Mycoses

NAME: MUHAMMAD
NOORAIMAN AHMAD
NOORDIN
GROUP : 30 A
 Definition
Amycosis(plural:Mycoses)is
afungalinfectionofanimals,including
humans.Mycosesarecommon,anda
varietyofenvironmentalandphysiological
conditionscancontributetothe
developmentoffungaldiseases.Inhalation
offungalsporesorlocalizedcolonizationof
theskinmayinitiatepersistentinfections;
therefore,mycosesoftenstartin
thelungsorontheskin
 Classification
Superficial
Cutaneous
Subcutaneous
Systemic
Opportunistic
 SuperficialMycoses
Superficial mycosesarelimitedtotheoutermostlayersof
theskinandhair.
AnexampleofafungalinfectionisTinea versicolor,a
fungusinfectionthatcommonlyaffectstheskinofyoung
people,especiallythechest,back,andupperarmsand
legs.Tineaversicoloriscausedbyafungusthatlivesinthe
skinofsomeadults.Itdoesn'tusuallyaffecttheface.This
fungusproducesspotsthatareeitherlighterthantheskin
orareddish-brown.Thisfungusexistsintwoforms,oneof
themcausingvisiblespots.Factorsthatcancausethe
fungustobecomemorevisibleincludehighhumidity,as
wellasimmuneorhormoneabnormalities.However,
almostallpeoplewiththisverycommonconditionare
healthy.
 Pityriasisversicolor--pigmentedlesionson
torso
Tineanigra--graytoblackmacularlesions
oftenonpalms
Blackpiedra--darkgrittydepositsonhair
Whitepiedra--softwhitishgranulesalong
hairshaft
Allarediagnosedbymicroscopyandare
easilytreatedbytopicalpreparations.
 CutaneousMycoses
Cutaneous mycosesextenddeeperintotheepidermis,andalso
includeinvasivehairandnaildiseases.Thesediseasesare
restrictedtothekeratinizedlayersoftheskin,hair,andnails.
Unlikethesuperficialmycoses,hostimmuneresponsesmaybe
evoked,resultinginpathologicchangesexpressedinthe
deeperlayersoftheskin.Theorganismsthatcausethese
diseasesarecalleddermatophytes.Theresultingdiseasesare
oftencalledringworm(eventhoughthereisnoworminvolved)
ortinea.Cutaneousmycosesarecaused
byMicrosporum,Trichophyton,andEpidermophytonfungi,
whichtogethercomprise41species.
Onecommondiseaseistheathlete'sfootwhichmost
commonlyaffectsmenandchildrenbeforepuberty.Itisdivided
inthreecategories:chronicinterdigitalathlete'sfoot,chronic
scalyathlete'sfoot,andacutevesicularathlete'sfoot.
 SubcutaneousMycoses
Subcutaneous mycosesinvolvethe
dermis,subcutaneoustissues,
muscle,andfascia.Theseinfections
arechronicandcanbeinitiatedby
piercingtraumatotheskin,which
allowsthefungitoenter.These
infectionsaredifficulttotreatand
mayrequiresurgicalinterventions
suchasdebridement.
 Subcutaneousinfections-over35
speciesproducechronic
inflammatorydiseaseof
subcutaneoustissuesand
lymphatics.e.g.sporotrichosis-
ulceratedlesionsatsiteof
inoculationfollowedbymultiple
nodules-causedbyadimorphic
fungus:Sporotrix schenckii
 SystemicMycosesdueto
PrimaryPathogens
Systemic mycoses due to primary
pathogensoriginateprimarilyin
thelungsandmayspreadtomanyorgan
systems.Organismsthatcausesystemic
mycosesareinherentlyvirulent.
Generally,primarypathogensthatcause
systemicmycosesaredimorphic.
 SystemicMycosesdueto
OppurtinisticPathogens
Systemic mycoses due to opportunistic
pathogensareinfectionsofpatientswith
immunedeficiencieswhowouldotherwisenot
beinfected.Examplesofimmunocompromised
conditionsincludeAIDS,alterationofnormal
florabyantibiotics,immunosuppressive
therapy,andmetastaticcancer.Examplesof
opportunisticmycoses
includeCandidiasis, Cryptococcosis and
Aspergillosis
 Systemicfungalinfections
areuncommon
Naturalimmunityishigh;physiologic
barriersinclude:
1.Skinandmucusmembranes
2.TissuetemperatureCfungigrow
betteratlessthan37C(mesophiles)
3.RedoxpotentialCin vivoconditions
tooreducingformostfungi
 SuperficialMycoses
Limitedtotheoutermostlayeroftheskin
Donotelicitimmuneresponse
Nodiscomfort
Cosmeticproblems
Limitedtostratumcorneum
4Infections
1.Pityriasisversicolor
2.Tineanigra
3.Blackpiedra
4.Whitepiedra
 PityriasisVersicolor
Malasseziafurfur(Pityrosporum
orbiculare)
Lipophilicyeastlikeorganism
Richinsebaceousglands
Mediaissupplementedwithfatty
acids
Existinbuddingyeast,occasionally
hyphal
 Lesionsarefoundintorso,armsand
abdomen
Scaleveryeasilychalkyappearance
Rarely,papularorgrowlikefolliculitis
ClinicalDiagnosis:KOH-
Spaghettiandmeatballs
Treatment:Azoles
 TineaNigra
Exophialawerneckii
Producemelaninblackorbrown
color
GrowsasyeastOlderhyphaewith
myceliaandconidia
 Tineanigra
Lesion-
graytoblackmacular
palms
Diagnosis-Skin
scrapingswithalkalistain
Cultures-Sabouraudss
mediapigmentedyeastandhyphae

 BlackPiedra
Piedraiahortae-existinteleomorphic
state
Culturesasexualstate -
olderculturesteleomorphic(asci,which
containspindleshapedascospores)
Clinicalfeature:presenceof
hardnodulesfoundalongtheinfectedhair
shaft
Nodulescontainasci
 WhitePiedra
Trichosporonbeigelii
Growsinmediawithoutcyclohexamide
Culturesarepastyandwhite
developeddeepradiatingfurrowsand
becomeyellowandcreamy
Microscopicexaminationseptate
hypaethatdevelopsintoarthroconidia
Hair-soft,pasty,creamcoloredgrowth
 Etiology

Etiology
Microsporum
Trichophyton
Epidermophyton
 Classification
Anatomiclocation Tineapedis
Tineacapitis
Tineacorporis
Tineacruris
Ecologiclocation
Geophilic Zoophilic
Anthrophilic
GeneralcharacteristicsofMacroconidiaand
MicroconidiaofDermatophytes

Genus Macroconidia Microconidia

Microsporum Numerous,thick Rare

walled,rough

Epidermophyton Numerous, Absent

smoothwalled

Trichophyton Rare,thinwalled, Abundant

smooth
 Diagnosis
Diagnosisisbasedupon:
1.Anatomicalsiteinfected
2.Typeoflesion
3.ExaminationwithaWoodslamp(366
A)
4.ExaminationofKOH-treatedskin
scalesfromtheinfectedarea
5.Cultureoftheorganism(nottoo
important)
 Treatment
Skinazoles,inhibitscytochrome
450dependentenzymesystemsat
thedemethylationstepfrom
lanosteroltoergosterol
Hair-Griseofulvin,oral,affects
microtubularsystem
 Treatment
Skin
removaloftheorganismby:
1.Seleniumsulfide
2.Thiosulfate
3.Salicylicacid
4.Hyposulfite
inhibitionofergosterolby:
1.miconazole
 Prevention
Keepingtheskincleananddry,aswellas
maintaininggoodhygiene,willhelplarger
topicalmycoses.Becausefungal
infectionsarecontagious,itisimportant
towashaftertouchingotherpeopleor
animals.Sportsclothingshouldalsobe
washedafteruse.Wearingflip-flopsif
usingacommunityswimming
poolorshowerwillalsohelpprevent
topicalinfections