INTRODUCTION

TO MEDICAL MYCOLOGY/
GENERAL MYCOLOGY
 FUNGI
Eukaryotes : cell walls composed of chitin
with or without cellulose
 Their nuclear structure
 Ultra structure study
Comprise an estimated 250,000 species, of
which only about 150 have been
shown to cause disease in human
– Some are beneficial to human kind
– Some are harmful
Beneficial :
Breaking down organic matter
Contributing to production of food
Produce proactive metabolites
Harmful :
Cause infection
They are chemoheterotrophic saprophytes
Morphology remains an important tool for
speciating fungi, especially filamentous
fungi, although morphologic clues can
also be useful in the identification of
yeast species
Mycology is the study of fungi

The fungi quite distinct from

bacteria
 Cell Wall and Membrane
Composed mainly of chitin rather than
peptidoglycan (bacteria)-so unaffected by
antibiotics
Chitin: consists of a polymer of N-
acetylglucosamine
Fungal Membrane contains ergosterol rather
than cholesterol found in mammalian
cells, use in antifungal agents such as
amphotericin which binds to ergosterol
 pores that disrupts membrane function
 cell death
 Cell Membrane
The imidazole antifungal drugs
(clotrimazole, ketoconazole, miconazole)
The triazole antifungal agents (fluconazole ,
itraconazole) interact with the C-14 α-
demethylase to block demethylation of
lansterol to ergosterol, vital component of
cell membrane and disruption of it’s
synthesis results in death
Ultrastructure of Typical Bacterial and Fungal Cell
The Fungal Cell Wall
 HABITAT
All fungi are heterotrophs (their require some
form of organic carbon for growth)
They depend on transport of soluble nutrients
across their cell membrane
To do this they secrete degradative enzymes
(proteases etc) into their immediate
environment, therefore they live on dead
organic material
So Natural Habitat : is soil or water containing
decaying organic matter
MODES OF FUNGAL GROWTH

UNICELLULAR
FILAMENTOUS
YEASTS
MOLDS

However there are some dimorphic fungi

( they switch between these two forms
depending on their environment)
 Dimorphic Fungi
Fungi that characteristically grow as a mold
under certain environmental conditions
(usually 25-30°C) and as a yeast under
other conditions (usually at 35-37°C).
Medically important dimorphic fungi can be
highly pathogenic; special caution is
warranted when handling fungal cultures
largely because of the risk of culturing one of
these organisms
 Dimorphic Fungi
Slow growing fungi that grow as molds at
25-30° and yeast at 35-37° (human body
temperature) The commonly considered
dimorphic fungi include :
Sporothrix schenckii
Histoplasma capsulatum
Blastomyces dermatitidis
Paracoccidioides brasiliensis
Coccidioides immitis
Penicillium marneffei
Filamentous (mold-like) Fungi
Thallus (vegetative
body) – mass of threads
with many branches
resembling cotton ball
Mass: mycelium
Threads: hyphae,
tubular cells that in
some fungi are divided
into segments –septate
whereas in other fungi
the hyphae are
uninterrupted by
crosswalls-nonseptate
Grow by branching and
tip elongation
 Yeasts

The term "yeast" is not always strictly

defined; generally single-cell fungi.
Normal flora of gastrointestinal and
genitourinary tracts
Most common fungal isolate from patients
Unicellular, eukaryotic, generally round to
oval
Multiply principally by blastoconidia (buds)
REPRODUCTION
 SPORULATION
The principle way in which fungi reproduce and
spread within the environment
Fungal spores are metabolically dormant,
protected cells, released by the mycelium in
enormous numbers
Borne by the air or water to new sites , where
they germinate and establish new colonies
Spores can be generate sexually or asexually
 ASEXUAL SPORULATION
(MITOSIS)

Color of a particular fungus seen on bread, culture plate is due to the

Conidia, easily airborne and disseminated
 SEXUAL SPORULATION
meiosis

Relatively rare compared to asexual sporulation, and spore shape often

Used as a method of identification
Pseudohyphae are the rule, true septate
hyphae may be formed by some
yeasts under certain conditions
Morphology may contribute to
identification, biochemical tests are
usually necessary for definitive
diagnosis
Growth at 37°, germ tube test, carbohydrate
assimilation, fermentation, urease test,
and phenol oxidase test
 Humans have a high level of innate
immunity to fungi and most of the
infections they cause are mild and self-
limiting
This resistance is due to:

1. The fatty acid content of the skin,

2. The pH of the skin, mucosal
surfaces and body fluids
3. Epithelial cell turnover
4. Normal flora
5. Transferrin
6. Cilia of the respiratory tract
 Identification of fungi base on

Morphology of :

Colony / thallus
Hyphae / mycelium
Spore
 COLONY
1) Yeast colony : macros : “Creamy”
micros : Yeast cell
e.g. : Cryptococcus neoformans
2) Yeast like colony : macros : “Creamy”
micros : Yeast cell +
Pseudohyphae
e.g. : Candida sp
3) Filamentous colony : macros : Mold
micros : hyphae / mycelial
e.g. : - Aspergillus

- Penicillium

- Rhizopus

- Mucor
HYPHAE
With cross wall / septa
Without cross wall (coenocytic)
SPORE
Asexually
Sexually
Asexual spore
Blastospore / blastoconidia

Arthrospore / arthroconidia

Chlamydospore

Sporangiospore

Conidiospore / conidia
Blastospore : “Budding”

e.g. : - Cryptococcus neoformans

- Candida sp
Arthrospore :

e.g. : - Coccidioides immitis

Chlamydospore :

e.g. : - Candida albicans

in cornmeal agar
Sporangiospore :

e.g. : - Rhizopus

- Mucor
Conidia : - Microconidia unicellular,small
- Macroconidia multicellular
 Macroconidia :

Sexual spore :
 Ascospore

 Basidiospore

 Zyqospore

Fungal infections is Mycoses

1) Superficial mycoses Superficial
2) Cutaneus mycoses mycoses
3) Subcutaneus mycoses
4) Systemik mycoses deep mycoses/
a) Pathogenic / Endemic profunda
b) Opportunistic
 Superficial mycoses :
Diseases : Agent :
 Pityriasis versicolor  Malassezia furfur
 White piedra  Tricosporon beigelii
 Black piedra  Piedraia hortae
 Pityriasis nigra  Exophiala werneckii

Cutaneus mycoses :
 Dermatophytosis
 Microsporum
 Trichophyton
 Epidermophyton

 Candidiasis
 Candida albicans
 Candida sp
 Subtacutaneus
mycosis :

 Mycetoma pedis Allescheria boydii

Actinomyces
 Chromoblastomycosis Fonsaeca
Phialophora
 Sporotrichosis
- Sporothrix schenckii
 Rhinosporidiosis
- Rhinosporidium seeberi
 Lobomycosis - Loboa loboi

All fungal diseases are not contagious :

Except : - Dermatophytosis
- Candidiasis
 Systemic mycosis :
Pathogenic / Endemic :
Diseases : Agent :
- Histoplasmosis - Histoplasma capsulatum
- Blastomycosis - Blastomyces dermatitidis
- Coccidioidomycosis - Coccidioides immitis
- Paracoccidioidomycosis - Paracoccidioides
brasiliensis
Opportunistic :
- Candidiasis - Candida albicans

- Cryptococcosis - Cryptococcus neoformans

- Aspergillosis - Aspergillus sp

- Zygomycosis - Mucor Rhizopus

 Laboratory Diagnostic
Laboratory Diagnostic :
1) Direct microscopic examination
2) Culture (Micro culture)

Successful isolation of fungus causing

diseases is dependent upon :
- Proper collection of specimen
- Proper handling & transport
- Promt & correct processing of the specimen
- The expertise of the technologist for identifying for
the fungus
Direct Microscopic Exam
- Is on essential step in diagnostic
- Provide a rapid & tentative diagnosis
Most mycological specimens are examined
in wet mount with 10% K0H solution

The specimens may be :

Sputum, exudate. Pus, blood, spinal/fluid,
Urine, skin scrapings, hair or biopsied tissue

The result may be :

- Hyphae (+)
- Yeast (+)
- Or hyphae & yeast (+)
Culture :
Media : Sabourand Dextrose Agar (SDA)
+ Antibiotic ( Streptomycin or
Chloramphenicol)
+ Cycloheximide/actidion
Temperature of incubation :
- Ussually at room temperature + 250C
- Dimorphic fungus able to grow at 250C
and 370C as well
- Incubate for 1 to 3 weeks