FUNGI.pdf

Characteristics/De Population Symptoms/ Treatment/ Fungi Subtype Location Diagnosis...

Characteristics/De Population Symptoms/ Treatment/ Fungi Subtype Location Diagnosis scription Affected Disease Prevention Superficial MYCOSES Pytyriasis versicolor Stratum Tinea nigra palmaris corneum Piedra M. globosa Pityriasis (tinea) versicolor M. sympodialis Pityriasis (tinea) versicolor Diffuse distribution of Direct KOH hypopigmented o Spag + meatballs Malassezia Low macules/patches = hyphae + Endogenous skin TREATMENT immune ↓turnover rate = ↑ spores colonizer Genetic infection Wood Lamp Related to Selenium M. furfur Skin Exposed o (+) Pale yellow to squamous cell sulfide to high Seborrheic white turnover rate Topical/Oral temp and dermatitis/dandruff (i- Culture Lipophilic Azole humidity competent) o Must contain olive oil to promote Opportunistic fungemia (i- growth compromised) Commonly misdiagnosed as Direct KOH malignant o Branched septae Young TREATMENT melanoma o Budding cells women No inflammatory Tinea nigra palmaris H. (exophiala) Palm Those o Melanized cell Keratolytic Hortaea reaction Hyperpigmented werneckii Sole who live in wall solutions Halotolerant macules warm Culture Azole drugs (high salt) coastals o Shiny, moist, Salicylic acid Dematiaceous (cell wall w/ yeast-like melanin) colonies  o Brown pigment → olive/greenish black KOH o Thick-walled Hard rhomboid cells Brown-black o 8 ascopores Piedraia P. hortae Gritty nodules Black Piedra Culture Have 8 o Sabouraud ascopores dextrose agar Those who (SDA) live in o SLOW growth T. ovoides tropical KOH T. asteroides countries: o Blastoconidia Removal of Hair o Arthroconidia infected hair T. inkin shaft Asia o Hyphal elements Topical agents Soft Latin/Sou Culture Yellow to th America o SDA white/cream Africa o PDA Trichosporon White Piedra Smooth to o RAPID growth Cutaneotrichos wrinkled Biochemical poron cutaneum Large o (-) Carbohydrate fermentation o Sugar assimilation o Urease positivity o Potassium nitrate  Characteristics/ Population Symptoms/ Treatment/ Fungi Subtype Location Diagnosis Description Affected Disease Prevention Subcutaneous MYCOSES Agents normally reside in soil or decaying vegetation Warm, moist, Sporotrichosis Deep skin arid, humid Chromoblastomycosis layers Phaeohyphomycosis Eumycetoma Entry: via inoculation w/ contaminated material “Rose handler’s KOH Disease” Yeast, rarely seen Thermally Sporotrichosis dimorphic Erythematous Specimen o Yeast = 35o- Painless nodule Biopsy 37oC Males May ulcerate Exudate Cigar shape o X-linked o Mold = 25 oC diff. Lymphocutaneous Stains TREATMENT Thin, rosette o Exposure sporotrichosis Gomori methamine Sporothrix S. schenckii pattern Deep skin Gardener 70% SS (cell wall black Oral dematiaceou Horticulturi Granulomatous nodules PAS (cell wall red) itraconazole s wall st Necrotic/ulcerative Amphotericin Forester lesions Culture (most Young colonies reliable) Blackish Fixed sporotrichosis SDA Shiny Non-granulomatous Brain Heart infusion agar w/ sheep blood Old Colonies Wrinkled, fuzzy Serology Not useful “Vice PEDRO made COMPACT CHROMOBLASTOMYCOSIS with Carlo Aquino” Flask-shape conidiophore Phialophora P. verrucossa Cup-shaped collarettes of KOH blastoconidia o (+) dark, spherical cells Short, branching chain Culture F. pedrosoi Blastoconidia o SDA Sympodial Chromoblastomycosis Colonies = wooly conidia TREATMENT Subcutan Gray-brown to Smaller, more Fonsecaea eous Tropical Localized, wart-like, scaly olive black compact Surgical Lower and lesions with Can’t grow at Broad base excision extremities Subtropical hemopurulent material. 37oC F. compactum connecting to Flucytosine regions o Digest gelatin conidia Itraconazole Chronic: Cauliflower-like Spherical nodules Specimen blastoconidia o Lesion scrapings Elongated o Biopsy Cladophialo C. carionii chains of phora conidiophores Histologic study Lateral terminal o Granuloma w/ conidia sclerotic bodies Rhinocladiel R. aquasera Conidia = la elliptical to clavate “ALTERNate JEANS ni RICHARD kita and CURVes, PHAEOHYPHOMYCOSIS ooh SPICy ROSTer DERMA.” Alternaria Alternaria sp. Culture (Fontana- Phaeohyphomycosis Masson) Exophalia E. jeanselmei Immunoco Erythematous nodule o Histologic mpromised Flucytosine Phialophoa P. richardisae Contain Brain Studies Itaconazole melanin in their Deep Cerebral o Large, septate, Curvularia Curvularia sp. Found in Amphotericin cell walls tissue phaeohypomycosis swollen hyphae soil, plants, B Bipolaris B. spicifera Saprophytic Bone Caused by o (+) melanin decaying Surgery Claudophialophora Culture Exserohilum E. rostratum matters bantiana o Yeast-like, olive Wangiella W. dermatitidis o Non-specific “Uy! BOY, FALse JEANS and MY EUMYCETOMA TOMATo in Greece (Grisea)” Pseudallesc Specimen P. boydii heria o Exudate P. boydii Acremonium A. falciforme (superinfected w/ o Nystatin Most are caused by M. mycetomatis India strep- and staph-) o Miconazole Exophalia E. jeanselmei Africa Culture Madurella M. Dematiac Latin o SDA w/ antibiotics sp. mycetomatis Eumycetoma eous Subcutane America o Best at 37oC o Itraconazol Swelling with suppurative Melanin ous o Slowed at 40oC e exudate in cell Muscle Found in soil Histologic study o Ketoconazo Granules drain at the skin walls Bone and vegetation o WHITE = P. boydii le Madurella surface via sinus tracts Produce & A. falciforme o Amphoteric M. grisea conidia at Infect via o BLACK = E. in B phialide inoculation jeanselmei & M. E. tips grisea jeanselmei o RED/BLACK = M. o Flucytosine mycetomatis  Characteristics/ Population Symptoms/ Treatment/ Fungi Subtype Location Diagnosis Description Affected Disease Prevention Cutaneous MYCOSES Chronic Higher Mild incidence Difficult to in hot, eradicate humid, Anthropophilic Species crowded identification via Tinea capitis areas. Specimen morph of Oral Scrapings of asexual conidia griseofulvin Susceptible: keratinized tissues Immuno- Terbinafine (skin, hair, nails) Dermatophyte Geophilic compromise KOH s d Tinea pedis, Acute Morphology of manuum, Inflammatory Tinea barbae (Barber’s asexual conidia cruris, corporis Resolve quick itch) Culture Bearded Itraconazole Species Pyogenic infections SDA regions Terbinafine Zoophilic identification via morph of Tinea Pedis asexual conidia Soles Infection via fomites Toe webs May lead to secondary bacterial infections Tinea Capitis Affects the skin of the scalp Trichophyton Hyphal Tinea Favus T. schoenleinii Hair shaft “She MEaNT TO elements Crusty lesion (dead RUB…” epithelial cell + Scutula) Hair loss Scar tissue on scalp  MICROCONIDIA Tinea Unguium (onychomycosis) Globose Originate from Tinea Tear-shaped manuum and Tinea Grape-like pedis cluster Disfigure nails Nails Whitish plaques on nail beds/plate Culture o Granular (if TREATMENT Tinea manuum, corporis, cruris abundant T. microconidia) Terbinafine mentagrophytes “Ringworm” = MACROCONIDIA o Smooth (if less Itraconazole Manuum + Cruris microconidia) Ungiectomy Hands “Jock itch” = Groin Smooth o Rapid Growth Torso Annular with clearing, Cigar-shaped Groin scaly center Thin-walled Separated by Red advancing border cross-walls Infection expands centrally Erythema Vesicle formation Pruritus Inner portion Culture Black dot T. capitis MICROCONIDIA of the hair o Powdery Weakened hair T. tonsurans (endothrix) o Velvety “black dots” on the Variable o Reddish-brown scalp Spore (round-peg) (“tonsorum” producing Along sounds like hyphae/short “tanso”) on conidiophores reverse side.  Tinea Unguium Nails (onychomycosis) TREATMENT MACROCONIDIA Originate from Tinea manuum and Tinea Terbinafine Variable (cigar- pedis Itraconazol cylinder) Disfigure nails Ungiectomy Rare Whitish plaques on nail beds/plate TREATMENT MICROCONIDIA Tinea Unguium (onychomycosis) Terbinafine Clavate-/Peg- Originate from Tinea shaped manuum and Tinea Itraconazol Undifferentiate pedis Ungiectomy d hyphae Disfigure nails Whitish plaques on Culture Nails nail beds/plate o Powdery Tinea manuum, o Velvety T. rubrum corporis, cruris o Red to burgundy “Ringworm” = (“rubrum” = ruby) Manuum + Cruris on reverse side. MACROCONIDIA “Jock itch” = Groin Annular with clearing, 3-8 cell Hands scaly center Cylindrical Torso Red advancing border Groin Infection expands centrally Erythema Vesicle formation Pruritus  Culture MICROCONIDIA o Fluffy and cream NOT useful for white colonies diagnostic Microsporum Outer o Deep lemon Grey Patch T. Capitis portion of yellow pigment on M. canis Children Composed of chain of “… the Dog hair shaft reverse side. MACROCONIDIA spore (canis)…” (ectothrix) 8-15 cell Wood Lamp Thick-walled o (+) greenish to Spindle-shaped silver Tapering/spiny tail MICROCONIDIA NOT useful for Culture diagnostic Microsporum o Powdery MACROCONIDIA o Granular M. gypseum 4-6 cell “… and the o Brown to red Thick walled GYPSEUM” pigment on Fusiform shape reverse side. Thin filamentous tail  MICROCONIDIA Tinea Unguium NONE (onychomycosis) Originate from Tinea manuum and Tinea pedis Disfigure nails Nails Whitish plaques on nail beds/plate Culture TREATMENT Tinea manuum, o Feathered edges Epidermophyt E. floccosum MACROCONIDIA corporis, cruris o Yellow to yellow Terbinafine on 2-5 cells “Ringworm” = tan colonies Smooth Itraconazole Hands Manuum + Cruris Thin Ungiectomy Torso “Jock itch” = Groin Broad/spatulate ends Groin Annular with clearing, scaly center Red advancing border Infection expands centrally Erythema Vesicle formation Pruritus