomously branched hyphae.

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