Mikroba eukariot:
Fungi
Algae
Protozoa
Parasitic helminths
Peran fungi
decomposer
Sumber antibiotik
Membantu proses pembuatan
makanan
Efek negatif: mycoses, produksi toxin,
merusak makanan
Kingdom Fungi
Terdiri dari >100,000 species dibagi
menjadi 2 groups:
macroscopic fungi ( mushrooms)
microscopic fungi (molds, yeasts)
Pokok Bahasan
Karakteristik fungi
Morfologi
Reproduksi
Nutrisi
Epidemiologi
Klasifikasi Fungi
Infeksi Fungi mycoses
1. Morfologi Fungi
Dinding sel: mengandung chitin
Membran sel: mengandung ergosterol
Mikroskopik: memiliki 2 macam morfologi:
yeast berbentuk bulat-oval
hyphae berbentuk filamen , disebut
juga:molds
Yeast
Unicellular fungi, nonfilamentous,
respiration.
When oxygen is not available, they ferment
Morfolog
i yeast
10
Hyphae / Molds
Multicellular, filamentous fungi (Long filaments of
(septa).
Coenocytic (Aseptate) hyphae: Long, continuous cells
that are not divided by septa.
Part of hiphae:
Vegetative Hypha: Portion that obtains nutrients.
Reproductive or Aerial Hypha: Portion connected with
reproduction.
up of many hyphae.
Morfologi hiphae/molds
12
Dimorphic Fungi
Can exist as both multicellular fungi
2. Reproduksi Fungi
Hiphae : form spores
asexual reproduction spores are formed
16
17
18
I. Zygospores:
Also known
as bread molds.
19
II. Ascospores
20
III. Basidospores
21
Nutrisi Fungi
heterotrophic
Mayoritas tidak membahayakan, hidup
22
INFEKSI JAMUR
(Mycoses)
Jamur Penyebab
Epidemiologi
Manifestasi klinik
Diagnosis
Mikrobiologi
Terapi
Mycoses
Merupakan infeksi kronis, karena
General Clinical
Classification of
Pathogenic
Fungi
Superficia
Cutaneus Subcutan
Sistemic
l
Pityriasis
versicolor
Tinea
niegra
Piedra
eus
Tinea pedis
Tinea
unguinum
Tinea
corporis
Tinea cruris
Tinea
manus
Tinea
capitis
Tinea
barbae
Chromoblas
tomycosisi
Sporothrico
sis
Mycetoma
Phaeohypo
mycois
Aspergillosis
Blastomycosi
s
Candidosis
Coccidioidom
ycosis
Histoplasmos
is
Cryptococcos
is
Geothrichosi
s
Paracoccidioi
domycosis
Zygomycosis
Opportonisti
c
Aspergillosis
Candidosis
Cryptococcosis
Zygomycosis
Geothricosis
Fusariosis
Trichosporonosi
s
Others
Factors to consider:
- Where do pathogens live in nature?
- How do they disseminate?
- What is the human portal of entry?
- Why is a human susceptible?
1.) Dermatophytoses:
Dermatophytoses (cont)
Fungi which caused ringworms
These diseases are classified by the mode
transmission:
a.) Anthropophilic implies organisms that
are spread from man to man
e.g.
Epidermophyton floccosum, Microsporum
audouinii, M. ferrugineum and
several Trichophyton spp.
Dermatophytoses (cont)
b.) Geophilic are organisms that live in soil
and maybe transmitted to man by soil
contact, e.g. Microsporum gypseum (often
causing tinea barbae).
c.) Zoophilic are organisms which are
transmitted to man from animals other than
man (dogs, cats, cattle, etc.). Some
zoophilic dermatophytes are Microsporum
canis, Trichophyton verrucosum and two
varieties of T. mentagrophytes.
Dermatophytoses (cont)
2.)
A.) Soil
Where fungi live forming hyphae and spores,
they enter the host via punctured wounds
and trauma. Spore size is not important.
The following are some examples of diseases
that are acquired by this mechanism.Example:
Subcutaneus mycosis (Sporothricosis, Mycetoma,
Chromomycosis) , Mycotic keratitis
Exogenously
acquired:Subcutaneus
mycoses
Exogenously acquired:Sporotrichos
Note hyphae and spores which live
in nature on plant material and are
the infectious particles.
dimorphic
Exogenously acquired:Mycotic
Keratitis
- Numerous fungi cause keratitis worldwide but mostly in
tropical or heavily agricultural areas. Spores and hyphae
are implanted onto eye following trauma.
Patient
3.) Endogenously
acquired
Candidiasis is the only major systemic
mycosis that is endogenous in origin. That
means that the numerous yeast species are
part of mans normal flora. This means that
the key to infection is predisposing factors,
e.g. 90 % of AIDS patients have candidiasis.
The only exception to being endogenous in
origin is STD candidiasis and nosocomial
acquired candidiasis, usually from hospital
workers.
Today, candidiasis is the most important
systemic mycoses in the world.
Candidiasis (cont)
Dissemination or disease spread is with yeast cells and/or
hyphae. The hyphae looks distorted, thus it is sometimes called
pseudohyphae.
The disease is worldwide and fatal in susceptible hosts.
Conclusions
1.) Most systemic mycoses are acquired from fungi
which live in soil on decaying vegetation.
2.) Fungi produce hyphae and spores which enter
humans via a punctured wound or, if less than 6
microns, can enter the lungs.
3.) Dermatophytoses (ringworms) can be transmitted
to man from soil, animals and other men.
4.) Candidiasis is the only major mycosis that is
endogenous in origin.
5.) Most systemic mycoses are seen in patients that
have depressed immunity. This may be genetic or
acquired.
1. Superficial Mycoses
Infections of hair shafts and
1. Superficial mycosis
Definition: Infections of hair shafts and superficial
epidermal cells. Limited to the stratum corneum.
No Inflamation. Cosmetic problem.
Disease
Causative
organisms
Malassezia
Pityriasis vers furfur
icolor
Incidence
Clinical
Manifestatio
n
Common
Hipopigment
ed macule
Tinea nigra
Exophiala
werneckii
Rare
White piedra
Trichosporon
beigelii
Common
Black piedra
Piedraia
Rare
black
macules
black nodule
on hair shaft
cremecolored
Clinical Manifestation
Diagnosis laboratorium
Spesimen: skin scrapping (kerokan
2. Cutaneus Mycoses
Infeksi jamur pada jaringan
Cutaneus mycoses
Disease
Causative
organisms
Incidence
Dermatophytes
(Microsporum,
DermatophytosisRi
Common
Trichophyton,
ngworm of the scal
Epidermophyton)
p,glabrous skin a
Candidiasis
of
Candida albicans
nd nails.
Common
skin andandnails. and related species.
Dermatophytosis: Ringworm of t
he scalp, glabrous skin and na
ils Disease
Symptoms
Tinea capitis
Tinea corporis
Tinea manus
Tinea cruris "jock
itch"
Tinea pedis"athlete's
foot"
Tinea unguium
infection of nails
Ectothrix
Endothrix
Dermatophytosis:
Clinical Manifestation
Tinea Pedis: is
transmitted via the
feet by desquamated
skin scales in
substrates like carpet
and matting
Dermatophytosis:
Clinical Manifestation
Tinea
cruris
Tinea Unguinum
Tinea barbae
Tinea corporis
Dermatophytosis: Clinical
Manifestation
Tinea Capitis: Exothrix, Endothrix,
Favus
Dermatophytosis:
Laboratoy Diagnosis
Spesimen: Skin Scrapings, nail
Method:
Direct Microscopy: KOH 10-20% and ink
parker
Culture: Sabouraud's dextrose agar
containing cycloheximide incubated at 2628C for 4 weeks
Skin scrapping:
hiphae
Exothrix:
spore
Culture on SDA
Endothrix:
spore
3. Subcutaneus Mycoses
Infeksi jamur pada jaringan subkutan.
Disebabkan oleh jamur saprofit yang
limfe.
3. Subcutaneus Mycoses
Disease
Causative
organisms
Sporotrichosis
Sporothrix
schenckii
Fonsecaea,
Chromoblastomyc Phialophora,
osis
Cladosporium
etc.
Mycotic
mycetoma
Pseudallescheri
a, Madurella,
Acremonium,
Exophiala etc.
Rare
Rare
Subcutaneus mycoses:
SPOROTRICHOSIS
Sinonim: Rose Garneners disease
Manifestasi klinis
Cutaneus sporotrichosis
Infeksi sistemik
Sporotrichosis
Characteristic
lymphadenopathy.
Pewarnaan GMS
pada spesimen
biopsi
Subcutaneus mycoses:
Chromoblastomycosis
Penyebab: Fonsecaea pedrosoi,
lembab
Kebanyakan pada kaki, didahului dgn luka
( bisa pada bagian tubuh lain)
Walaupun jarang, dapat menyerang otak
(menyebar secra hematogen)
Chromomycosis
Subcutaneus mycoses:
MYCETOMA
Sinonim: Madura foot
Penyebab:
Jamur (Eumycotic mycetoma)
Kuman yang mirip jamur (Actinomycotic mycetoma)
Gx klinis:
infeksi subkutan yang membengkak seperti
Mycetomas
4. Systemic Mycoses
Disease
Causative
organisms
Incidence
Histoplasmosis
Histoplasma
capsulatum
Histoplasma dubosii
Rare*
Coccidioidomycosi
s
Coccidioides
immitis
Rare*
Blastomycosis
Blastomyces
dermatitidis
Rare*
Paracoccidioidomy Paracoccidioides
cosis
brasiliensis
*more common in endemic areas.
Sporotrichosis
Sporothrix schenkii
Rare*
Rare
Histoplasmosis
intracellular infection of the
reticuloendothelial system
caused by the inhalation of conidia from
Histoplasma capsulatum
Isolation:soil enriched with excreta from
chicken, starlings (burung jalak) and bats
(kelelawar).
Major endemic: River Valley in the U.S.A.
Two varieties of H. capsulatum: var.
capsulatum (common) and var. duboisii
HISTOPLASSMOSIS
Clinical manifestations:
95% of cases of histoplasmosis are
Histoplasmosis
COCCIDIOIDOMYCOSIS
initially:a respiratory infection,
resulting from the inhalation of
conidia,
resolves rapidly leaving the patient
with a strong specific immunity
in some individuals the disease may
progress.
Coccidioidomycosis (cont)
5. Opportunistic Mycoses
Adalah infeksi yang terjadi pada manusia/hewan dengan
Diabetes melitus
Resipien organ transplan
Terapi steroid
penyakit.
Penyebab: Flora normal ataupun fungi yang ada di lingkungan
5. Opportunistic
Infection
Disease
Causative organisms
Incidence
Candidiasis
Candida albicansand
related species.
Common
Cryptococcosis
Cryptococcus
neoformans
Rare/Common
Aspergillosis
Aspergillus fumigatus
etc.
Rare
Zygomycosis
(Mucormycosis
)
Rhizopus, Mucor,
Rhizomucor,
Absidia etc.
Rare
Rare
Opportunistic mycoses:
Candidiasis
Candidiasis also called as Monoliasis,
Can infect Skin, Mucosa, or Internal Organs
Normal flora
Clinical Manifestation
Laboratory diagnosis
Clinical specimen:
Skin scrapings,
Mucosal scrapping,
Vaginal secretions
Blood ans other body fluid
Method:
Direct mikroskopic
Cultures : on Sabouraud's Glucose agar
PCR
Morphology
A true yeast
Round 4 10 microns
Surrounded by Mucopolysaccharide
capsule.
Negative staining with India Ink and
Nigrosin
60% of the infected prove positive by
India Ink preparation on examination of
CSF
Life cycle of
C.neofromans
Pathogenesis
Enters through lungs - inhalation of
Basidiospores of C neoformans
Enters deep into lungs.
Self limiting in most cases,
Pulmonary infections can occur.
Present as discrete nodules Cryptococcoma.
Pathogenesis
Can infect normal humans
Abnormalities of T lymphocyte function
Laboratory Diagnosis.
Mikroskopic: Indian ink staining, Gram
staining
Kultur :Cultures on Sabouraud
dextrose agar
Serologis: detection of Capsular antigen
Treatment
Immune competent - Antifungal drug
AIDS patients are not totally
Prevention:
Avoid contact with Birds
Aspergillosis
In nature > 100 species of
Morphology
Khas: hifa dengan
Pathogenesis - varied
clinical presentations
Allergic Aspergillosis Atopic individuals,
Pathogenesis
Aspergilloma A
Invasive Aspergillosis
occurs in
immunocompromised
with underlying
disease
A.fumigatus >>
Fungus invades blood
vessels, causes
thrombosis septic
emboli
Can spread to Kidney
and heart.
Pathogenesis