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Fungal allergies and infections


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Fungal allergies and infections

  2. 2. SUPERFICIAL MYCOSES 1.Tinea versicolor 2.Tinea nigra 3.Piedra 4.Dermatophytoses SUBCUTANEOUS MYCOSES 1.Mycotic mycetoma 2.Chromoblastomycosis 3.Sporotrichosis 4.Rhinosporidiosis SYSTEMIC MYCOSES 1.Coccidioidomycosis 2.Histoplasmosis 3.Blastomycosis OPPURTUNISTIC MYCOSES 1. Aspergillosis 2.Candidiasis 3.cryptococcus 4.Mucormycosis
  4. 4. TINEA VERSICOLOR- PYTIRIASIS VERSICOLOR chronic involving s.corneum mainly in tropics. causative agent- Malassezia furfur Clinical features- Decolorations on chest,skin, abdomen , upper limbs Laboratory Diagnosis-yeast like cells and brached filaments on skin scrapings. Treatment Topical lotions like selenium sulfide shampoo, ketoconazole shampoo or cream,. terbinafine cream should be used for 2 weeks.
  5. 5. TINEA NIGRA causative agent- Exophiala werneckii and Exophilia castellani. Clinical features- Infections oof S.corneum of palms and back, producing black lesions. Laboratory Diagnosis- Skin scrapings show brownish septhate hyphae.
  6. 6. PIEDRA nodule formation on hair shaft, which may be either black or white in color White Piedra--Trichosporon beigelli Black Piedra-piedraria hortae
  7. 7. DERMATOPHYTOSES Commonly known as tinea by a group of keratinophilic fungi known as dermatophytes. They digest keratin by keratinases • Trichophytonspecies: lnfect skin, hair and nail. • Microsporum species: Infect skin and hair. • Epidermophyton species: lnfect skin and nail Clinical features- lesions on skin-- circular,dry,scaly and itchy. lesions on hair-kerion,favus,alopecia and scarring kerion- nails infected are deformed, fabrile and discoloured. favus- chronic type that develop in hair.
  8. 8. 1 . Tinea corporis (body) : "ringworm" 2. Tinea cruris (groin ) : "jock itch" 3. Tinea pedis (feet): "athlete's foot" 4. Tinea capitis (scalp) 5. Tinea unguium (nail): "Onychomycosis"
  9. 9. • Diagnosis- Wood lamps examination positive for various Microsporum species and Trichophyton schoenleinii. Specimen Collection • Skin scrapings, hair plucks and nail clippings Direct Examination specimen is mounted in KOH and is examined for the presence of thin septate hyaline hyphae and arthroconidia. TREATMENT Oral terbinafine or itraconazole
  10. 10. SUBCUTANEOUS MYCOSES 1.Mycotic mycetoma 2.Chromoblastomycosis 3.Sporotrichosis 4.Rhinosporidiosis
  11. 11. Mycotic mycetoma chronic granulomatous infection of the skin and subcutaneous tissues.
  12. 12. • Laboratory Diagnosis- examination of granules and biopsy of the lesion Treatment surgical removal of the lesion followed by use of: Antifungal agents for eumycetoma (itraconazole or amphotericin B for 8- 24 months) Antibiotics for actinomycetoma such as Welsh regimen (amikacin plus cotrimoxazole).
  13. 13. Chromoblastomycosis causative agent- Phialophora verrucosa ,Cladosporium carrionii, Fonsecaea species RESERVOIR copper-coloredsoil saprophytes can be found on rotting wood Clinical features-Following a puncture wound, a small ,violet wart-like lesion develops. With time, clusters of these skin lesions can develop (resembling cauliflower) DIAGNOSIS • Skin scrapings with KOH prepreveal copper-colored cells, called sclerotic bodies TREATMENT 1 . ltraconazole 2. Local excision
  14. 14. Sporotrichosis causative agent-Sporothrix schenckii RESERVOIR--Found on rose thorns Clinical features 1 . Subcutaneous nodule g raduallyappears at site of thorn prick 2 . This nodule becomes necrotic and ulcerates This ulcer heals, but new nodules pop up nearby along the lymphatictracts DIAGNOSIS Dimorphic Culture at 25°C: will grow branching hyphae Culture at 37°C will grow yeastcells TREATMENT ltraconazole,Fluconazole andOral potassium iodide
  15. 15. Rhinosporidoisis causative agent- Rhinosporidium seeberi Clinical features- mainly confined to mucous membranes and lesions seen in nasal cavity, eye,skin etc DIAGNOSIS- endospores are seen in lesions examinbations. TREATMENT- exicision of the polyp
  16. 16. SYSTEMIC 1.Coccidioidomycosis 2.Histoplasmosis 3.Blastomycosis
  17. 17. Coccidioidomycosis causative agent-Coccidioides immitis RESERVOIR- Desert areas of the southwestern US Clinical features- 1 . Asymptomatic (in most persons) 2 . Respiratorytransmission 2. Pneumonia 3. Disseminated: lungs,skin, bones, and meninges A small percentage of individualswith this infection willdevelop painful erythematousnodular lesions called erythemanodosum DIAGNOSIS-Dimorphic Culture at 25°C: will grow branching hyphae Culture at 37°C will grow yeastcells 1.Biopsy of affected tissue: lung biopsy, skin biopsy, etc. A. Silver stain or KOH prep B. Culture on Sabou raud's agar 2. Serology 3. Skin test TREATMENT . Amphotericin B, ltraconazole and Fluconazole
  18. 18. Histoplasmosis causative agent-Histoplasma capsulatum RESERVOIR- Present in bird and bat droppings Respiratory transmission Clinical features- . Asymptomatic (in most persons) 2 . Pneumonia: lesions calcify , which can be seen on chest X-ray 3 . Disseminated DIAGNOSIS-Lung biopsy A. Silver stain specimen B . Culture on Sabouraud's agar will reveal hyphae at 25 °C,and yeast at 37 °C. 2 . Serology 3. Skin test (tests for exposure only) 4. Urine antigen test TREATMENT- ltraconazole andAmphotericin B
  19. 19. Blastomycosis causative agent-Blastomyces dermatitidis RESERVOIR-Resides in soilrotten wood Respiratory transmission Clinical features- 1.Asymptomatic (uncommon) 2 . Pneumonia: lesions rarely calcify 3. Disseminated 4. Cutaneous: skin u lcers DIAGNOSIS - Biopsy of affected tissue: lungbiopsy, skin biopsy, etc . A. Silver stain speci men B . Culture on Sabouraud's agar 2 . Serology 3. Skin test TREATMENT-. ltraconazole,Ketoconazole and Amphotericin B
  20. 20. OPPURTUNISTIC MYCOSES 1. Aspergillosis 2.Candidiasis 3.cryptococcus 4.Mucormycosis
  21. 21. Aspergillosis causative agent-Aspergillus fumigatus, Aspergillus flavus and Aspergillus niger Clinical features- 1.Allergic bronchopulmonaryaspergillosis (lgE mediated): asthmatype 2. Aspergilloma (fungus ball) :associated with hemoptysis 3 . Invasive aspergillosis: necrotizingpneumonia. May disseminate in immunocompromised 4 . Aflatoxin consumption can cause liverdamage and liver cancer DIAGNOSIS- aspergillosis - high levels of IgE and eosinophills Aspergilloma: diagnose with chest X-ray TREATMENT-Amphotericin B
  22. 22. Candidiasis causative agent-Candida albicans RESERVOIR- normal inhabitants of skin and mucous Clinical features- cutaneous candidiosis , Mucosal lesions , intestinal candidiosis , bronchiopulmonary candidiosis and catheter assosiated and systemic infections DIAGNOSIS--Gram +ve cells from lesions and formation of chlamydospores in sarrbouraud agar culture. TREATMENT- Amphotericin B
  23. 23. cryptococcus • causative agent-Cryptococcus neoformans • RESERVOIR- soil saprophyte and found in feaces of pigions and birds • Clinical features- Meningitiss , pnemonia and skin lesions • DIAGNOSIS-. India-ink stain of (CSF) : observe encapsulatedyeast 2.cryptococcal antigen test of C S F :detects polysaccharide antigens • 3 .Fungal culture • TREATMENT- Amphotericin B
  24. 24. Mucormycosis causative agent-Rhizopus ,Rhizomucor and Mucour RESERVOIR- Saprophytic molds ubiquitous in nature Clinical features- 1.Rhinocerebral : starts on nasal mucosa and invades the sinus and orbit 2. Pulmonary mucormycoses DIAGNOSIS-Biopsy and Black nasal discharge TREATMENT - I.V Amphotericin B combined with surgical Drainage.
  25. 25. REFERENCES- 1. Ananthanarayan and paniker's Textbook of Microbiology. 10th edition. 2.Clinical microbiology made Ridiculously simple - 6th edition
  26. 26. THANK YOU