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Medical Mycology
Medical Mycology
MYCOLOGY
study of fungi, including their taxonomy, environmental impact,
and genetic and biochemical properties
MEDICAL MYCOLOGY
science devoted to the study of fungi and their relationship to
human disease
scientific discipline encompasses single-celled yeasts and
filamentous moulds as agents of disease
Fungal agents include:
TRUE PATHOGENS
OPPORTUNISTIC PATHOGENS
TERMINOLOGIES
DEMATIACEOUS FUNGI
fungi whose cell wall contain MELANIN, which imparts brown
to black pigment
DIMORPHIC FUNGI
fungi that have two growth forms, such as mold and yeast
which develop under different growth conditions
IMPERFECT FUNGI
fungi that lack sexual reproduction; they are represented
only by and ANAMORPH, mitotic or asexual reproductive state
PERFECT FUNGI
fungi that are capable of fungal reproduction = TELEOMORPH
POLYMORPHIC FUNGI
have more than one independent form or spore stage in their
life cycle
MOLD
hyphal or mycelial colony of growth
YEAST
unicellular, spherical to ellipsoid (3-5um) fungal cells; reproduce
by budding
EPIDEMIOLOGY
Humans are relatively resistant to infections caused
by fungi except for DIMORPHIC FUNGI
Major Predisposing Factors:
immunocompromised host
immunosuppressive agents or serious underlying
diseases
complex surgical procedures
antibacterial therapy
EPIDEMIOLOGY
Generally are NOT COMMUNICABLE
Humans acquire mycoses through:
Inhalation of spores
Direct contact with spores
Inoculation by trauma into the skin
FUNGI: GENERAL CHARACTERISTICS
EUKARYOTIC
THALLOPHYTES
have true nuclei and are heterotrophic members of the plant
family
CHITIN in the cell wall
ERGOSTEROL in the cell membrane
Lack of chlorophyll
Lack of susceptibility to antibacterial antibiotics
SAPROPHYTIC nature
derive nutrition from organic materials
FUNGI: GENERAL CHARACTERISTICS
Obligate aerobes
Almost all molds are aerobic
Most yeasts are facultative anaerobes
Most are more resistant to osmotic pressure than
bacteria
Can grow on very low moisture content
Require less nitrogen than bacteria
Often capable of metabolizing complex
carbohydrates, such as lignin
Fungi vs Bacteria
Fungi Bacteria
Nucleus Defined nuclear membrane No membrane
Mitochondria Present Absent
Cell wall Glucans; mannans; chitins Peptidoglycan
Contain sterols; no respiratory
Cell membrane Sterols absent; With respiratory enzymes
enzymes
Antibiotic Resistant to penicillins, tetracycline Resistant to griseofulvin and amphotericin
susceptibility and chloramphenicol B
Dimorphism Mycelial or yeast forms none
More than one and CHON
Chromosome Only one but not CHON associated
associated
Sedimentation
80s 70s
coefficient
Cultivation < pH 6.0 pH 7.2-7.6
MORPHOLOGIC FORMS OF FUNGI
YEASTS
single vegetative cells
usually spherical or ellipsoidal (3-15um)
grows from 35°C to 37°C Cryptococcus neoformans
Masson-Fontana Stain
used to determine hyphal
pigmentation in tissue
stains melanin
Phaeoid hyphae: brown
Hyaline hyphae: pink to red
Spiral hyphae Antler hyphae Racquet hyphae
GENERAL MORPHOLOGIC FEATURES OF MOLDS
MYCELIUM
mass of intertwining structure composed of hyphae
accumulates during active growth
ASEXUAL REPRODUCTION
IMPERFECT FUNGI or FUNGI IMPERFECTI = ANAMORPH
do not exhibit a sexual phase
spores are produced asexually from mycelium
Mitosis Cytoplasmic and Nuclear Division
Rhizopus Zygospores
d. OOSPORES
formed by heterogenous fetilization
involve the fusion of cells from separate, nonidentical hyphae
ASEXUAL SPORES
a.ARTHROCONIDIA
ARTHROSPORES
conidia that result from the simple fragmentation of hyphal cells
simplest type of sporulation
appear as square, rectangular, barrel-shaped thick-walled cells
when mature
thick walled and maybe adjacent or alternate in arrangement
Disjunctor cells empty spaces that appear between each
arthrospores in alternate arrangement
Example:
Cocciodioides immitis
Geothrichum candidum
Arthroconidia formation (A) produced
by the breaking down of a hyphal
strand (B) into individual rectangular
units (×430).
b. BLASTOCONIDIA
BLASTOSPORES
conidial formation through a budding process
daughter cells buds off the mother cell and is pinched off
may elongate to form PSEUDOHYPHAE
Example: Candida
Blastic Conidiogenesis
parent cell enlarges, a septum forms and the
enlarge portion splits off to form a daughter cell
Thallic Conidiogenesis
septum forms first and new growth beyond
the septum becomes daughter cell
Conidia (asexual spores [A]) produced on In this preparation of a Trichophyton species,
specialized structures (conidiophores [B]) of the numerous, small, spherical microconidia
Aspergillus (×430). (A) are contrasted with a large, elongated
macroconidium (B) (×430).
CONIDIA
MICROCONIDIA
small, unicellular with a round,
elliptical, or pyriform shape
Sessile Microconidia
Pednculate Microconidia
MACROCONIDIA
large, usually multiseptate, and
club oval or spindle shaped
thick or thin walled
spiny (ECHINULATE) or smooth
surface
Phialoconidia
conidia that are
produced by a "vase-
shaped" conidiogenous
cell = PHIALIDE
Example: Aspergillus
Single, simple, slender, tubular conidiophore (phialide) that
produces a cluster of conidia, held together as a
gelatinous mass
Example: Acremonium
Conidiophores form a PENICILLUS that terminates in
secondary branches (metulae) and phialides, from
which chains of conidia are borne
Example: Penicillium and Paecilomyces
Flask-shaped PHIALIDES giving rise to
long chains of conidia characteristic
of Aspergilli. The basal conidia are
the youngest. Mature conidia have
rough walls. 400x.
Chain of conidia was
produced by an
ANNELLIDE
CLASSIFICATION OF FUNGI
I. Botanical Taxonomy
A. Zygomycota
B. Ascomycota
C. Basidiomycota
D. Deuteromycota
II. Type of Mycoses
A. Superficial and Cutaneous Mycoses
B. Subcutaneous Mycoses
C. Systemic Mycoses
D. Opportunistic Mycoses
I. Taxonomy of Fungi
A. Zygomycota
include Glomeromycota and subphylum, Mucoromycotina,
and Entomophthoracortina
produce hyaline sparsely septate hyphae
Clinically important
Asexual reproduction: SPORANGIOSPORES genera:
Sexual reproduction: ZYGOSPORES Rhizopus
Mucor
Rhizomucor
Lichtheimia(formerly
Absidia)
Cunninghamella
B. Ascomycota
ubiquitous in nature and produce true septate hyphae
all exhibit a sexual form (teleomorph) but also exist in
an asexual form (anamorph) Microsporum spp.
Asexual reproduction: Conidia Trichophytonspp.
Sexual reproduction: Ascospores Pseudallescheria boydii
Anamorph:
Scedosporium
apiospermum
Graphium
H. capsulatum
Teleomorph: Ajellomyces
Aspergillus
Scedosporium apiospermum Graphium Teleomorph: Eurotium
C. Basidiomycota
reproduce sexually through the formation of
BASIDIOSPORES
generally plant pathogens or environmental organisms
that rarely cause disease in humans
clamp connections occur at the septations in the
vegetative hyphae
Examples: smuts, rusts, mushrooms, and Cryptococcus neoformans complex
SPOROTHRICOSIS
MYCETOMA
CHROMOBLASTOMYCOSIS
PHAEOHYPHOMYCOSIS
C. SYSTEMIC MYCOSES
systemic fungal infections
primarily involve the LUNGS
disseminate and involve any organ system
ASPERGILLOSIS
CANDIDIASIS
CRYPTOCOCCOSIS
ZYGOMYCOSIS