The goal of teaching: 1. The morphology and biology of the fungi Classification of medically important fungi Fungal morphology and structure Antifungal (AF) - Mechanisms of action Fungi - biology and physiology Fungal infections (FI) - classification 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 dermatomycoses 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 of superficial / invasive oprtunistic FI Penicillium - morphology, biology Pathogenesis Zygomycetes (Mucor, Rhisopus, Absidia) - morphology, biology. Pathogenesis Pneumocystis - morphology, biology. Pathogenesis
COMMON CAUSES OF FI Skin, hair, nail: Malassezia Trichophyton Microsporum Epidermophyton Candida Superficial mycoses: : Malassezia Exophiala (Cladosporum) werneckii Trichosporon beigelli Piedraea hortae... Cutaneous mycoses dermatomycoses / tinea: Trichophyton Microsporum Epidermophyton Candida Aspergillus Othomycoses: Aspergillus Candida... Keratomycoses: Fusarium Aspergillus Onichomycoses: Candida Dermatophytes Undermatophytes moluds Mucocutaneous mycoses: Candida Geotrichum Rhinosporidium seeberi...
Malassezia (Pityrosporum) Yeasts, NF of skin, lipophilic species: M.furfur, M.sympodialis, M.globosa... Unlipophilic species: M. pahidermatis Pathogenesis: Pityriasis versicolor (tinea versicolor) Malassezia foliculitis Seborrheic dermatitis (pityriasis simplex capitis - dandruff) Atopic dermatitis (systemic infection - rare / lipid th) LDg/ DMP Culture Th/ AF local MM2
Pytiriasis versicolor (tinea versicolor) Slight, recurrent disease of the superficial layers of the skin (stratum corneum) Lesions- with small circular flakes (scaling) Predisposing factors: sweating, gender, genetic basis... Predilection sites: chest, back, shoulders System types: infants and adults, CVC DDG: erithrasma, vitiligo Hypo-pigmentation Hyper-pigmentation
Dermatophytes Trichophyton (around 20 species) Microsporum (around 17 species) Epidermophyton (2 species) Highly contagious, cosmopolitan distribution Keratinophilic: hair, nails, and superficial layer of skin (reproduction) Anthropophilic species Zoophilic species Geophilic species
Dermatophytes The most frequent species in human: Trichophyton rubrum Trichophyton interdigitale Epidermophyton floccosum Microsporum canis Trichophyton verrucosum Source of infection: people, animals, soil Antropophilic species: Microsporum M. audouinii M. ferrugineum Trichophyton T. concentricum T. interdigitale T. rubrum T. schoenleinii T. tonsurans T. violaceum Zoophilic species: Microsporum M. canis M. equinum M. gallinae Trichophyton T. equinum T. mentagrophytes T. simii T. verrucosum Geophilic species: Microcporum M. gypseum M.nanum M.persicolor Trichophyton T. ajeloii Epidermophyton E. floccosum
Dermatophytes Trichophyton Macroconidia (rare) Microconidia (numerous) Microsporum Macroconidia (numerous) Microconidia (rare) Epidermophyton Macroconidia (only) Microconidia (absent)
Microscopic characteristics of dermatophytoses Macroconidia / multicellular fusiform cylindrical drumstick shape Microconidia / unicellular pyriform in clusters
D E R M A T O F I T I Localization of dermatophytes and characteristics essential for identification Trichophyton I group (skin, nails, hair - type ectotrix)» T. mentagrophytes» T. rubrum» T. verrucosum Trichophyton II group (skin, nails, hair - type endotrix)» T. tonsurans» T. schoenleinii» T. violaceum macroconidia rare (pencil shaped 3-8 cells ) numerous microconidia in clusters Microsporum (hair and skin) Numerous macroconidia (elliptical, fusiform 3-7 cells) Macrodonidia by hyphae, one Epidermophyton (skin and nails) Only macroconidia (rounded, with 2-4 cells)
DERMATOPHYTOSES TINEA/RINGWORM/DERMATOMYCOSES Indicate infection of the superficial layers of skin, hair and nails caused by dermatophytes or other fungi
DERMATOPHYTOSIS (Tinea) localization
Trichophyton (around 20 species) Skin Hair Nails
Herpes tonsurans LDg/ DMP Th/ AF Culture MM2
Herpes tonsurans LDg/ DMP Th/ AF Culture MM2
Trichophyton mentagrophytes Herpes tonsurans Trichophytia superficialis LDg/ DMP Th/ AF Culture MM2
Trichophytia profunda Kerion Celsii Sycosis barbae LDg/ DMP Th/ AF Culture MM2
Kerion Celsi LDg/ DMP Th/ AF Culture MM2
Sycosis barbae LDg/ DMP Th/ AF Culture MM2
Favus -Trichophyton schoenleinii LDg/ DMP Th/ AF Culture MM2
Tinea imbricata - T. concentricum
Trichophyton mentagrophytes v. interdigitale
Onychomycosis - T. mentagrophytes Itraconazole pulse Dr Decroix, Belgium
Microsporum (17 species) Skin Hair type ectotrix rare - nails
Microsporum gypseum
Microsporum canis
Microsporum gypseum Microsporum canis
Microsporia LDg/ DMP Th/ AF Culture
Epidermophyton (2 species) Skin Nails
Epidermophyton floccosum Tinea corporis Tinea pedis LDg/ DMP Th/ AF Culture
Epidermophyton floccosum Macroconida (phase contrast 400X) Macroconidia (LFCB 400X)
Dermatophytid immunopatological manifestation Fungal Ag in complex with Ab in the skin
Epidermophyton floccosum (Harz) Langeron et Milochevitch Trichophyton schoenleinii (Lebert) Langeron et Milochevitch Sima Milošević (1896-1943) Langeron, 1950. Trichophyton milochevitch