1. The morphology and biology of the fungi

Classification of medically important fungi

• Fungal morphology and structure • Antifungal - Mechanisms of action • Fungi - biology and physiology• Fungal infections (FI) - classification

1. The morphology and biology of the fungi

Classification of medically important fungi

• Fungal morphology and structure • Antifungal - Mechanisms of action • Fungi - biology and physiology• Fungal infections (FI) - classification

The goal of teaching: 2. Common fungi which primarily cause skin,

hair and nail FI • Malassezia - morphology, biology

Pathogenesis of pitiriasis versicolor,

Pathogenesis of seborrheic dermatitis • Trichophyton - morphology, biology• Microsporum - morphology, biology• Epidermophyton - morphology, biology

Pathogenesis of dermatophytoses

2. Common fungi which primarily cause skin, hair and nail FI

• Malassezia - morphology, biology

Pathogenesis of pitiriasis versicolor,

Pathogenesis of seborrheic dermatitis • Trichophyton - morphology, biology• Microsporum - morphology, biology• Epidermophyton - morphology, biology

Pathogenesis of dermatophytoses

3. Common fungi which causes superficial / invasive / oprtunistic FI

• Candida - morphology, biology

Pathogenesis • Cryptococcus - morphology, biology.

Pathogenesis • Aspergillus - morphology, biology.

Pathogenesis • Fusarium - morphology, biology.

Pathogenesis

3. Common fungi which causes superficial / invasive / oprtunistic FI

• Candida - morphology, biology

Pathogenesis • Cryptococcus - morphology, biology.

Pathogenesis • Aspergillus - morphology, biology.

Pathogenesis • Fusarium - morphology, biology.

Pathogenesis

4. Other fungi which causes superficial / invasive oprtunistic FI

• Penicillium - morphology, biology

Pathogenesis • Zygomycetes (Mucor, Rhisopus, Absidia) -

morphology, biology.

Pathogenesis • Pneumocystis - morphology, biology.

Pathogenesis

4. Other fungi which causes superficial / invasive oprtunistic FI

• Penicillium - morphology, biology

Pathogenesis • Zygomycetes (Mucor, Rhisopus, Absidia) -

morphology, biology.

Pathogenesis • Pneumocystis - morphology, biology.

Pathogenesis

Zygomycetes/Mucormycetes

genus Mucor, genus Rhisopus

genus Absidia

Zygomycetes/Mucormycetes

genus Mucor, genus Rhisopus

genus Absidia

Mucor Absidia Rhizopus

Zygomycetes (mucoraceae, phycomycetes) Mucor, Rhizopus, Absidia

Ubiquitous fungi, contaminants, and cause of acute - severe infections, fulminant course

Ubiquitous fungi, contaminants, and cause of acute - severe infections, fulminant course

Mucor

Culture Preparation from a culture (sporangium with sporangiospores)

Aseptate hyphae

Rhizoid - “stolon”

Aseptate hyphae

Rhizoid - “stolon”

Rhizopus oryzae

Rhizopus; zygomycosis, phycomycosis, mucormycosis

Rhizopus

Absidia

Fast growing colonies, wooly or

cotton, white to light gray Spherical sporangium -wide neck

cup-shaped columella

Zygomycosis/mucormycosis/phycomycosis

Acute fungal disease Spores enter after

trauma ketoacidosis

Acute fungal disease Spores enter after

trauma ketoacidosis

Diseases:• rhinocerebral

(nasal mucosa-paranasal sinuses, bone, orbit, CNS)

• thoracic (lungs, dissemination)

• abodminal• primary cutaneous form

(burns)

Diseases:• rhinocerebral

(nasal mucosa-paranasal sinuses, bone, orbit, CNS)

• thoracic (lungs, dissemination)

• abodminal• primary cutaneous form

(burns)

Rhinocerebral zygomycosis Subcutaneous zygomycosis

Zygomycosis

LDg/DMP PH culture (rapid growth)

LDg/DMP PH culture (rapid growth)

MM2MM2

Lung zygomycosis

Lung hyphae (H&E)

Penicillium spp.Penicillium spp.

Penicillium Mildew

Pure culture

Mixed culture

(different mould)

Mould, ubiquitous fungi, contaminantsMould, ubiquitous fungi, contaminants

Culture Preparation from a culture

Penicillium

• Penicilliosis: lung (rarely dissemination)

keratitis

otomycosis

onychomycosis• Mycoallergosis• Mycotoxicosis

• P. marneffei – Asia, disseminated infection, AIDS

Penicillium

PneumocystisPneumocystis

Pneumocystis jirovecii (P. carinii)

• Extracellular pathogen, respiratory tract, an opportunist

• Cycle - trophozoites (polymorphic-unicellular forms 1-2.5 μm)precyst (sporocyst, 4-5 μm)cysts (spores) 5-8 μm with 8 intracystic bodies (octet)

• Reproduction - asexual and sexual

• Extracellular pathogen, respiratory tract, an opportunist

• Cycle - trophozoites (polymorphic-unicellular forms 1-2.5 μm)precyst (sporocyst, 4-5 μm)cysts (spores) 5-8 μm with 8 intracystic bodies (octet)

• Reproduction - asexual and sexual

• Cosmopolitan distribution - healthy carriers, rodents, dogs, cats (only human infection with human types?)

• Pathogenicity - adherence to pneumocyte in alveola in lungs, pleuritis, rare hematogenous

dissemination

• Cosmopolitan distribution - healthy carriers, rodents, dogs, cats (only human infection with human types?)

• Pathogenicity - adherence to pneumocyte in alveola in lungs, pleuritis, rare hematogenous

dissemination

P. jirovecii (P. carinii)

PCP (Chest radiography)

BAL- cysts (100X)

LDg/ DMP PH Ag

PCRCan not be cultivated!!! MM2MM2

Pneumocystis carinii (jirovecii)

Granularni eksudat u plućima

Staining of bronchoalveolar lavage (BAL) with Gomori Methenamine Silver (GMS) is used for the diagnosis.

Cyst wall is stained, and cysts resemble the "indented" ping-pong balls.

Parasites within the cysts can not be seen

Pneumocystis jirovecii (P. carinii)