FUNGI

Introduction

They were classified accordingly due to the

presence of unique rigid cell wall, which is
chemically different from the bacterial cell wall.
The fungal cell wall is rich in carbohydrates
composed of polymers of acetyl glucosamine
(glucose molecules linked with amino and acetyl
groups) and hence is coined as chitin, which
forms a thick layer protecting the inner
organelles from the adverse external
environment.
 Moulds

are made up of rope-like filamentous

structure called hyphae.

hyphae help in the interexchange of

cytosol and organelles between
adjacent cells.

hyphal filaments group together to

form a mess-like appearance called
the mycelium.
 Yeasts are unicellular eukaryotic
organisms, and they resemble bacterial
colonies as they appear smooth and
mucoid on the media.
YEAST They are aerobic organisms but their
growth is enhanced in anaerobic
conditions. They acquire energy from an
organic compound by oxidation.
YEAST
 Yeast-Like Fungi

They partly resemble yeast cells

and also develop pseudohyphae
resembling hyphal filaments.
Dimorphic Fungi

They exist as yeast-like colonies at

37°C and transform themselves into
mould-like colonies at 25°C especially
when they are found in the soil; hence,
the mould forms are saprophytic, and
the yeast forms are considered as
pathogenic. Systemic infections are
mostly caused by dimorphic fungi.
 TAXONOMICAL CLASSIFICATION
These are lower fungi with non-septate hyphae, and they produce
ZYGOMYCETES sporangiospores (asexual spores).

They produce septate hyphae and ascospores. (Sexual spores are

ASCOMYCETES present inside the sac or ascus.)

They produce septate hyphae and basidiospores. (Sexual spores are

BASIDIOMYCETES present in the basidium.)

DEUTEROMYCETES They produce septate hyphae and cannot be classified into sexual
or asexual because their sexual state is unknown. However, most
or FUNGI fungi appear to share common features with ascomycetes.
IMPERFECTI
 In fungi, it is made up of chitin and
polysaccharide, whereas in the case of
plants, it is replaced by cellulose.
The fungal species are ubiquitous
CELL WALL OF organisms and are found in the soil,

FUNGI dead decaying matter, and all moist

places.
Genetic studies have proved that the
animal kingdom shares a closely related
link with fungi than plants.
 > They reproduce by either asexual or
sexual reproduction; both the
FUNGAL reproduction systems produce spores.
> They are very resistant and can resist
REPRODUCTION even dry and adverse conditions.
> Asexual spores are of two types:
vegetative spores and aerial spores.
 are formed by budding, formation of septa in the hyphal filament,
or folding and thickening of hyphal filaments (resulting in thick-
VEGETATIVE SPORES walled spores). All these spores are identical because they divide
mitotically. They are of three types, namely, arthrospores,
blastospores, and chlamydospores.

are of four types, namely, conidiospores, microconidia,

AERIAL SPORES macroconidia, and sporangiospores. These spores are both
exogenous and endogenous in nature.

SEXUAL SPORES are of three types, namely, zygospores, ascospores, and

basidiospores. Haploid spores are formed inside each sporangium.
Sexual reproduction is by the fusion of cells followed immediately
by meiosis.
 The diseases caused by fungi are called
mycoses. These infections are caused to
humans and animals through the
inhalation of fungal spores (which enter
the lungs, get localized, and cause
respiratory infection) or inoculation of
spores or pathogenic fungi through cuts
MYCOSES (which localize in the skin).

These fungal infections are classified

into four types, which are as follows:
1. Superficial mycosis
2. Subcutaneous mycosis
3. Deep mycosis
4. Opportunistic mycosis
 Mycoses affecting the outermost layers
of the skin, hair, and nail are classified
under superficial mycoses. They
externally localize on the layers of the
skin, hair, and nail and grow well on the
dead layers. Superficial mycoses are
SUPERFICIAL hence classified into two types, namely,
surface mycoses and cutaneous
MYCOSIS mycoses.
Surface mycoses affect the outermost
layer of the skin and do not have any
kind of inciting response because they
do not invade the innermost layer of the
skin. Surface mycoses are mild
persistent infections caused due to
insanitary conditions.
 Pityriasis versicolor or Tinea versicolor
This fungus causes superficial mycoses in humans.
Pityrosporum orbiculare or
Malassezia globosa is the fungus responsible for the surface
infection.
 They are yeasts that live on
the skin in few numbers but
FUNGAL
multiply during adverse
CHARACTERISTICS
conditions leading to skin
infections.
 1. Mild patches are found on
the chest, back, neck, and
arms.
2. These patches lead to
pigmentation.
SYMPTOMS 3. This discolouration starts
spreading in untreated
conditions.
4. Dryness is also observed on
the patches.
5. Itching is also observed.
 The transmission is mainly due
to contact, adherence, and
invasion of the pathogenic
fungi. Improper sanitation
during hot weather due to
over-sweating will
overpopulate the yeasts
PATHOGENESIS
present on the skin causing
infection. These yeast-like
fungi become pathogenic
when they change their
morphology from that of yeast
to that of mycelium. Hence,
they are dimorphic in nature.
 The samples collected are skin
scrapings of the lesions by a
special
LABORATORY DIAGNOSIS technique using Sellotapes.
Sellotapes are placed on the
lesions and removed for
further testing.
 Topical application of
ointments are prescribed,
which is a combination of
benzoic
TREATMENT acid, salicylic acid, ciclopirox
olamine, and tincture of iodine
called as Whitfield’s ointment.
Any sulphur-containing
ointment is also prescribed.
 Tinea nigra

Tinea nigra is the superficial mycosis caused by the fungus

Hortaea werneckii.
 They are dimorphic fungi that
exist in both yeast and hyphal
forms
and are responsible for
FUNGAL
asymptomatic mycoses. These
CHARACTERISTICS
fungi are saprophytic in nature
and are
found on dead and decayed
materials.
 1. Mild patches are seen on
palms and foot soles.
2. These patches become
brownish or black in colour.
SYMPTOMS
They are irregular in shape.
3. Itching is also observed.
4. Skin growth like scales is
seen.
 The entry is mainly though the
inoculation of the fungus
through cuts and wounds
during contact with the
fungus. They enter, localize,
and cause superficial infection
on the palms and foot soles.
PATHOGENESIS
They are halotolerant and
hence are able to survive in
human tissues by accumulating
and utilizing melanin.
Sometimes, this mycosis is
confused with a type of skin
cancer.
 Skin scrapings are collected
for wet mount processing
(KOH mount)
and viewed under the
microscope demonstrating the
budding yeast cells on the
LABORATORY DIAGNOSIS
branched hyphal
filaments. Culturing using SDA
is done, and moist white-
colored colonies appear after
a
week’s time.
 1. Tropical application of
antifungal ointments
TREATMENT 2. Following good hygiene
3. Avoiding the exposure to
moist and dirty places
PIEDRA

Piedra is a disease caused in hair follicles.

They are of two types, namely, white piedra
and black piedra.
WHITE PIEDRA
> White Piedra is caused by Trichosporon
beigelii.
>They are asexually reproductive fungi that
are a part of the normal flora. These are
yeast-like fungi that change to septate hyphal
filaments.
BLACK PIEDRA
> It is caused by Piedraia hortae, which
causes superficial infections of the hair
and scalp. It is an asexual fungi that is
transmitted from one person to another
through contact.
> Black nodules are found on the hair shafts
of the beard and scalp.
SYMPTOMS
1. Acclimation of white lump of yeast cells on
the hair follicles of the head, the beard, and
even pubic hair
2. Hair loss
3. Itching
PATHOGENESIS
The fungi are transmitted on close contact
with the infected person’s towel, soap, comb,
and so on. The white nodules found on the
hair shafts are nothing but the spores that are
transmitted by contact.
LABORATORY
DIAGNOSIS
Physical examination of the hair and wet
mount preparation using KOH of the hair with
nodules is done. The wet mount is then viewed
under the microscope. The affected hairs are
also collected and cultured using SDA
medium.
TREATMENT
1. Applying tropical antifungal ointments
(imidazoles and selenium sulphide)
2. Applying amphotericin B ointments
3. Using separate towels, soaps, and combs
4. Following proper hygiene
SUBCUTANEOUS MYCOSIS
It is a type of mycosis that causes disease in living tissues leading to tissue
damage. It is of three
types, namely, mycetoma, chromoblastomycosis, and rhinosporidiosis.
 Mycetoma
Mycetoma is a persistent subcutaneous granulomatous infection
that affects the foot. It is otherwise called as Madura foot
because it was first identified in Madurai by Gill in 1842. This
mycosis affects the subcutaneous tissue, and as the infection
progresses, bones are also damaged.
 Characteristics: Actinomycetes
or filamentous fungi cause
mycetoma.
Actinomycetes are higher
forms of bacteria but are
FUNGAL
filamentous in nature and
CHARACTERISTICS
hence grouped under fungi.
These actinomycetes are
filamentous,
aerobic in nature, and belong
to Mycobacterium sp.
SYMPTOMS
1. Itching
2. Swelling in the area of itching
3. Pus formation
4. Ulceration and nodules
5. Pus expulsion
6. Irritation in the area of infection
7. Disfiguration of the leg
PATHOGENESIS
The mode of transmission is by the inoculation
of the fungus or actinomycetes
through cuts or wounds from the soil.
The infection starts with mild itching and
swelling mostly in the foot region. The swelling
further enlarges due to the accumulation of
dead cells with granules. The infection spreads
due to the expulsion of pus as the discharge,
and it affects the bones.
LABORATORY
DIAGNOSIS
The samples collected are the pus exudates.
These are smeared for Gram staining, and a
wet mount preparation is done for the
identification of actinomycetes
(Gram-positive in nature) or Eumycetes.
TREATMENT
1. Surgery and removal of the abscess at the
early stage should be done with proper
administration of oral antifungal and
antibacterial drug therapy.
2. Rifampicin, dapsone, and sulphonamides
are given in the case of actinomycetoma.
3. Itraconazole and ketoconazole can be given
in the case of eumycetoma.
4. The treatment should be prolonged for a
certain period of time for the complete
eradication of the pathogen.
 Chromoblastomycosis
Chromoblastomycosis is caused by five different vegetative fungi
that cause subcutaneous mycosis. They cause persistent
infections that slowly progress and form granulomatous lesions
ending up in the accumulation of keratinocytes in the epidermal
layer resulting in the sloughing of the skin.
 Phialophora verrucosa are thermos-shaped phialides and mug-
shaped collarettes.
Cladophialophora carrionii are arranged in chains and divide by
budding.
Rhinocladiella aquaspersa produces terminal conidia, which are
elliptical in shape.

Fungal Characteristics Fonsecaea pedrosoi are polymorphic in nature, hence changing the
shape of their conidia.

The shape of the conidia produced by Fonsecaea compacta is

spherical,

and they are much smaller when compared with that of Fonsecaea
pedrosoi.
SYMPTOMS LABORATORY
DIAGNOSIS
1. Itching in the area of entry of the pathogen
is observed.
1. KOH wet mount preparation
2. Since the infection is a slow process,
2. Histopathological analysis to check the
swelling with pus formation occurs.
multinucleated giant cells with the granules
3. Nodules are formed as the infection drains
and sclerotic bodies inside and outside the
into the lymph.
cells
4. Ulceration is commonly seen.
3. Culturing using SDA and checking for
brown or black mouldy colonies
PATHOGENESIS
This fungus is very resistant due to the
melanin cell wall and hence is not easily
TREATMENT
eliminated by the immune cells.
1. Surgical removal of the pustule and proper
The fungus affects the tissue-forming
oral treatment
hyperplasia of the epidermis producing
2. Heat therapy (early stages)
nodules with pus formation, which is painless.
3. Antifungal agents such as flucystosine,
This fungus drains into the lymphatics, and in
ketoconazole, and itraconazole
severe conditions, this might result in the
damage of different organs of the body.
 Rhinosporidiosis
Rhinosporidiosis, a granulomatous infection of the nose, eyes,
and mouth, is caused by Rhinosporidium seeberi. This fungus is
classified under lower aquatic protistan parasites that affect
humans and amphibians.
 This species was first classified
under moulds and then under
protozoa; and
finally, after using molecular
CHARACTERIZATION tools, the analysis proved that
it is a aquatic protistan
parasite. It
belongs to a group called
Mesomycetozoa.
SYMPTOMS
The accumulation of a large mass of cells that
hangs out as a separate layer is seen.
Pus accumulation leads to foul smell.
Breathing difficulty due to the protrusion of
the layer is observed.
PATHOGENESIS
People who are mostly affected by this
infection are fishermen and washermen as
they are in constant contact with water
habitats facilitating the entry by the inoculation
of the pathogen through cuts and wounds.
LABORATORY
DIAGNOSIS
The skin biopsy is taken for histopathological
analysis, and KOH wet mounting is also done
for the identification of the pathogen that is in
the form of endospores within the
sporangium. Serological tests are also done.
TREATMENT
1. Surgery is a good option.
2. Intravenous administration of amphotericin
B and dapsone is done to avoid the spread
of infection.
 DEEP MYCOSIS

Deep mycosis is otherwise called as systemic mycosis. This infection involves

both pathogenic and opportunistic fungi. The pathogenic fungi gain the entry,
whereas the opportunistic fungi suppress the immune system and affect it.
Histoplasmosis is a type of systemic mycosis found in humans and animals.
 Histoplasmosis
Histoplasmosis is a systemic mycosis caused by Histoplasma
capsulatum. This affects the respiratory system causing
pulmonary infection in humans. It is a saprophytic fungi mostly
found in the soil.
 It is a dimorphic fungus that
exists in both the mould and
the yeast
form. It appears to be round
FUNGAL solo-celled microconidia
CHARACTERISTICS (uninucleated cells). When
grown in a
laboratory medium, it
produces mouldy white
colonies.

SYMPTOMS
1. Dry cough
2. Body pain
3. High fever
4. Restlessness
5. Lymphadenopathy
6. Fatal in severe cases affecting the liver,
eyes, and glands.
PATHOGENESIS
The entry of the intracellular pathogen is by
inhalation, and the moulds convert
themselves into the yeast form and start
invading the tissues. These yeast cells are
engulfed by alveolar macrophages.
This results in pulmonary infection mostly in
men, children, and immunocompetent
patients such as those with AIDS and those
undergoing therapy.
LABORATORY
DIAGNOSIS
After the collection of specimens, they are
processed for direct microscopy method by
histopathological staining or Giemsa staining
to view the intracellular yeast.
Serological tests such as complement fixation
test are done for confirmation. Enzyme
immunoassay is done to find out the
circulatory antigens that are very sensitive, and
it is one of the confirmatory tests done.
TREATMENT
1. Itraconazole can be administered.
2. Amphotericin B can be given.
3. Relapses may occur for
immunocompromized patients; hence,
prolonged treatment with itraconazole is
supplemented for them to avoid cross-
infection.
OPPORTUNISTIC MYCOSIS

Opportunistic mycoses are infections that occur in immunocompromized

patients. This type of infection depends on the load of organisms and the
virulence caused by them to the host where the host defense gets suppressed
leading to opportunistic mycosis.
 Candidiasis
Candidiasis is caused by Candida albicans, Candida tropicalis,
Candida parapsilosis, and Candida krusei. These organisms are a
part of the normal flora of the skin and gastrointestinal tract.
 The cells are oval-shaped and
divide by budding, which form
into a pseudohyphae. Some
species such as Candida
FUNGAL albicans are dimorphic in
CHARACTERISTICS nature. This fungus
produces smooth white
colored colonies on solid agar
medium and appears within 24
hours.
SYMPTOMS
1. Painless lesions occur.
2. Unpleasant white patches are seen on the
mouth, skin, and genital regions.
3. On eruption of the lesions, pus-like
exudates with blood come out, making it very
painful.
4. This eruption might lead to the spread of
infection to the respiratory system and other
parts of the body.
5. Hematologic diseases such as anemia,
lymphoma, and chronic granulomatous dis-
ease occur in severe cases.
6. Vulvovaginitis (irritation and vaginal
discharges) is also observed.
PATHOGENESIS
The route of entry is airborne, or it is sexually
transmitted through the genital tract. Airborne
entry causes oral thrush infecting the tongue,
lips, and palate.
Sexually transmitted candidiasis affects the
vaginal valve causing vaginal thrush called vul-
vovaginitis. Infections of the skin and nails,
that is, cutaneous candidiasis and
onychomycosis.
LABORATORY TREATMENT
DIAGNOSIS
1. Tropical applications are given for the
infected skin and nails.
1. Blood 2. Ketoconazole, nystatin, and amphotericin B
2. Swabs (throat and vaginal) can be administered.
3. Skin scrapings 3. This type of oral treatment can be
4. Nails prolonged for immunosuppressive patients.
5. Urine 4. Less use of antibiotics is very important to
6. Vaginal discharges maintain the balance of the microbial flora.
7. Cerebrospinal fluid

Direct microscopic method is done by

histopathological staining of the tissue biopsies
or Gram staining of the swabs and samples
obtained to demonstrate the yeast cells and
the pseudohyphae in the samples. Wet mounts
of skin scrapings and nail samples are
prepared using 10% KOH.
 Cryptococosis
Cryptococcosis refers to the opportunistic fungal infections
caused by Cryptococcus neoformans and Cryptococcus gattii.
These organisms are mostly found in the soil, feces of birds, and
even on trees. They are yeast-like fungi with much resistant
capsules that protect them from the external environment.
Hence, they are much resistant pathogenic organisms.
 They are yeast-like fungi
encapsulated by a thick cover
of polysaccharide called as
FUNGAL capsule. They produce mucoid
CHARACTERISTICS white colonies; this mucoid
nature is mainly due to
the presence of the capsule
around the organisms.
SYMPTOMS
1. Fever
2. Head ache
3. Body pain
4. Flu symptoms
5. Central nervous system affected in severe
cases, causing encephalitis
PATHOGENESIS
The mode of transmission is by the inhalation
of the fungal cells. They enter
the respiratory system affecting the circulating
cells and compromise the immune system by
resisting the immune reactions. They multiply
and infect other parts of the body, especially
the central nervous system causing
meningoencephalitis (inflammation of the
brain tissues and meninges).
LABORATORY
DIAGNOSIS
A special staining technique is employed by
using Indian ink for the demonstration of the
capsule, which is the confirmatory test for
cryptococcosis. The serological test for the
demonstration of capsular antigen in the
sample using commercial antibodies is very
sensitive and effective.
TREATMENT
1. Amphotericin B and flucystosine can be
administered.
2. A combination of both is prescribed in
severe cases such as immunocompromized
patients.
3. Prolonged treatment is provided to avoid
recurrent infections.
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