Part 5 (Mycology) – Chapter 47 (Basic Mycology)
Pathogenesis
Many fungi will elicit the formation of
what (pathological) structures in the
body?
What part of the immune system is
involved in the formation of a
granuloma?
What is cell-mediated
immunity/immune response?
What does a positive skin test (= a
delayed hypersensitivity skin reaction
after intradermal injection with an
antigen) indicate?
What does a negative skin test for a
pathogen indicate?
Skin testing with Candida antigens is
useful because it can be used to
determine what? (explain)
What are 3 defence mechanisms the
host-defence uses to prevent/limit
infection with fungi (give examples)
What are the 2 important host defenses
in the respiratory tract? are
What antibodies (immunoglobulins) are
produced in response to fungal
infection
The cell-mediated immune response
(formation of granulomas) is protective.
Suppression of the cell-mediated
immune response can therefore lead to
what?
If a patient has coccidioidomycosis and
then receives an intradermal injection
of coccidioidomycosis specific fungal
antigens (as a part of a delayed
hypersensitivity skin test) it will result
in what clinically? Explain.
Granulomas
Granuloma formation is a cell-mediated immune
response
Cell-mediated immunity is an immune response
that does not involve antibodies, but rather involves
(1) the activation of phagocytes, (2) antigen-specific
cytotoxic T-lymphocytes, and the (3) release of
various cytokines in response to an antigen.
Past or present activation of the cell-mediated
immune system (due to exposure to that specific
pathogen)
A negative skin test makes the diagnosis unlikely
unless the patient is immunocompromised.
Whether cell-mediated immunity is normal –
because most people carry Candida as part of the
normal flora
Intact skin - effective against certain fungi
(e.g., Candida, dermatophytes).
Hormone-associated skin changes (puberty) limit
ringworm of the scalp (caused by Trichophyton).
The normal flora (of skin and mucous membranes)
suppresses fungal growth (e.g. inhibition of C.
albicans overgrowth)
(1) the mucous membranes of the nasopharynx
(traps inhaled fungal spores)
(2) alveolar macrophages.
IgG and IgM (their roles in protection from disease is
uncertain though)
Reactivation and dissemination of asymptomatic
fungal infections.
In addition, suppression of the cell-mediated
immune response can lead to disease caused by
opportunistic fungi.
A positive skin test (which indicates exposure to the
fungal antigen – currently or in the past)
Coccidioidomycosis (= a major systemic fungal
infection). Major systemic fungal infections produce
granulomas.
Granulomas are a cell-mediated immune system
response.
Activation of the cell-mediated immune system
 results in a response to certain fungal antigens
injected intradermally.

Structure and Growth

What are the major systemic fungal diseases

coccidioidomycosis, histoplasmosis, and blastomycosis