Mycology Flashcards
Fungal ball infection of the lung
Absidia spp.
Distinctive funnel-like expansion of the terminal conidiophore
4 day growth
Acremonium
Acremonium have long slender phialides that produce oval, unicellular microconidia that cluster at the tip of the phialide.
The clusters of microconidia are easily disrupted from the tip of the phialide.
Fungal conidia type
Aleurioconidia are formed from a newly formed hyphal branch which then separates from the main hypha by formation of a cross wall.
The porocondia of Alternaria are formed in chains and have a club-like shape.
Alternaria produces dematiaceous (dark), poroconidia with transverse and longitudinal septa (muriform).
Alternaria
Alternaria
Characterized by chains or groups of large dematiaceous (dark-colored), club shaped conidia. Many of the conidia show both transverse and longitudial segmenation.
Antifungal with ability to form pore in cell wall
Amphotericin B
Azole mechanism
Inhibition of cytochrome P-450 to block synthesis of ergosterol
Nucleic acid synthesis inhibitor used for cryptococcus meningitis
5-FC
Bone marrow toxicity and resistance can develop in days so always use in combination
Target of echinocandins
Block B-1,3-glucan synthase inhibitors
Echinocandins do not work on…
Zygomycetes
Fungal conidia type
Arthrocondia are formed by structural changes in the cell walls and septa of preformed hyphae. They are produced along the entire length of the hypha.
Product of diploid yeast that undergo meiosis
Ascospores.
On routine Kinyoun acid-fast stain, ascospores stain red and vegetative cells stain blue.
Aspergillis in a lung specimen (Ag stain)
In tissue, Aspergillis produces hyphal filaments only. Note the cross walls and regular 45o angle branching of the hyphae. Compare this to Candida albicans (produces yeast and hyphae) and Rhizopus (produces large, aseptate hyphae with irregular branching).
Aspergillus
ID Fungus
Aspergillus flavus
Aspergillus fumigatus
Chains of conidia on phialides arising from a swollen vesicle. Compare this with Penicillium and Scopulariopsis. Aspergillus is an opportunistic fungus.
ID fungus
Aspergillus fumigatus
Antigen used to detect Aspergillus
galactomannan
Aspergillus nidulans
This species is most likely to produce a cleistothecium, indicated by the yellow arrow
3.5 day old brown/black smooth yeast colony
Usually considered a contaminant but visceral infections reported
Aureobasidium pullulans
What is the identifying characteristic of Aureobasidium pullulans?
Black yeast-like colony
Bent-knee conidiophores
Beauveria
ID Fungus
Bipolaris spp.
The production of polar germ tubes is a characteristic that is associated with which dematiaceous fungi?
Bipolaris
ID fungus
Candida albicans is a yeast that produces white and creamy colonies.
May see starring of colonies, particularly on CHOC agar
Candida albicans can be differentiated from other yeasts by its positive germ tube test.
Candida albicans in sputum (Gram stain)
Note the budding forms and pseudohyphae. Yeast usually stain purple with a Gram stain, but this slide has been overdecolorized so some look pink.
Appearance of Candida albicans on chromagar
mottled green
Candida albicans in tissue (Ag stain)
Budding yeast (Blastoconidia), pseudohyphae and true hyphal forms all in the same tissue are characteristic of Candida albicans infection. The only other fungus that has yeast and hyphae in the same specimen is Malassezia furfur but it is usually only found in the superficial skin infection called tinea versicolor.
Chlamydospores of Candida albicans
When Candida albicans is grown on a “starvation medium” such as corn meal agar, it produces diagnostic large, round, thick-walled structures called chlamydospores. Budding yeast (blastoconidia) and pseudohyphae are also seen.
Appearance of Candida dublinensis on chromagar
solid green
Observed in the bottom photograph is the surface of a niger seed agar plate on which are growing inoculation streaks of two different yeast species, the one to the left representing the clinical isolate; the one to the right a control strain.
Candida dubliniensis is the correct response. Distinctive is the appearance of rough colonies with extending “feet” from the outer margins as seen in the streak to the left on the surface of the niger seed agar plate, in contrast to the colonies with smooth borders as observed in the control streak of Candida albicans as seen to the right. Clinical cases of oropharyngeal thrush may be obsereved in patients with AIDS, and niger seed (“bird seed”) agar plates should be set up to identify C. dubliniensis. Carbohydrate assimilation profiles, inoculation to CHROMagar or the use of species-specific DNA probes may also be performed to make this distinction.
Candida krusei on chromagar
lavender + DRY
Photomicrograph of yeast grown on cornmeal agar
Candida parapsilosis
Spider or cross match stick colonies is characteristic
Appearance of Candida parapsilosis on chromagar
light pink Also known to give off multiple colony types
Appearance of Candida tropicalis on chromagar
blue-purple (periwinkle)
Rapid test used to identify C. albicans
Germ tube. A positive germ tube is the initial growth of true hyphae. It grows straight out of the cell and the base is not constricted, unlike pseudohyphae which are elongated buds.
Chaetomium produces a fruiting body called an ascocarp which is covered with hair-like protrusions (setae) and contains large numbers of oval ascospores.
Taken from patient with verrucous (warty) dermatitis, can be ulcerated or crusted
Chromoblastomycosis
Often described as “copper pennies”
ID disease
Chromoblastomycosis is a chronic disease that follows inoculation of soil molds into subcutaneous tissue. Typical lesions are large warty growths frequently described as cauliflower lesions.
The four organisms that cause chromoblastomycosis are Cladophialophora (Cladosporium) carrionii, Phialophora verrucosa, and two Fonsecaea spp.
ID fungus causing Chromoblastomycosis
Colonies of Cladophialophora carrionii grow slowly and tolerate temperatures up to 37º C.
Microscopic ID
The hyphae are septate and dematiaceous (dark).
Laterally and terminally produced conodiophores bear long branching chains of brown, smooth, oval conidia that are easily disrupted.
Dark scars on the conidia are typical at the points of attachment.
ID fungus causing Chromoblastomycosis
Fonsecaea are dematiaceous molds that may produce four types of conidiation.
Fonsecaea type: compact conidiophores produce conidia borne on slightly swollen denticles and may give rise to secondary and successive rows of conidia.
Rhinocladiella type: oval conidia are borne on swollen denticles at the tip and along the sides of the conidiophore. (Pictured)
Cladosporium type: conidiophores produce shield-shaped conidia that bear oval conidia in branching short chains. The conidia have scars of attachment.
Phialophora type: vase-shaped phialides with collarettes produce oval to round conidia.
Key characteristics of chromomycosis molds
Dark, velvety surface
Growth takes more than five days
Chromomycosis
Long chains of elliptical condidia separated by a distinct scar, called a dysjunctor
What type of sporulation is this?
Cladosporium sporulation
Chromomycosis
Small clusters and short chains of elliptical conidia produced from the tip of a conidiophore.
What type of sporulation is this?
Exophiala sporulation
ID fungus causing Phaeohyphomycosis
Colonies of Exophiala spp. are slow growing with a dark olive to black yeast-like appearance.
- As the colony matures, the texture becomes velvety.
- The reverse is black.
Microscopic ID
- Exophiala spp. produce profuse oval conidia.
- The conidiogenous cells are annellides. As each conidium is produced, a scar forms at the terminal end of the annellide.
Chrysosporium is a large, diverse group which produce aleurioconidia that are usually unicellular and form at the ends of short conidiophores, intercalary, or directly from the hyphae.
two day rapid growth at 30oC
Circinella spp.
Distinct backward curve of the sporangiophores
ID fungus causing Phaeohyphomycosis
Cladophialophora bantiana grows at a moderate rate.
- Colonies are olive to gray-black with a velvety texture.
- The reverse is black.
Microscopic ID
- The conidiophores of Cladophialophora bantiana are poorly differentiated from the septate hyphae.
- The conidiophores produce long chains of oval conidia.
ID fungus that appeared after 8 days on SabHI from a darkened superficial skin infection
Cladophialophora carrionii
Causative agent of valley fever
(flu-like symptoms, pneumonia, skin nodules, arthritis)
Coccidioides immitis
Fungal conidia type
Annelloconidia are formed by budding that leaves ring-like scars on the mother cell (annellide).
The ring-like scars are useful morphological features which help to distinguish molds that produce annelloconidia from other molds
Fungal conidia type
Blastoconidia are formed by budding. Buds are produced by de novo growth from the mother cell.
This is the manner in which most yeast cells reproduce.
Some molds have a yeast phase in which they reproduce by the formation of blastoconidia.
Fungal conidia type
Chlamydoconidia are formed by structural changes in the cell walls and septa of hyphae. They can be located terminally or within the length of the hypha.
Fungal conidia type
Phialoconidia are formed by budding from a mother cell (phialide) which may be distinguished by a collarette.
Fungal conidia type
Poroconidia are produced through a pre-existing pore on the mother cell.
Cryptococcus Capsule (India Ink Wet Mount)
Stain used for capsule visualization of Cryptococcus neoformans
India ink
Fungus infecting immunocompetent patients because of highly virulent alpha-mating forms
Cryptococcus gattii
ID cause of systemic mycosis
The India ink preparation is the traditional method used to look for Cyptococcus neoformans in cerebrospinal fluid.
The yeast’s capsule creates a halo around the cell.
The India ink preparation is often replaced by an antigen test which is more sensitive for detection of C. neoformans.
Histologic examination of clinical material occasionally reveals intracellular encapsulated yeast.
Cryptococcus neoformans may be visible on direct Gram stain of cerebrospinal fluid.
The yeast cells may vary in size.
Cryptococcus neoformans tissue section
The stained capsule of Cryptococcus appears as a fuzzy area outside the cell wall. Note that the buds of Cryptococcus have a narrow base compared to those of Blastomyces.
Any yeast from a lower respiratory site must be ruled out for…
Cryptococcus (urease positive)
Zygomycete with fruiting bodies
Cunninghamella
Curvularia produce curved poroconidia which arise from bent (geniculate) conidiophores.
Cause of black piedra
Piedraia hortae
Epidermophyton (Lactophenol blue)
Epidermophyton (Lactophenol Blue)
Athletes foot sample from a young football player
Epidermophyton floccosum
Silky pale strands projecting from the colony
Club shaped macroconidia
Epidermophyte
ID fungus
Epidermophyton floccosum causes infections of the skin and nails, but not hair.
A microscopic preparation of a E. floccosum colony demonstrates club-shaped macroconidia that may appear singlely or in clusters. The walls of the macroconidia are smooth.
Microconidia are not produced.
Epidermophyton floccosum
Epidermophyton floccusum
The characteristic club-shaped macroconidia have 2-4 septa and occur in groups of 2-3. Unlike the other dermatophytes, Epidermophyton does not have microconidia.
ID fungus
Microsporum canis causes skin and hair infections.
A microscopic preparation of a Microsporum canis colony will demonstrate spindle shaped macroconidia which have thick walls, rough exteriors, and often taper to curved apical knobs.
A few club-shaped microcondidia may be present.
Microsporum canis
Microsporum canis
The characteristic spindle-shaped, thick-walled macroconidia of Microsporum canis have up to 15 septa. Microconidia may be present.
Microsporum gypsum
The characteristic ellipsoidal macroconidia of Microsporum gypsum usually have 4-6 septa. Microconidia may be present.
Cause of pityriasis(tinea) versicolor, seborrhoeic dermatitis (including dandruff)
Malassezia
ID disease and cause
Tinea nigra is characterized by darkly pigmented non-inflammed lesions in the surface of the skin.
It is caused by Phaeoannellomyces (Exophiala) werneckii, a darkly pigmented (dematiaceous) mold.
A KOH preparation of skin scrapings from a tinea nigra lesion would demonstrate the presence of dark hyphal elements.
Cause of tinea nigra
Hortaea werneckii
ID disease and agent
Tinea versicolor is characterized by altered coloration of the stratum corneum due to overgrowth of Malassezia furfur, a skin commensal.
Often don’t need a culture to ID, but when Malassezia furfur is suspected as the etiological agent it is necessary to add sterile olive oil to the surface of the culture media for growth of this lipophilic organism.
Biochemicals to distinguish from T. mentagrophytes from T. rubrum
hair perforation = positive
urea = positive
BCP-MSG = profuse growth with alkalinization.
Trichophyton mentagrophytes
Note the characteristic cigar-shaped, thin-walled macroconidia indicative of the genus Trichophyton. Microconidia are usually abundant. The coiled hyphae seen in this slide are characteristic of the species Trichophyton mentagrophytes.
ID fungus
Trichophyton mentagrophytes may infect any body surface. It most frequently causes athlete’s foot.
A microscopic preparation of a T. mentagrophytes colony will demonstrate round, clustered microconidia. Spiral hyphae and thin, smooth-walled macroconidia may also be seen.
“Birds on a Fence” microconidia along hyphae is characteristic of…
Trichophyton rubrum
ID fungus
Trichophyton rubrum infects nails and the skin of hands, feet, and torso. It rarely infects hair.
A microscopic preparation of a Trichophyton rubrum colony will demonstrate teardrop shaped solitary microconidia.
Thin, cigar or pencil-shaped macroconidia may also be present.
ID fungus
Right panel: Agars 3&4 contain thiamine
Tricophyton tonsurans commonly causes ringworm of the scalp. It may also infect skin and nails.
A microscopic preparation of a T. tonsurans colony will demonstrate microconidia of variable morphology. The microconidia may appear as teardrops, pegs, clubs or round balloon shapes.
Nutritional requirement tests using Trichophyton agars can be used to separate T. tonsurans from other Trichophyton species. The growth of T. tonsurans is enhanced by thiamine and grows better on Trichophyton identification agars containing thiamine (agars #3 & #4 rather than on #1 & #2).
Trichophyton rubrum
The macroconidia of Trichophyton are characteristically cigar-shaped and thin-walled. Microconidia are usually abundant. A culture of T. rubrum is generally a bright ruby color as the name implies. Note, however, that other types of fungi may also be red.
Cause of white piedra
Trichosporon spp.