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SOME DISEASES CAUSED BY FILAMENTOUS FUNGI
• Chromoblastomycosis
• Mycetoma
• Mucormycosis ****
• Aspergillosis ****
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CHROMOBLASTOMYCOSIS
A chronic localized infection of the subcutaneous tissue caused by several species of dematiaceous fungi
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Chromoblastomycosis
Fonsecaea pedrosoi
Cladosporium carrionii
Phialophora verrucosa
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Ecological AssociationChromoblastomycosis
• Soil
• Decaying vegetation
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Sclerotic Bodies
A fungus form resulting from host defenses
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SCLEROTIC BODIESwww.freelivedoctorcom
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Chromoblastomycosis
Melanin may be a virulence factor
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Geographic distribution
World-wide
(usually warmer climates)
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CLINICAL SPECIMENS
• PUS
• BIOPSY MATERIAL
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TREATMENT
• EXCISION
• TERBINEFINE
• ITRACONAZOLE
• POSACONAZOLE
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No Serological Tests Available
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Mycetoma
• Tumefaction
• Granules
• Draining sinus tracts
• Muscle invasion
• Bone invasion
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Mycetoma agents
• Madurella mycetomatis
• Phialophora jeanselmei
• Pseudallescheria boydii
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GEOGRAPHIC DISTRIBUTION
WARM CLIMATES
(SE United States, South America, Africa)
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ECOLOGICAL ASSOCIATION
SOIL
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Clinical SpecimensMycetoma
• Pus
• Tissue
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IDENTIFICATION
• Colonial morphology
• Conidia formation
• Granules– Color– Size shape– Texture
• Biochemical reactions
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De
DEMATIACEOUS HYPHAEwww.freelivedoctorcom
Serological TestPseudalescheria
Immunodiffusion
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Therapy
Terbinefine
Itraconazole
Posaconazole
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Mucormycosis
An acute infection characterized by inflammation and vascular invasion and thrombosis.
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Portal of entry
• Inhalation
• Ingestion
• Surface contamination (burns)
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Mucormycosis
*Rhizopus species
Mucor species
Absidia species.
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GEOGRAPHIC DISTRIBUTION
WORLDWIDE
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ECOLOGICAL NICHE
UBIQUITOUS
• FOOD
• SOIL
• ORGANIC DEBRIS
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UNCONTROLLED DIABETIC
Rapidly fatal
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MUCORMYCOSIS
CLINICAL SIGNS
Ketoacidosis
Nasal stuffiness
Proptosis
Eschar
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CHARACTERISITICS OF MUCOR INFECTION
• AFFINITY FOR ARTERIAL INVASION
• NASAL OR SINUS INFECTIONS
• DIRECT EXTENSION TO THE BRAIN THROUGH CRIBIFORM PLATE
• RAPIDLY FATAL
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WIDE, NON-SEPTATE, RIBBON-LIKEwww.freelivedoctorcom
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TREATMENT
MUCORMYCOSIS
• Control diabetes (or other underlying condition)
• Biopsy
• Culture
• Surgery (Debridement)
• Amphotericin B
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SEROLOGIC TEST
IMMUNODIFFUSION
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ASPERGILLOSIS
A variety of diseases:
pulmonary, external ears, eyes, meninges, sinuses or blood stream
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CLINICAL TYPES OF PULMONARY DISEASE
1. ALLERGIC
2. FUNGUS BALL
3. INVASIVE
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Difficult to diagnose
1. Clinical symptoms are not specific
2. Radiography not specific (except fungus ball)
3. Blood cultures seldom positive
4. Serology seldom positive (early)
5. Need invasive procedures for early detection
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COMMON PATHOGENIC SPECIES
• A. FUMIGATUS
• A. NIGER
• A. FLAVUS
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GEOGRAPHIC DISTRIBUTION
WORLD-WIDE
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ECOLOGICAL ASSOCIATION
UBIQUITOUS
• SOIL
• DECAYING VEGETATION
• FOOD
• MEDICATION
• AIR VENTS
• DISINFECTANTSwww.freelivedoctorcom
Culture
• More than 900 species• Slow growing• Various gross colors• Spores
– Size– Shape– Texture– color
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HISTOPATHOLOGY
• DICHOTOMOUS BRANCHING
• WIDE, SEPTATE HYPHAE
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DICHOTOMOUS BRANCHING
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Aspergilloma
Cavity wall
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SEROLOGIC TESTS
1. IMMUNODIFFUSION
(antibody)
2. EIA - GALACTOMANNAN
(antigen)
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DRUG OF CHOICE
VORICONAZOLE
AMPHOTERICIN B
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DIMORPHIC FUNGI(Endemic Mycoses)
COMMON CHARACTERISTICS
• LIMITED GEOGRAPHIC AREA
• SPECIFIC ECOLOGICAL NICHE
• SYSTEMIC INFECTIONS
• MORPHOLOGICALLY DISTINCT
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BLASTOMYCOSIS
Blastomyces dermatitidis
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BLASTOMYCOSIS
A CHRONIC SUPPURATIVE AND GRANULOMATOUS DISEASE OF ANY TISSUE WITH A PREDILECTION FOR LUNGS, SKIN, PROSTATE AND BONE.
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PORTAL OF ENTRY
INHALATION
INOCULATION
(rare)
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CLINICAL FORMS
1. SYSTEMIC
USUALLY PULMONARY
2. CUTANEOUS
PRIMARY
SECONDARY
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Pulmonary Symptoms
• Anorexia
• Weight loss
• Cough
• Hemoptysis
• Night sweats
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CLINICAL SPECIMENS
• SKIN SCRAPINGS
• SPUTUM
• PUS
• BIOPSY MATERIAL
• URINE
• BRONCHIAL WASHINGSwww.freelivedoctorcom
ECOLOGICAL ASSOCIATION
ORGANIC DEBRIS
(SOIL, ROTTED WOOD, DECAYED VEGETATION)
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Virulence Factor
BAD1
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Identification
• 1. Microscopic observation
• 2. Conversion
• 3. DNA Probe
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Wet Mount
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SEROLOGIC TEST
• IMMUNODIFFUSION
• COMPLEMENT FIXATION
• EIA
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DRUGS OF CHOICE
•ITRACONAZOLE
•AMPHOTERICIN B
•VORICONAZOLEwww.freelivedoctorcom
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