Group 7

Topic:
SYSTEMIC FUNGI

Group members:
Carreon, Kristine Mae
Cortes, Sheila Mae
Icao, Marie Gold
Sotis,
 Systemic Fungi
• Systemic mycoses are fungal infections
affecting internal organs. In the right
circumstances the fungi enter the body via the
lungs, through the gut, paranasal sinuses or
skin.
COMMON SYSTEMIC FUNGI INFECTIONS

Histoplasma
 Coccidiodes
 Paracoccidiodes
 Blastomyces
 Prevention and Control
 Asymptomatic or mild primary infection – NO
THERAPY NEEDED
 With progressive lesion- Oral Ketoconazole
 In disseminated diseases- Amphotericin B
 There are no means of prevention except
avoiding exposure in endemic area.
 COCCIDIOIDES
Coccidioides immitis
 Morphology
Microscopically:
• Non budding
• Thick walled spherule

Culture appearance (Microscopically):

• Small, septate hyphae that often
exhibit right-angle branches and
racquet forms
 Identification Techniques
• Direct Detection Methods
• Antigen-Protein
• Nucleic Acid Amplification/Nucleic Acid
Probe
• Cultivation/Culture
• Serodiagnosis
– Precipitation test
– Latex Agglutination Test
– Complement Fixation Test
 Mode of Transmission

• INHALATION

• ORGAN TRANSPLANTATION

• DIRECT CONTACT WITH WOUND INFECTION

 Prevention & Control

• Avoid areas with a lot of dust

(e.g., construction)

• Avoid activites that involve close

contact to dirt and dust
(e.g., gardening, digging)
PARACOCCIDIOIDES
Paracoccidioide brasiliensis
- is a dimorphic fungus, causative
agent of the disease
Paracoccidioidomycosis.
- affiliated with the family
Ajellomycetaceae.
- has the ability to grow an oval yeast-
like form at 37 °C and an elongated
mycelial form produced at room
temperature.
- Incubated for 10-20 days at 37c
(mycelial for of P. brasiliensis converted
to the yeast form in vitro by Blood
Heart infusion agar or blood-glucose-
cysteine agar.
- Yeast cells have multiple buds
- 6-3um in diameter
 Paracoccidioidomycosis
• Is a rare fungal disease
• initial infection usually occurs in the lungs
(multipolar budding yeasts that resembles a
“Ships’s wheel”), may also spread to the skin,
mucous membranes, lymph nodes and internal
organ.
• The fungus is thought to exist in soil as a mold,
and infection occurs following inhalation of spores
(conidia).
• Lungs- fungus converted into yeast that may
spread throughout other site.
• examination of sputum or pus.
• may also be made by the examination
of tissue samples (biopsy specimens)
from the lungs, skin, and/or lymph
nodes.
• Blood tests may also be useful for the
diagnosis of paracoccidioidomycosis.
BLASTOMYCES
 What is blastomyces?
• is a dimorphic fungus
• Blastomycosis is an infection caused by inhaling
microscopic particles (spores) produced by the
fungus Blastomyces dermatitidis. Blastomycosis
may be limited to the lungs or also involve the
skin and bones. In its most severe form, the
infection can spread throughout the body and
involve many organ systems (systemic).
• is a fungal infection of humans and other animals,
notably dogs and occasionally cats
 What Causes
Blastomycosis
?
 Blastomycosis is caused when the
conidial forms (spores) of the fungus
becomes airborne and are inhaled by a
person or susceptible animal. Although
the spores can be destroyed by
specialized lung cells, the fungal cells are
dimorphic and some spores may change
into a yeast-like form that is much more
resistant to the lung's defensive cells. The
body temperature triggers the change
from spores to yeast forms; these yeast
forms multiply, and some may be
transferred to other organs and the skin
by the blood or lymphatic system. This Picture of yeast-like cells
action happens during the incubation of Blastomyces dermatitidis from a
period described below in the symptom patient with blastomycosis
section.
 MORPHOLOGY

• dimorphic fungus meaning its morphology

can express two different forms primarily
depending on temperature. At ambient
environmental temperatures (~25 to 30oC) ,
Blastomyces is found in a filamentous mould
form. At body temperature (37oC) it grows in
a discrete yeast form.
– Macroscopic Morphology
– Microscopic Morphology
 Macroscopic Morphology
• Grown at 25 to 30oC:
• Filamentous fungus form
• Moderately slow growth, usually maturing in about 2
weeks but suspect cultures should be held for 8
weeks prior to discarding as negative.
• Exhibits a cottony or downy texture.
• Colonies produce white areal hyphae on the surface
which may turn a yellowish to tan colour as the
colony ages. The reverse is typically a light tan to
brown.
Filamentous fungus form
 Microscopic Morphology
• Grown at 25 to 30oC:
• Blastomyces dermatitidis produces septate hyphae
• Unbranched conidiophores of rather short, yet varying
length extend from the hyphae
• Conidia are hyaline (clear) and are produced singly at
the apex of the conidiophore or can develop directly on
the hyphae.
• Conidia are unicellular, round to pyriform (tear-drop) in
shape (~2 to 10 µm dia.) Conidia at the terminal end of
the conidiophore resemble a ‘lollipop’ in structure.
Yeast form
Grown at 37oC:
• Yeast form
• Slow to moderate growth
• Yeast form has been described as creamy,
heaped or wrinkled, granular to verrucose
(with projections). The yeast form is cream
to tan in colour.
• The yeast form of Blastomyces
dermatitidis is inhibited by cycloheximide.
 Test for Identification
• Sputum specimens processed with 10%
potassium hydroxide, cytology smears,
or a fungal stain
• Culture of sputum or tissue specimens
• Enzyme immunoassay (EIA) techniques
on sputum, tissue, or bronchoscopic
specimens
• Imaging studies (eg, chest radiography,
CT, MRI)
 Mode of Transmission

• inhalation of airborne conidia

• Cutaneous infection possible through
direct inoculation
 Prevention and Control
• Amphotericin B has been used but
with erratic results
• 2-hydroxystilbamidine
• Ketoconazole, less nephrotoxicity
• Prevent fomite inhalation in
endemic area
 Pathology

In the environment, blastomyces dermatitidis exists a mold (1) with septate aerial hyphae. The
hyphae produce conidial spores (2) these spores are either inhaled or inoculated into the skin(3)
of the susceptible host. The warmer the temperature inside the host signals a transformation
(4) into a broad-based budding yeast. The yeast may continue to colonized the lungs or
disseminate in the bloodsteam (5) to other parts of the body, such as skin, bones and joints,
organs and central nervous system.