Notes on Common Medical Fungi

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Malassezia Furfur:

• Hypopigmented spots on chest and back.

• KOH mount: spaghetti and meatballs.

• Fungemia in premature infants.

Dermatophyte Infections:

• Tinea capitis: ringworm of scalp.

• Tinea barbae: ringworm of bearded region.

• Tinea corporis: infection of glabrous skin.

• Tinea cruris: jock itch.

• Tinea pedis: athlete's foot.

• KOH mount: arthroconidia and hyphae.

• Treatments: topical imidazoles or tolnaftate; oral imidazoles or griseofulvin where hair/skin is infected.

Sporothrix Schenckii:

• Live on plants; infects by traumatic implantation.

Diseases:

• Sporotrichosis (rose gardener's disease).

• Pulmonary sporotrichosis.

Histoplasma Capsulatum:

• Soil of bird and bat feces.

• Cave explorers infected.

• Facultative intracellular parasite; tiny; many fit into RES cells.

Diseases:

• Fungus flu.

Coccidioides Immitis:

• Dimorphic.

• Desert sand.

Diseases:

• Valley fever; complications in third trimester of pregnancy.

Blastomyces Dermatitidis:

• Dismorphic fungus.

• Rotting wood.

• Causes blastomycosis: pulmonary disease; self-resolves.

Aspergillius Fumigatus:

• Monomorphic.

• Allergic bronchopulmonary asperillosis/asthma, allergies.

• Fungus ball.

• Invasive aspergillosis.

Treatment:

Itraconazole or amphotericin B.

Candida Albicans:

• Yeast.

• Endogenous to mucous membrane.

Diseases:

• Oral thrush: IC hosts.

• Esophagitis, gastritis, septicemia, endocarditis, yeast vaginitis.

• KOH mount: pseudohyphae, true hyphae, budding yeasts.

Treatment:

Topical:

• Imidazoles or oral imidazoles; nystatin.

Disseminated:

• Amphotericin B or fluconazole.

Cryptococcus Neoformans:

• Monomorphic.

• Soil/pigeon droppings; seen in pigeon breeders.

• Predisposing conditions: AIDS/meningitis/Hodgkin's; acute pulmonary.

• Antigen detected in CSF.

• Treatment: amphotericin B or fluconazole.

Mucur, Rhizopus, Absedia:

• Soil.

• Rhinocerebral infections in ketoacidotic diabetic and leukemic patients.

• KOH mount: broad, ribbon-like nonseptate hyphae; 90 degree angle.

• Treatment: amphotericin B.

Pneumocystis Carinii:

• Fungus; obligate extracellular parasite.

• Causes interstitial pneumonia; fever, cough, shortness of breath.

• Silver-staining cysts; honeycomb appearance on H and E stain.

Treatment:

• Trimethoprim/sulfamethoxazole.

Additional Readings:

Basic Mycology

1. Common Medical Fungi

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