Medical Mycology

Introduction to Basics

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 Introduction
• Mykes (Greek word) : Mushroom
• Fungi are eukaryotic; differ from bacteria
and other prokaryotes.
1. Cell walls containing chitin (rigidity & support), mannan &
other polysaccharides
2. Cytoplasmic membrane contains ergosterols
3. Possess true nuclei with nuclear membrane & paired
chromosomes.
4. Divide asexually, sexually or by both
5. Unicellular or multicellular

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 Characteristics of Fungus
• Diverse group of chemo heterotrophs
– > 90,000 known species
• Saprophytes
– Digest dead organic matter
• Parasites
– Obtain nutrients from tissues of organisms
• Molds & mushrooms are multicellular
• Yeasts are unicellular

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 Fungus Everywhere

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 How the fungus are nourished

• All are chemo heterotrophs

• Absorption of nutrients: powerful
Exoenzyme
• Grow at lower pH-5 than bacteria
• Grow in high salt and sugar

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 Mycology
• Present as saprophytes in soil, decaying
plants ,nature.
• Eukaryotes
• Known before bacteria Botanists
• Developing Nations changing trends
USA
• More serious and even fatal diseases,
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 FUNGI (Mycology)
 Diverse group of heterotrophs.
– Many are ecologically important saprophytes (consume dead and
decaying matter)
– Others are parasites.
 Most are multicellular, but yeasts are unicellular.
 Most are aerobes or facultative anaerobes.
Over 100,000 fungal species identified. Only
about 100 are human or animal pathogens.
– Most human fungal infections are nosocomial and/or occur in
– uncompromised individ.uals (opportunistic infections).

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 Understanding the Structure of
Fungi
• Yeasts and molds have different structural and
reproductive characteristics
– Yeast are unicellular, nucleated rounded fungi while
molds are multicellular, filamentous fungi
– Yeast reproduce by a process called budding while
molds produce spores to reproduce
– Some yeast are opportunistic pathogens in that they
cause disease in immuno-compromised individuals
– Yeast are used in the preparation in the variety of
foods

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 Predisposing factors
• Use of
Antibiotics,
• Use of
steroids
,
• Immunosup
pressive
conditio 9
 Fungal Diseases
• Mycosis- fungal infection
– < 100 cause human disease
– Not highly contagious
– Humans acquire from nature
• Groups based on degree on tissue
involvement and mode of entry
• Cutaneous mycoses-
dermatophytes
– Epidermis, hair & nails
– Contagious-direct or indirect
contact 10
 Fungal Morphology
Hyphae (threads)
Yeasts
making up a mycelium

Many pathogenic fungi

are dimorphic, forming
hyphae at ambient
temperatures but yeasts
at body temperature.

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 Structure of Fungi
• Vegetative structures involved
in catabolism and growth
• Thallus- in molds and fleshy
fungi
– Tubular filaments of cells-hyphae
– Septate hyphae - cross walls that divide them
intounicellular units
• Pores to allow cytoplasm & nuclei to pass
– Coenocytic hyphae- no septa, continuous
cells with many nuclei
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 Basic structure of Fungus
• Cell wall is rigid
• Contains
Chitin,Mannan, Polysaccharides,
Cytoplasm contains Sterols.
Contains True Nuclei, Paired
chromosome. Divide
Sexually, Asexually or by Both
Can have specialized cells

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Characteristics of fungi
A. eukaryotic, non- vascular organisms
B.reproduce by means of spores, usually
wind-disseminated
C.both sexual (meiotic) and asexual
(mitotic) spores may be produced,
depending on the species and conditions
D.typically not motile, although a few (e.g.
Chytrids) have a motile phase.

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Understanding the Terms in Mycology
• Simplest Unicellular, Budding yeasts,
• Tubular elongations Thread like
structures called as Hyphae
• Tangled mass is called as Mycelium
• Molding produces filamentous fungi.
• Septate Aseptate
• Grown up Aerial Mycelium
• Grows into media Vegetative mycelium

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 Understanding the Structure of
Fungus
• Simplest fungus :- Unicellular budding
yeast
• Hypha :- Elongation of apical cell
produces a tubular, thread like structure
called hypha
• Mycelium :- Tangled mass of hyphae is called
mycelium. Fungi producing mycelia are
called molds or filamentous fungi.
• Hyphae may be septate or non-septate
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 CLASSIFICATION
• Depending on cell morphology
1. Yeasts
2. Yeast like fungi
3. Molds
4. Dimorphic fungi

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Yeast
s • Unicellular fungi
which reproduce
by budding
• On culture -
produce
smooth, creamy
colonies
e. g
Cryptococcus
neoformans
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 Yeast like fungi
• Grow partly as yeasts and partly as
elongated cells resembling hyphae which
are called pseudo hyphae. e.g.
Candida albicans

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 Molds/ Filamentous fungi
• Form true mycelia &
reproduce by formation
of different types of
spores.
• Vegetative/ aerial
hyphae
e.g. Rhizopus,
Mucor

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 4. Dimorphic fungi
• Occur in 2 forms
Molds (Filaments) – 25 C (soil)
Yeasts – 37 C (in host tissue)
Most fungi causing systemic infections are
dimorphic:
– Histoplasma capsulatum
– Blastomyces dermatidis
– Paracoccidioides brasiliensis
– Coccidioides immitis
– Penicillium marneffei
– Sporothrix schenkii
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 Reproduction in fungi
• Sexual - formation of Zygospore, ascospores
or basidiospores
• Asexual reproduction – budding or
fission
• Asexual spores are formed on or in specialized
structures.
• Vary in size, shape & colour but these
characteristics are constant for a particular
species.
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 Reproduction in fungi
• Micro
conidia -
Small, single
celled
• Macro
conidia
– Large, single
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 Systematic classification
• Based on sexual spore formation:
4 classes
1. Zygomycetes
2. Ascomycete reproduce
s sexually
3. Basidiomyce
4. tes
Deuteromycetes (fungi imperfectii)
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 Zygomycetes
• Lower fungi
• Broad, nonseptate
hyphae
• Asexual spores -
Sporangiospores:
present within a swollen
sac- like structure called
Sporangium
• e.g. Rhizopus, Mucor
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 Ascomycetes
• Includes both yeasts & filamentous fungi
• Narrow, septate hyphae
• Asexual spores are called conidia borne on
conidiophore eg.Penicillium, Aspergillus
 Basidiomycetes
• Sexual fusion results in the formation of a
club shaped organ called base or basidium
which bear
spores called basidiospores

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 Deuteromycetes
or Fungi imperfectii
• Group of fungi whose sexual
phases are not identified.
• Grow as molds as well as
yeasts.
• Asexual stage – conidia
e.g. Candida, Cryptococcus
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 Fungal Infections/ Mycoses
• Superficial mycoses:
– 2 types: surface and cutaneous mycoses
– Skin, hair & nails.
– Mild but chronic disease
• Deep mycoses:
– 2 types: subcutaneous & systemic mycoses
– Caused by soil saprophytes
– Infection is accidental
– Range from a symptomatic infection to fatal disease

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 Superficial: Surface mycoses
• Live exclusively on dead surfaces of
skin and its appendages
• No contact with living tissue, hence
no inflammatory response
1. Tinea versicolor
2. Tinea nigra
3. Piedra

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Superficial: Cutaneous mycoses
• Cornified layer of skin & its appendages

• Contact with living tissue, hence

inflammatory & allergic responses seen
1. Dermatophytes – skin, hair & nails
2. 3 genera - Trichophyton
Microsporum
Epidermophyton

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 Deep mycoses
Subcutaneous mycoses Systemic mycoses
1. Mycotic 1. Cryptococcoses
Mycetom 2. Blastomycosis
a
3. Coccidioidomy
2. Chromoblastomy c oses
c oses
4. Histoplasmoses
3. Sporotrichosis
4. Rhinosporidiosis 33
 Candidiasis
• Caused by candida sps, forms a
bridge between superficial & deep
mycoses as it can cause cutaneous as
well as systemic infections
• Can also cause opportunistc
infections

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 Opportunistic infections
• Pts with debilitating disease, altered physiological
state
• Mainly caused by fungi which are common lab
contaminant on culture media
– Aspergillus
– Pencillium
– Mucor
– Rhizopus
• Produce serious & fatal infections

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 Useful Properties of Fungi

Source of food Antibiotic production

e.g. mushrooms e.g. Penicillin from
Penicillium notatum

Fermentation - Production of
alcohol, bread, cheese
e.g. Sacchromyces spps
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Useful Properties of Fungi

Ergot from Claviceps Vaccines for Hepatitis B –

purpurea, used to Sacchromyces cerevisiae
induce uterine
contractions

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 Diagnosis/Treatment
• Grown in medium that selects for fungal
growth
– Grow at 25 C and 37 C
• KOH preparations of skin biopsies
– Dissolves keratin in skin scrapings or
biopsies
– Leaves only fungal cells
• Therapy- amphotericin B or
ketoconazole
– Toxic to humans
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Thank You