Medical MycologySystemic Mycoses

Hugh B. Fackrell

Filename; fungi_system.ppt

Fungal Infections

• Opportunistic Infections

• Superficial fungal infections

• Cutaneous Mycoses

• Subcutaneous Mycoses

• Systemic Mycoses

Systemic or Deep Mycoses

• Histoplasmosis

• Coccidiomycosis

• Blastomycosis

• Cryptococcosis

Histoplasmosis before HIV

• Before the appearance of HIV, approximately 95% of the cases reported of histoplasmosis capsulati where inapparent, subclinical, or benign and five percent of them where a chronic progressive lung disease with chronic cutaneous or systemic disease, or an acute fulminating fatal systemic disease.

Histoplasmosis After HIV

• Now the disease is almost always seen in HIV positive patients or other immunocompromised individuals.

• All stages of this disease may mimic tuberculosis.

• Histoplasmosis may coexist with actinomycosis, other mycoses, sarcoidosis, or tuberculosis.

Histoplasmosis

• Histoplasma capsulatum

• Ohio,Mississippi valleys

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Coccidiomycosis

• SW deserts, San Joaquin

• Coccidioides immitus

Valley Fever

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Blastomycosis

• Blastomyces dermatitidi

• as histo but rarer.

• Canada- Manitoba and St.Lawrence river valley

• Disease in horses.
  • Veternarians at risk.

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Cryptococcosis

• Cryptococcus neoformans

• Sporadic

• Pigeons

• Meningitis form
  • fatal

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Systemic Mycoses: Disease Patterns

• Subacute respiratory infection

• Acute infection

• Severe disseminated infection

Systemic Mycoses:Subacute Respiratory Infection

• Low fever

• Non-productive cough

• Mild & self limiting

Systemic Mycoses:Acute Infections

• Productive cough

• purulent sputum

• pain in chest

• Weight loss.

• night sweats

• X-ray positive

• one,many lesions

• consolidation

Differential diagnosis: pneumonia, tumour.

Systemic Mycoses:Severe Disseminated Infections

• Acute Infections +
  • spread to other organs
  • chronic

Differential diagnosis t.b.

Systemic Mycoses:Diagnosis

• X-ray

• Immunochemical
  skin test
  
  serology

• Microscopy
  Sputum
  
  biopsy
  autopsy

Systemic Mycoses: Transmission

Fungal spores inhaled ...pneumonitis..no human to human transmission

Primary source bird and bat droppings and roosts. If roosts disturbed- dust, aerosol .

Chickens, Pigeons,starlings.

Systemic Mycoses:Treatment

Amphotericin B

and/or

5-fluorocytosine