Mycology

1. Actinomyces & Nocardia

Actinomyces also form dense cellular micro-colonies surrounded by neutrophils and macrophages, so the organism within these
structures is protected from host defenses and antibiotics, thus, aggressive antimicrobial therapy is essential.

2. Cryptococcus neoformans:
- Oval, Budding Yeast surrounded by a wide polysaccharide capsule (Seen By India Ink)
- Capsule is important Virulence Factor bcs:
1. Resistance to phagocytosis
2. Aids in identification (India Ink)
3. Suppress T-cell function
- Disease:
1. Central nervous system = Meningitis with headache, fever & neck Stiffness
2. Pulmonary = Pneumonia
3. Visceral
4. Cutaneous / Mucocutaneous = Cellulitis
- Transmitted by Inhalation of pigeon droppings
- C. neoformans differs from Candida spp. by being Urease + and Not forming Pseudohyphae.
- Rx: Amphotericin B, Fluorocytosine & Fluconazole in AIDS patients

3. Candida albicans:
Dimorphic; forms pseudohyphae and budding yeasts (Germ Tubes & Chlamydospores are key features)
- Disease:
1. Thrush & Esophagitis
2. Onychomycosis
3. Ocular Candidiasis
4. Diaper rash
5. Vaginitis
- Rx: Fluconazole
4. Dermatophytes (Cutaneous Infections):
- Ringworms (molds) that cause Skin Lesions
- Types:
1. Trichophyton = Hair, Skin & Nails
2. Microsporum = Skin & Hair
3. Epidermophyton = Skin & Nails
- Diseases:
1. Tinea Corporis = Body
2. Tinea Pedis = Feet (Athlete's Foot)
3. Tinea Unguium = Nails
4. Tinea Capitis = Scalp (Cap = Hat) (Associated w/ Cats & Dogs)
5. Tinea Cruris = Groin & Axilla (Jock Itch)
6. Tinea Barbae = Beard & Mustache
7. Tinea Manuum = Hands
8. Tinea Versicolor = Skin
- Rx: Griseofulvin & Terbinafine

5. Chromoblastomycosis:
- A Chronic localized infection of the subcutaneous tissue caused by several species of dematiaceous fungi
- Rx: Terbinafine & itraconazole

6. Mucormycosis:
- broad, nonseptate hyphae branching at wide angles
- Mostly occur in patients with uncontrolled diabetes (DKA) & anabolic steroid addicts (Mucor = DKA)
- Inhalation of spores through the nose → Žfungi proliferate in blood vessels, penetrate the cribriform plate, and enter the
brain.
- Rapidly fatal
- Rx: Control diabetes & Amphotericin B

7. Aspergillus:
- Acute angle (45°) dichotomous branching of septate hyphae. (Aspergillus)
- Disease:
1. Invasive aspergillosis in immunocompromised
2. aspergillomas in pre-existing lung cavities, especially after TB infection (Fungus Ball)
3. Allergic bronchopulmonary aspergillosis (ABPA): Associated with asthma and cystic fibrosis; may cause bronchiectasis and
eosinophilia
- Some species of Aspergillus produce aflatoxins
- Rx: Voriconazole & Amphotericin B

8. Histoplasmosis:
- Histo = within Histiocytes (Macrophages) , Plasma = resemble Plasmodium (Malaria) (Go to RES)
- Dimorphic fungus that exists as a mold in soil and as a yeast in tissue, transmitted by inhalation
- In bone marrow aspirates, oval yeast cells within macrophages are seen microscopically
- Primarily asymptomatic. May cause Pulmonary or disseminated Histoplasmosis
- Rx: Itraconazole or Amphotericin B

9. Blastomyces dermatitidis:
- Dimorphic fungus that exists as a mold in soil and as a yeast in tissue, transmitted by inhalation
- A Chronic Suppurative And Granulomatous Disease Of Lungs, Skin, Prostate And Bone
- Usually Fatal
- Yeasts appear Thick Double Walled
- Rx: Itraconazole or Amphotericin B or Voriconazole

10. Coccidioidomycosis:
- Dimorphic fungus that exists as a mold in soil and as a Spherule in tissue, transmitted by inhalation
- The presence of Spherules In tissue specimens is pathognomonic for Coccidioides immitis infection