(1) Superficial, Cutaneous, & Subcutaneous Fungi Flashcards
What are the 5 Classification of FUNGI?
- Superficial
- Cutaneous
- Subcutaneous
- Endemic (primary, systematic)
- Opportunistic
Superficial Fungi
what are the characteristic of Superficial Fungi
- Fungi that reside on the superficial part of the bod
- No cellular response of the host
- Skin
- Hair
- No pathology elicited by presence of the fungus
Superficial Fungi
- Seen or observed outside of the body or protective covering of the body, e.g., outer layer of skin
- Does not penetrate the skin or the inside of the body
Fungi that reside on the superficial part of the body
Superficial Fungi
The immune system is not activated which occurs only when the organism gains entry to the body
No cellular response of the host
Superficial Fungi
- All genus and species under superficial infection causes infection mainly on the skin- main site
- Ptyriasis versicolor and Tinea nigra
Skin
Superficial Fungi
Black Piedra and White Piedra
Hair
Superficial Fungi
Since there is no pathology, there is no observable changes seen in the infected site. No serious condition elicited
No pathology elicited by presence of the fungus
Superficial Fungi
MOT of Superficial Fungi
- Person to Person Contact
- Contaminated garment
Enumerate the specific genus and species for Superficial Fungi
- Malassezia furfur (Lipohilic yeast)
- Hortaea (Exophiala) wernickii
- Piedra Agent
Superficial Fungi
- Fat-loving; fungus needs fat for growth
- Endogenous saprophyte/normal skin flora: normally resides in the skin
Malassezia furfur (Lipohilic yeast)
Superficial Fungi
what does the Malassezia furfur causes?
Tinea or Pityriasis versicolor
chronic, mild, asymptomatic infection of stratum corneum (outermost later of the skin)
Superficial Fungi
what can be the clinical presenation of Tinea or Pityriasis versicolor?
Versicolor (causes an opposite color change in the skin):
- Hypopigmented skin (dark skin to lighter)
- Hyperpigmented skin (lighter skin to darker)
Ex. Dark colored skin person – infected area lightens; Light colored skin – infected area
darkens
Superficial Fungi - Malassezia furfur
Tiny, multiple, macular spots, scale and enlarge coalesce to form ____ ____ of intermittent scaling of various shades and colors depending on skin color
parang pimpols
gyrating areas
Superficial fungi
TOF
Areas of skin fail to tan normally if infected with Malassezia furfur
T
Malessezia furfur grown in large numbers in and about hair follicles and sebaceous glands
FOLLICULITIS
Superficial Fungi - Malassezia furfur
- Predominates in the hair follicle causing inflammation
- Appears like an allergic reaction causing reddening of affected area
FOLLICULITIS
Superficial Fungi - Malassezia furfur
Clinical sample used?
Skin (skin scraping ig)
Superficial Fungi - Malassezia furfur
what are the 2 laboratory identification?
- KOH smear
- Culture
Malassezia furfur - Lab Identification
- cluster of round, budding yeast cells (up to 8 um in size) and short, septate, unbranched, nonpigmented hyphal fragments;
- lesions fluoresce under Wood’s lamp
KOH smear
Malassezia furfur - Lab Identification
KOH smear wtih PAS (periodic acid-schiff stain) what will be the characteristic appearance
Spaghetti and Meatballs
- Spaghetti: long hyphal fragments
- Meatballs: budding yeast cells
clusters of budding yeast0like cells and short angular hyphal forms
Malassezia furfur - Lab Identification
this lab identification is not necessary for diagnosis
Culture
Malassezia furfur - Lab Identification
Enumerate the consideration for culture
- Grows well at 37’C
- Medium: malt agar or Sabouraud’s agar containing streptomycin, penicillin, and actidione
- Culture should be covered with a layer of olive oil
Malassezia furfur - Lab Identification
what is the purpose of culture?
Academic Purposes
Malassezia furfur - Lab Identification
give the morphgology found in the culture
Yeastlike cells with only a rare elongation to form hyphal elements
Superficial FUngi
- Normal flora of the skin
- Causes Tinea nigra or Tinea nigra palmaris
Hortaea (Exophiala) wernickii
Hortaea (Exophiala) wernickii
- superficial chronic and asymptomatic infection of the stratum corneum
- Prevalent in warm coastal areas and among young women
- Manifestation of Hortaea wernickii
Tinea nigra or Tinea nigra palmaris
Hortaeae wernickii
what is the appearance of Tinear nigra or Tinea nigra palmaris
Appear as dark (brown to black) discoloration often on the palm and sole
Laboratory sample for Hortaea wernickii
skin scrapings from the periphery of the lesion
ALWAYS NEAR THE LESION!
what are the laboratory examination employed for Exophiala wernickii
- 10% KOH smear (routine)
- Culture (Not required)
after the KOH smear what will be the appearance of Exophiala wernickii
- Brownish to olivaceous
- Multiple branched
- Septate hyphae
- Budding cells
For culture, what would be the morphology for Exophiala wernickii
- Shiny, moist, adherent, yeastiike colony
- Brownish, olive to shiny greenish black
- Colonies: two-celled, cylindrical to spindle-shaped tlike cells that ta toward the ends
Enumerate the prognosis and theraphy for Exophiala wernickii
- Daily applicatim of Whitfield’s ointment with tincture of iodine, 2% salicylic acid, 3% sulfur 10% thiabendazole
- Topical imidazoles or triazoles
- Griseofulvin is NOT EFFECTIVE (one of the common anti-fungal medication)
Prognosis and theraphy
enumerate the content of Whitfields ointment for Exophiala wernickii
- Whitfields ointment
- Tincture of iodine
- 2% salicylic acid
- 3% Sulfur
Prognosis and theraphy
what are the considered topical to be used for Exophiala wernickii
Topical imidazoles or Triazoles
Prognosis and theraphy
it is one of the common anti-fungal medication but is not effective for Exophiala wernickii
Griseofulvin
Superficial Fungi
General meaning it resides on the hair or infects the hair
Piedra Agent
what are the 2 specific genus and spp for piedra agents?
- Pidraia hortai (black piedra)
- Trichosporon beigelii (white piedra)
source of piedra agent
Environment and skin flora
Give the clinical presentation of Black piedra
Black nodules are gritty, hard, brown to black encrustations that vary in size frorn microscopic to a few mm and in depth up to 150um
Give the clinical presentation of Black piedra
- Softer granule, whitet red, green or light brown
- Beard, axilla, groin
- Assæiated with lax hygiene
What would be the theraphy for piedra agent
- Shave or cut the infected hair
- Topical fungicides: bichloride of mercury (1:2000) benzoic acid and salicylic acid combinations, 3% sulfur
ointment and 2% formalin
kindly give the contents of topical fungicide for piedra agent
- bichloride of mercury (1:2000)
- benzoic acid and salicylic acid combinations
- 3% sulfur ointment and 2% formalin
what would be the love specimen for piedra agent
none, its not love dumbass
lab specimen for piedra agent
HAIR
Enumerate the Lab identifaction for piedra agent
- Routine 10% KOH smear
- Culture
give the morphology of piedra agent after KOH smear
- Black piedra: ASCOSPORE
- White piedra: ARHTOSPORES
Cultiure
Trichosporon beigelii (white piedra) when cultured this is inhibeted by?
Inhibited by cycloheximide in mycologic selective media (mycosel)
Trichosporon beigelii (white piedra) when cultured grows rapidly on?
Sabourauds agar
Trichosporon beigelii (white piedra) characteristic of colony
Cream-colored yeastlike colony that develops radial furrows and irregular folds with and
Often separates the from the media
Piedraia hortai (black colony) grows very slow at what temp when cultured?
25’C (RT)
Piedraia hortai (black colony) Grows very slowly at 250C (room temperature), developing into?
Small, dark brown to black conical, adherent colonies
Piedraia hortai (black colony) characteristic of colony in the media
Colony-Rusty Red pigment in media
Piedraia hortai (black colony) morphology under the micrscop after culture
Thick-walled, closely septate hyphae,
chlamydoconidiat and swollen, irregular cells
