OPPORTUNISTIC
MYCOSES
Opportunistic Mycosis
1.
2.
3.
4.
5.
6.
7.
Generally harmless
Can become pathogenic in a host who is:
Seriously debilitated/traumatized,
Use of IV catheters
C.albicans
C.tropicalis
C.glabrata
C.Krusei
Prominent Infections
with Candida
Prominent
Infections with Candida
1) Candidiasis
Normal flora
OPPORTUNISTIC
MYCOSES
(Continuation Candidiasis)
Laboratory Diagnosis
Skin scrapings
Mucosal scrapping
Vaginal secretions
Observations
[ Microscopic observation after Gram
staining
[ Gram + yeast cells
Serology
Molecular Methods
Microscopy
KOH preparation
Culturing
CHROM agar
allows the detection of mixed species of Candida
[ C. albicans (greencolonies)
[ C. tropicalis (blue colonies)
[ C. parapsilosis (white)
[ C. glabrata (pink)
OPPORTUNISTIC
MYCOSES
2) Cryptococcosis
Serotypes
A true yeast
4 serotypes
- A,B,C,D
Pathogenesis
Cryptococcus neoformans
A Capsulated yeast A true yeast.
A sporadic disease in the past.
Most common infection in AIDS patients.
Structure of C. neoformans
Morphology
A true yeast
Round 4 10 microns
Thick in vivo
Culturing
Pathogenesis
Can mimic
Tuberculosis
X-ray showing pulmonary cryptococcal
infection [right upper lobe]
OPPORTUNISTIC
MYCOSES
(ContinuationC.neoformans)
Laboratory Diagnosis
Urease test
Blood cultures
ELISA
Laboratory Diagnosis.
A positive cryptococcal antigen latex test. It should be noted that the detection
of cryptococcal capsular polysaccharide antigen in spinal fluid is now the
method of choice for diagnosing patients with cryptococcal meningitis
Treatment
Immune competent
[ Fuconazole,Itraconazole
Immune Deficient
[ Amphotericin B
[ Flu cytosine
3) Aspergillosis
Morphology
Allergic Aspergillosis
[ Atopic individuals, with elevated IgE
levels
[ 10-20% of Asthmatics react to
A.fumigatus
Allergic alveoitis
[ Follows particularly heavy and
repeated exposure to larger number of
spores
Maltsters Lung
[ Causes allergic alveolitis, who handle
barley on which A.claveus has
sporulated during malting process
Aspergilloma
[ A fungal ball, fungus colonize
Preexisting (Tuberculosis) cavities in
the lung and form compact ball of
Mycelium which is later surrounded by
dense fibrous wall presents with
cough, sputum production
Haemoptysis
[ Occurs due to invasion of blood
vessels
Invasive Aspergillosis
[ Occurs in immunocompromised with
underlying disease
[ Neutropenia Most common
predisposing factor
[ A.fumigatus is the most common
infecting species
[ In Bone marrow recipients leads to
high mortality Lung sole site in 70% of
patients
[ Fungus invades blood vessels, causes
thrombosis septic emboli
[ Can spread to Kidney and heart.
Endocarditis
[ A rare complication
[ Open heart surgeries are risk factors
[
Poor prognosis Paranasal granulomas
[ Caused by A.flavus, A,fumigtus may
invade paranasal sinuses spread to
bone to orbit of the eye, and Brain
OPPORTUNISTIC
MYCOSES
4) Zygomycosis
Sporangiophores in groups
Other manifestations
Laboratory Diagnosis
Histological sections
Microscopy
Culturing
Treatment
Surgical interventions
Mucor
Microscopy
Having branched
sporangiophores
Absidia
Mucormycosis
OPPORTUNISTIC
MYCOSES
5) Pneumocytosis
Predisposing factors
Corticosteroid therapy
Transplant recipients
Antineoplastic therapy
Transplant recipients
Morphology
Spherical, Elliptical
Immunity Pneumocytosis
Treatment
Prophylaxis
Pathogenesis
Diagnosis
Ideal specimens:
[ 1 Bronchoalveloar lavage 2 Lung biopsy
[ 3 Induced sputum Stains preferred
[ 1 Giemsa
[ Toludine blue
[ Methenamine silver
[ Calcofluor white
[ X ray of Chest supports the Diagnosis
OPPORTUNISTIC
MYCOSES
6) Pencilliosis marneffi
A dimorphic fungi
Mould at 25c
Yeast at 37c
Disease
Hyalohyphomycosis
Phaeohyphomycosis
Causative
organisms
Penicillium
Paecilomyces
Beauveria
Fusarium
Scopulariopsis etc.
Cladosporium
Exophiala
Wangiella
Bipolaris
Exserohilum
Curvularia
Incidence
Rare
Rare
References:
Inhalation of Conidia
Laboratory Diagnosis
Microscopy
Immunoblot methods
PCR
Treatment