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Medical MycologyMedical MycologySystemic MycosesSystemic Mycoses

Hugh B. Fackrell

Filename; fungi_system.ppt

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Fungal InfectionsFungal Infections

Opportunistic Infections Superficial fungal infections Cutaneous Mycoses Subcutaneous Mycoses

Systemic Mycoses

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Systemic or Deep MycosesSystemic or Deep Mycoses

HistoplasmosisHistoplasmosisCoccidiomycosisCoccidiomycosisBlastomycosisBlastomycosisCryptococcosisCryptococcosis

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Histoplasmosis before HIVHistoplasmosis before HIV

Before the appearance of HIV, approximately 95% of the cases reported of histoplasmosis capsulati where inapparent, subclinical, or benign and five percent of them where a chronic progressive lung disease with chronic cutaneous or systemic disease, or an acute fulminating fatal systemic disease.

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Histoplasmosis After HIVHistoplasmosis After HIV

Now the disease is almost always seen in HIV positive patients or other immunocompromised individuals.

All stages of this disease may mimic tuberculosis.

Histoplasmosis may coexist with actinomycosis, other mycoses, sarcoidosis, or tuberculosis.

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HistoplasmosisHistoplasmosis Histoplasma capsulatum Ohio,Mississippi valleys

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vv

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CoccidiomycosisCoccidiomycosis

SW deserts, San JoaquinSW deserts, San Joaquin Coccidioides immitusCoccidioides immitus

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Valley FeverValley Fever

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BlastomycosisBlastomycosis

Blastomyces dermatitidi as histo but rarer. Canada- Manitoba and St.Lawrence river

valley Disease in horses.

– Veternarians at risk.

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CryptococcosisCryptococcosis

Cryptococcus neoformans Sporadic Pigeons Meningitis form

– fatal

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31 04/21/23Click on image for more details

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Systemic Mycoses:Systemic Mycoses: Disease Patterns Disease Patterns

Subacute respiratory infection Acute infection Severe disseminated infection

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Systemic Mycoses:Systemic Mycoses:Subacute Respiratory InfectionSubacute Respiratory Infection Low fever Non-productive cough Mild & self limiting

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Systemic Mycoses:Systemic Mycoses:Acute InfectionsAcute Infections

Productive cough purulent sputum pain in chest Weight loss.

night sweats X-ray positive one,many lesions consolidation

Differential diagnosis: pneumonia, tumour.

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Systemic Mycoses:Systemic Mycoses:Severe Disseminated InfectionsSevere Disseminated Infections Acute Infections +

– spread to other organs

– chronic

Differential diagnosis t.b.

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Systemic Mycoses:Systemic Mycoses:DiagnosisDiagnosis

X-ray Immunochemical

skin test

serology Microscopy

Sputum

biopsy

autopsy

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Systemic Mycoses: Systemic Mycoses: Transmission Transmission

Fungal spores inhaled ...pneumonitis..no human to human transmission

Primary source bird and bat droppings and roosts. If roosts disturbed- dust, aerosol .

Chickens, Pigeons,starlings.

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Systemic Mycoses:Systemic Mycoses:TreatmentTreatment

Amphotericin B

and/or

5-fluorocytosine