MUST TO KNOW IN MYCOLOGY Flashcards
Fluoresces on Wood’s lamp
M. canis
Agent of dandruff
M. canis
Medium for dermatophytes
Mycosel
: inhibit bacteria
: inhibit fungal contaminants
Chloramphenicol
Cycloheximide
Czapek’s medium
Aspergillus
Forms at 35’C (yeasts)
Germ tube
Gram (+), oval cells w/ or w/o buds and pseudomycelia
Candida
General culture media
SDA
Basic structure of fungi
Hyphae
Spore
Chlamydospore
Cornmeal agar
Media w/ olive oil
M. furfur
Hair baiting test
T. mentagrophytes
Infects hair, skin, and nails
Trichophyton
Red color
T. rubrum
Teardrop conidia
T. rubrum
Favic chandelier (antler)
T. schoenleinii
Phycomycetes/Zygomycetes
Coenocytic (aseptate)
Ascospores
S. cerevisiae
(+) Nigerseed/Birdseed
(+) Urease
(+) India ink
(+) Phenoloxidase
C. neoformans
Arthrospores “TACGeo”
Trichosporon beigelii
Aureobasidium
Coccidioides
Geotrichum candidum
Blastospores
Yeast
Direct microscopic
Clearing
10% KOH
Commonly used stain (fungal culture)
LPCB
: preservative
: killing agent
: stains the chitin (cell wall)
Lactic acid
Phenol
Cotton blue
Unsuitable for fungal culture
Suitable for bacteria and viruses only
Swab
Wright’s/Giemsa stain
H. capsulatum
Dichotomous
Aspergillus
Thrush
C. albicans
Diaper rash
C. albicans
Moniliasis
C. albicans
In tissue: mold/yeast form
C. albicans
Macroconidia and microconidia
Dermatophytes
Specimen for systemic mycoses
Sputum
ID of yeast
Free of CHO
CHO assimilation
Dimorphic fungi
BHIA
High risk to lab personnel
C. immitis
Filamentous
Room temperature
Molds
Round/tissue form
37’C
Yeasts
Fungal cell wall
Chitin
Fungal cell membrane
Ergosterol
Aerial/vegetative/substrate
Reproductive
Hyphae
Spores
Aseptate hyphae
Septate hyphae
Sporangiophore
Conidiophore
Sexual spores
Ascospores
Basidiospores
Oospores
Asexual spores
: rounding terminal hyphae or intercalary (within)
: budding off (yeasts)
: dermatophytes
: barrel-shaped, produced from fragmentation of mycelium
Chlamydospores
Blastospores
Conidia (macro/micro)
Arthrospores
Skin and hair
10% KOH preparation
Hyphae, yeasts, spores
10% KOH preparation
Dissolves tissue
10% KOH preparation
Fluorescent dye
Calcofluor white
Stains the chitin (cell wall)
Calcofluor white
Green
Calcofluor white
H. capsulatum: the only fungi seen in blood smear
Giemsa/Wright’s stain
Periodic Acid Schiff
Glycogen:
No glycogen:
purple
pink
Black
Gomori silver
SDA + phenol red
SDA + cycloheximide + gentamicin
Dermatophyte test medium
Inhibitory mold agar
Pigment
Potato dextrose agar
Chlamydospore of C. albicans
Cornmeal Tween 80 agar
(+) M. canis
(-) M. audouinii
Rice medium
C. neoformans (black colonies)
Staib’s nigerseed agar
(+) T. mentagrophytes
(+) C. neoformans
Urea agar
Cottonseed agar
B. dermatitidis
Biochemical tests
API20C, ID32C
CHROMagar
Candida
For unknown yeast
Germ tube test
Dalmau-Plate
Cornmeal agar
Candida
Mannan antigen
Galactomannan
Aspergillus
Fungicidal agents
Target:
Ergosterol
-Amphotericin B: systemic fungi (most common)
-Nystatin
-Azole (Fluconazole): fungistatic
-Griseofulvin (IV): dermatophytes
AST methods
Broth microdilution method
E-test method
Microscopic exam
Genus-spp ID (molds)
Non invasive
Superficial Mycoses
No immune response from the host
Superficial Mycoses
MOT: person-to-person (garment)
Superficial Mycoses
Superficial Mycoses:
-M. furfur
-P. hortai
-T. beigelii
-P. werneckii
Ptyriasis versicolor (An-An)
M. furfur
Hypo/Hyperpigmentation of skin
M. furfur
KOH: budding yeast cells and hyphae
M. furfur
PAS: “Spaghetti and meatballs”
M. furfur
Lipophilic: require lipids for growth (SDA + olive oil)
M. furfur
Hair
Piedra agents
Black piedra
P. hortai
Dematiaceous
P. hortai
Ascospores (sexual)
P. hortai
White piedra
T. beigelii
Cream colored
T. beigelii
Arthrospores (asexual)
T. beigelii
Tinea nigra
Phaeoannelomyces (Exophiala) werneckii
Brownish spot (dark pigmentation)
Phaeoannelomyces (Exophiala) werneckii
Dematiaeous: moist, shiny-black and yeast-like colonies
Phaeoannelomyces (Exophiala) werneckii
Cutaneous mycoses
= skin, hair, nails
= skin, hair
= skin, nails
Trichophyton
Microsporum
Epidermophyton
Keratinophilic
Dermatophytes
Tinea or ringworm
Dermatophytes
Dermatophytes
Endothrix:
Ectothrix:
-T. tonsurans: dandruff (Tinea capitis)
-T. violaceum
-M. gypseum
-M. canis
-T. verrucosum
Beard
Scalp
Body
Groin
Foot (Athlete’s foot)
Nails
Tinea barbae
Tinea capitis
Tinea corporis
Tinea cruris
Tinea pedis
Tinea unguium
Red pigment
T. rubrum
Microconidia: tear-drop shaped (side)
Macroconidia: pencil-shaped
T. rubrum
Colony: Fluffy white w/ red color reverse
T. rubrum
Microconidia: grape-like (cluster)
T. mentagrophytes
(+) Hair penetration test: V-shaped
(+) Urease
T. mentagrophytes
Thiamine-requiring
T. tonsurans
Black dot tinea capitis
T. tonsurans
Microconidia: Balloon-shaped
T. tonsurans
Colony: Creamy white w/ crater-like depression
T. tonsurans
Require thiamine and inositol
T. schoenleinii
Cause Favus: chronic hair infection
T. schoenleinii
Favic chandelier hyphae
T. schoenleinii
Microconidia: clavate/pyriform
T. verrucosum
Macroconidia: rat-tail/string-bean-shaped
T. verrucosum
Macroconidia: spindle-shaped, echinulate
M. canis
(+) Wood’s lamp
M. canis
Geophilic
M. gypseum
Macroconidia: oblong (ellipsoidal) w/ blunt/rounded ends
M. gypseum
(-) Wood’s lamp
M. gypseum
Anthropophilic
M. audouinii
Tinea capitis (old)
M. audouinii
(NG) Rice medium
M. audouinii
Macroconidia: club shaped in pairs
E. floccosum
Dutch pants fuseaux
E. floccosum
Tx: Dermatophytes
Local antifungal creams:
Oral
-Miconazole
-Tolnaltate
-Griseofulvin
-Ketoconazole
MOT: skin trauma/prick
Habitat: soil
Subcutaneous Mycoses
Biopsy, granules (PAS, H&E)
Subcutaneous Mycoses
Subcutaneous Mycoses:
-Sporothrix schenckii
-Madura foot agents
-Chromoblastomycosis agents
-Rhinosporidium seeberi
-Loboa loboi
Mold form: flowerette/daisy-like conidia
S. schenckii
Yeast form: Cigar-shaped (asteroid) bodies
S. schenckii
Rose Gardener’s disease
S. schenckii
Cord-like multiple subcutaneous nodules
S. schenckii
Colony: White to black
S. schenckii
Maduromycosis:
mycetoma
Madura foot agents:
P. boydii = most common cause
Madurella
Leptosphaeria
Actinomycetes
Tissue form: Granules
Madura foot agents
Lesion: granulomatous lesions on foot w/ multiple draining sinus tracts
Madura foot agents
Cleistothecia
P. boydii
:Teleomorph/sexual form
: anamorph/asexual form
P. boydii
Scedosporium apiospermum
Dematiaceous fungi
Chromoblastomycosis agents
Type of sporulation: ID of genus and species
Chromoblastomycosis agents
Chromoblastomycosis agents:
- Phialophora verrucosa
- Fonsecaea pedrosoi
- Cladosporium carrionii
-Vase-like
-TOS: phialophore
- Phialophora verrucosa
-Short chain
-w/ 1’, 2’, 3’ conidia
-TOS: Acrotheca
- Fonsecaea pedrosoi
-Long chain (branching)
-TOS: Cladosporium
- Cladosporium carrionii
Infected tissue: Brown sclerotic bodies (Medlar bodies)
Chromoblastomycosis agents
Lesion: Cauliflower-like
Chromoblastomycosis agents
Colonies: Dark w/ jet black reverse
Chromoblastomycosis agents
Size: 300 μm
R. seeberi
Rhinosporidiosis
R. seeberi
MOT: swimming
R. seeberi
Polypoid masses in nose and pharynx
R. seeberi
Tissue form: Sporangium (sac-like structures filled w/ endospores)
R. seeberi
Lobomycosis
L. loboi
Lesion: Keloid-like subcutaneous nodule involving the extremities
L. loboi
Tissue form: Multiple budding cells in chain (Sampaloc-like/Longganisa-like)
L. loboi
Dimorphic
Systemic Mycoses
MOT: inhalation of spores (mold) – infectious
Systemic Mycoses
Specimen: Sputum
Systemic Mycoses
BSL III = require BSC class II
Systemic Mycoses
No person-to-person contact
Systemic Mycoses
Colonies: cottony white to brown
Systemic Mycoses
Systemic Mycoses Exoantigen test:
-B. dermatitidis
-P. brasiliensis
-H. capsulatum
-C. immitis
Agent of:
-North American blastomycosis
-Chicago disease
-Gilchrist disease
B. dermatitidis
Pneumonia and skin infections
B. dermatitidis
Mold form: Lollipop in appearance
B. dermatitidis
P. brasiliensis
Yeast form: Single-budding yeast w/ broad based (double centered) – diagnostic
B. dermatitidis
Mickey mouse cap
B. dermatitidis
Culture: Medium w/ cycloheximide
Tissue: KOH
B. dermatitidis
Tx: Amphotericin B
B. dermatitidis
Agent of:
-South American Blastomycosis
-Lutz Splendore-Almeida disease
P. brasiliensis
Infects spleen, liver, lymph node, skin, lungs
P. brasiliensis
Yeast form: Multiple budding yeast resembling Mariner’s wheel
P. brasiliensis
RES parasite
H. capsulatum
Agent of Darling’s disease
H. capsulatum
“Arise of Tutankhamen’s tomb”
H. capsulatum
USA = endemic dimorphic ffungus
H. capsulatum
MOT: inhalation of spores from guanos (droppings of birds, starlings/chickens,
and bats)
H. capsulatum
Mold form: Tuberculate macroconidia
H. capsulatum
Yeast form: Yeast cells intracellular in macrophages
H. capsulatum
Culture: Medium w/ cycloheximide (BM, sputum, tissue)
H. capsulatum
Double cell
H. duboisii
Figure of 8
H. duboisii
Causes African histoplasmosis
H. duboisii
Grows in ↑ N2
H. duboisii
Tuberculate macroconidia (resembles H. capsulatum)
Sepedonium
To differentiate: monomorphic
Sepedonium
Agent of:
-Desert fever
-San Joaquin Valley fever
C. immitis
Alkaline soil
C. immitis
High humidity
C. immitis
Lab. acquired infection
C. immitis
Mold form: Barrel-shaped arthroconidia (200μm)
C. immitis
Yeast form: spherule w/ endospores
C. immitis
Culture: medium w/ cycloheximide (30’C)
C. immitis
Not processed —(send)—> Reference lab
C. immitis
Lab. Diagnosis (Systemic mycoses)
1. Direct examination
a. Histoplasma:
b. Blastomyces, Paracoccidioides, Coccidioides:
- Cultures
= RT’ (mold)
= 37’C (yeast) - Immunological tests
a. Coccidioidin
b. Histoplasmin
Wright’s/Giemsa
- KOH: tissue form
- PAS
- H&E
a. SDA
b. BHIA + blood
Exoantigen Test
Principle:
= B. dermatitidis
= C. immitis
= H. capsulatum
= P. brasiliensis
Double Diffusion
A
HS, HL, F
H & M
1, 2, 3
Normal flora (Ex. Candida)
At risk: immunocompromised person
Opportunistic Mycoses
Opportunistic Mycoses:
-Candida
-Cryptococcus
-Aspergillus
Normal flora: skin, mucous membrane, GIT
C. albicans
Produce yeast and hyphae in vivo
C. albicans
-Germ tube
-Chlamydospore
-Blastoconidia
-Pseudohyphae
-True hyphae
C. albicans
(+) Sucrose
C. albicans
EMB: feathering colonies
C. albicans
Diseases:
-Thrush
-Diaper rash
-Candidiasis (Old: Moniliasis): cutaneous, oropharyngeal (white patches), esophagitis, cheilitis, onchomycosis, vulvovaginitis, invasive infection (CNS, blood)
C. albicans
Predisposing factors:
-Prolong antibiotic use especially broad spectrum = disturb pH
-Pregnancy
-DM
-Malnutrition
C. albicans
Lab. Diagnosis:
1. (G) SDA
2. Screening test: Germ tube test
= Organisms + Serum —(35’C for 2-3 hours)—> (+) Germ tube
3. Confirmatory test: Chlamydospore Cornmeal agar
= C. albicans → Inoculate: CMA —(RT’ for 48-72 hours)—> (+) Chlamydospore
C. albicans
Other Candida spp
= infection on immunocompromised host
= 2nd common spp
= hematological disorders
= endocarditis
C. tropicalis
C. glabrata
C. krusei
C. parapsilosis
Lab. Diagnosis (Candida)
Vaginal pH:
Rule out vaginosis/Trichomoniasis =
Vaginal discharge =
Fungal culture
4.5
alkaline pH
10% KOH (Whiff’s test)
(+) Germ tube test
= (+) Chlamydospores, (+) Sucrose, (G) 42’C
= (-) Chlamydospores, (-) Sucrose, (NG) 42’C
= (+) Arthrospores
= (NG) 42’C, double conidia
C. albicans
C. stellatoidea
G. candidum
C. dubliniensis
Found in pigeon droppings and soil
Cryptococcus (Filobasidiella) neoformans
MOT: inhalation of airborne organism
Cryptococcus (Filobasidiella) neoformans
Encapsulated yeast (India ink)
Cryptococcus (Filobasidiella) neoformans
Diseases:
-Meningitis
-Torulosis (Old: Cryptococcosis)
-Pneumonia
Cryptococcus (Filobasidiella) neoformans
Lab. Diagnosis:
-Old: India ink preparation = CSF, pulmonary tissue
-New: Latex agglutination (Ag): capsule
Cryptococcus (Filobasidiella) neoformans
-Biochemical tests:
= (+) Inositol
= (+) Urease
= (-) NO3 assimilation = yellow
= (+) Phenoloxidase = makes the colonies black
= (+) Phospholipase
Cryptococcus (Filobasidiella) neoformans
(G) Birdseed agar
Cryptococcus (Filobasidiella) neoformans
= Assimilate creatinine
Cryptococcus (Filobasidiella) neoformans
= Colonies: Yeastlike, mucoid, cream to brown
Cryptococcus (Filobasidiella) neoformans
Culture: SDA w/o cycloheximide
Cryptococcus (Filobasidiella) neoformans
Tx: Amphotericin B, Fluconazole
Cryptococcus (Filobasidiella) neoformans
Resemble C. neoformans
Encapsulated
Rhodotorula
To differentiate: = pink colonies, (+) Urease, (+) NO3 assimilation
Rhodotorula
Bread mold
Aspergillus
Septate hyphae
Aspergillus
Found in nature: soil, plant, air
Aspergillus
Vesicles: swollen conidiophores
Aspergillus
Aflatoxin (toxicoses) = HCC
A. flavus
Fungus ball
A. fumigatus
Aspergilloma
A. fumigatus
Brown to black spore
A. niger
10% KOH
SDA
Ag detection (serum) = Galactomannan
Lab. Diagnosis (Aspergillus)
Agents: Zygomycetes
Zygomycosis/ Mucormycosis:
-Rhizopus
-Absidia
-Mucor
Zygomycosis/ Mucormycosis
MOT: inhalation of airborne conidia
Zygomycosis/ Mucormycosis
Infections:
-Rhinocerebral: Rhino-facial-cranial
-Lungs, GIT, skin
Zygomycosis/ Mucormycosis
Lab. Diagnosis:
-Culture w/ SDA
Zygomycosis/ Mucormycosis
Brush-like conidiophores
Penicillium
Colony: white to bluish green, yellow/brown
Penicillium
Sickle or canoe shaped, multiseptate macroconidia
Fusarium
Colony: Cottony white to pink or purple colony
Fusarium
Dematiaceous fungi (Except Chromoblastomycosis agents)
Phaeohyphomycosis
Phaeohyphomycosis:
-Alternaria
-Bipolaris
-Curvularia
-Dreschlera
-Exophiala
(Old: P. carinii) Old: Protozoan cyst (parasite) because it has no ergosterol
New: Fungi because of DNA homology
P. jiroveci
Diseases:
-#1 cause of pneumonia in AIDS patient
-#1 opportunistic infection in AIDS patient
P. jiroveci
Lab. Diagnosis:
-Masson-Fontana silver stain
-Mucicarmine: stain for spherule
P. jiroveci
