Sporotrichosis Mycetoma Rhinosporidiosis Chromoblastomycosis

Subcutaneous zygomycosis

PhaeohyphomycosisUlocladium sp.

Hyalohyphomycosis

Chromoblastomycosis or dermatitis

verrucosa

A localized chronic

mycosis of skin,

Worldwide esp. tropical zone

Rough, irregular lesions at Foot and leg

lesions

Habit in nature but infect to open wound

Dematiaceous fungi

เชือ้สาเหตุPhialophora verrucosa Fonsecaea pedrosoi

Fonsecaea compacta Cladosporium carionii

Chromoblastomycosis

Fonsecaea compacta Cladosporium carionii

Rhinocladiella aquaspersa พบน้อย

ตุ่มใส และตุ่มหนอง papule / pustule: violaceous papule / pustule: violaceous ุ ุ

นูน ยกตัว VerrucousVerrucous cauliflower-likecauliflower-like

หนอง serous exudate , pusserous exudate , pusหนอง serous exudate , pusserous exudate , pus

สะเกด็แห้ง crust (red to greyish)crust (red to greyish)

localized lesion

Cat: nonpruriticswelling in nasal

planum

Dog: ventral abdominal l ilesion

sclerotic bodies: 5-12 mm

• Brownish round with muriform

5 - 12 um

planate-dividing

specimens: tissue, skin

scraping

l ti

KOH-preparation

hi t th l

Culture

sclerotic bodies at the

lesion

histopathology

Sabouraud

Dextrose Agar

(SDA)

Brown,

Slowly grow

,livaceo

us black

velvet or fluffy

blastoconidia (acropetalous conidiation)

Cladosporium type Rhinocladiella(Acrotheca) type

Phialophora type Fonsecaea type

การพสิูจน์ชนิด

Genus Cladosporium• Cladosporium type

Genus Phialophora• Phialophora type

Genus Rhinocladiella• Rhinocladiella

type

Genus Fonsecaea• All 4 types but

mostly form Fonsecaea type

F. compacta : compact head conidia

( ) ‘Rhi l di ll • two rows of conidia(a) ‘Rhinocladiellatype’

(b) ‘Cladosporium type’

(c) ‘Phialophora type’

• two rows of conidia• role of conidiogenuos cell • one conidial

• Phialides

Zygomycosis: A historycaused byfungi of the order entomophthorales and mucorales

Conidiobolus coronatus: an etiological agent of nasal granulomain horses (1961)

The first case of human infection (1965) from Jamaica

Tropical countries of Africa, Asia and America

Reported in Thailand (1981)

Basidiobolomycosisy• (Entomophthoromycosis basidiobolae)

d b lConidiobolomycosis• (Entomophthoromycosis conidiobolae)

Rhinocerebral zygomycosis in sheep (Morris et al., 2001)

H tH tFungus Fungus

Conidiobolus coronatus

Organ involvedOrgan involved

Orofaciallesion

Sinus and

SourceSource

Soil

HostHost

Horses

Llamas

C. incongruus

C. lamprauges

turbinate bone

Nodular subcutaneous

lesions

Insect

Decaying vegetation

Sheeps

Dogs

Sheep Conidiobolomycosis in Brazil, Silva et al., 2007.

geographical host transmissions source of um

distributions

Africa

Asia

host

human

transmissions

wound contamination

infections

Reptile feces

decayed plantob

olu

s ra

na

ru

America horse insect

bitted

plant

intestinal content of

insects

B

asi

dio

Hor

se • Nasal granuloma with bilateral nasal swellings

• epistaxis• symptoms of

dyspnea Chi

mpa

nzee

• Tumorousswellings on the exterior and interior of the nose

• Both eyebrowsdyspnea C

การตรวจทางห้องปฏบิตักิาร

Tissue sample Splendore hoeppli material observed by H&E

KOH-preparation Histopathology

eosinophilic material coats the grains that are characteristic of the exudatein lesions of mycosis

Large hyphae

8-20 μm

การเพาะเชือ้จากสิ่งส่งตรวจur

e on

SD

A

• grow at room temperature

l b

Hyp

hae • Young

colony: AseptateA i hi

ck-w

alle

d os

pore

sore

• Spherical conidia

• Prominent ill

Cul

tu • glabrous colony

• Aging colony: sparsely septation C

onid

ia: t

hzy

go papillae conidia

Beak-like zygospore

Syncephalestrum sp.

Syncephalastrumracemosum

Cylindrical merosporangia

Fast growing, cottony to fluffy,

becoming dark grey

Soil and dung in tropical and

subtropical regions

Human pathogen, horse normal eye flora (Rosa et al., 2003)

Merosporangia : thin-walled, contain 5-10 globose to ovoid, smooth-walled sporangiospores (merospores).

B. ranarum ( haptosporus) asexual spore

Single globose conidia

Elongated conidia

Secondary conidia

germinate

How to differentiate them?

STRUCTURE DIFFERENTIATION

Ejected sporangioles possessing papilla Basidiobolus (-)Conidiobolus (+)( )

Sporangiophores with swollen apices Basidiobolus (+)Conidiobolus (-)

ZygosporesBasidiobolus (+)Conidiobolus coronatus (-)Conidiobolus incongruus (+)

Zygospores with conjugation beaks Basidiobolus (+)Conidiobolus incongruus (-)

Subcutaneous phaeohyphomycosis

Alternaris alternata in mare

Dematiaceous fungi

an opportunistic fungal infection

• Alternaris alternata in mare• Curvularia sp. • Phialemonium curvatum• Ochroconis tshawytschae in salmon, O. humicola in trout• Exophiala jeanselmei• Wangiella dermatitidis

Wound infection

Hosts: Dog cat horse chameleons and trout

• pus • black hyphae

Phaeomycotic abscesses contained

Skin sinus and lung

การวนิิจฉัยทางห้องปฏบิตักิาร

• Dematiaceous septate

hematoxylin and eosin (HE)

periodic acid–Schiffphyphae

• Dark yeast cell• Moniliform hyphae• Sclerotic cell

Staining tools

p(PAS)

Gomori–methenaminesilver (GMS)

Fontana–Massontechniques.

Histopathology

KOH preparation from abscess content (grain)

Culture on SDA for 1 week

Alternaris alternata Curvularia sp. Phialemoniumcurvatum

Ochroconis sp. Exophiala jeanselmei Wangiella dermatitidis

Dematiaceous fungus within the keratin of follicular infundibulum.

Epithelioid-like macrophages, multinucleated giant cells, and lymphocytes

Pyogranulomatous perifolliculitis.

Intrafollicular fungi stained black.

Number of hyaline (non-dematiaceous)

Wound infection

Subcutaneous abscesses

hyaline septate hyphae in grain

Clinical material• Skin and nail scrapings N t h h l

การวนิิจฉัยทางห้องปฏบิตักิาร

p g• urine, sputum • bronchial washings• cerebrospinal fluid• blood; tissue biopsies

Direct Microscopy

Note hyphalelements are often difficult

to detect in H&E stained

sections.

• 10% KOH and Parker ink• Exudates : centrifuged and sediment then examined

with 10% KOH and Parker ink• Tissue sections should be stained

Scedosporiumapiospermum

Fusarium sp. Penicillium sp. Aspergillus sp.

Paecilomyces sp. Acremonium sp. Beauveria sp.Scopulariopsis sp.

Pythiosis: Pythium insidiosum

Pythiuminsidios

um

Ulcerative pyogranulomatous

or fibrogranulomatous

Horse, cattle,

cat and dogs.

Tropical and

subtropical

areas.

Ventral trunk and head Formation of the Pythium

i idi ' i Scanning electron

insidiosum's sporangia and zoospores (a to h) and release of the flagellated zoopores in water (i).

microscopy of Pythium insidiosum'ssporangia.

• Sporangia of Sporangia of Pythium insidiosumon a grass leaf.

Culture plate of Pythium insidiosum (Sabouraud).

Cat pythiosis: tumoral-like mass caused by Pythium insidiosum.

Cutaneous dog pythiosisAtypical case of equine pythiosis. The infection began in the lower extremity and spread, trough lymphatic vessels, to the horse's chest.

Typical cutaneous pythiosis in an equine. Small white masses, known as "kunkers", are observed in the center of the lesion.

Kunkers or leeches:

Granulomatous coagula consist of necrotic Mc, Eoand hyphae

Horse pythiosis with bone involvement (from a chronic case of the disease).

• "Kunkers" removed from the above case. These masses containe viable hyphae of P. insidiosum.

Subcutaneous pythiosis in a Texan boy . Orbital pythiosis is common in children and should be differentiated from orbital zygomycosis and aspergillosis and Thai boy with pythiosis in his carotid artery

• Amputated section of a patient leg that had pythiosis.The picture shows the aneurysm in the femoral artery caused by P. insidiosum from a Thai human patient.

Phylum Chytridiomycota

Diseases of amphibians and

reptiles

Emerging infectious

Abnormal epidermal

sloughing and

Hemorrhage in the skin

diseases

Mass mortality

sloughing and ulceration

A population pyramid to demonstrate the factors thought to heighten the impact of chytridiomycosis in amphibian populations.

Excessive sloughing of skin with thallus of fungi

bInoculum from the suspect tissue Dissecting needle

Observe mycelium on microscopy

Prevent airborne spores

1% formaldehyde for 1 to 5 minutes 70% alcohol

sterile water Culture on agar media

Agar: sweet wort agar, Sabouraud's agar Czapek agar

Low-nutrient: maintaining the Low nutrient: maintaining the strains in collection cultures

spores + mycelium transfer onto agar

Inoculation at a room temperature

4–10°C allow to survive up

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