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.
• Causes: fungus flu.

Coccidioides immitis:
• Dimorphic.
• Desert sand.
• Causes: 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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