Mycoses

• HIDDEN CRISIS: HOW 150 PEOPLE DIE EVERY HOUR FROM FUNGAL INFECTION WHILE THE WORLD TURNS A BLIND EYE
• Fungal diseases as neglected pathogens: A wake-up call to public health officials
• Serious Fungal Infections. The size of the problem
• Serious Fungal Infections


  • AIDS and opportunistic fungal diseases
  • Tuberculosis And TB-like Fungal Diseases
  • Cancer And Fungal Infections
  • Eye Infections (Fungal Keratitis)
  • Neglected Tropical Fungal Diseases
• AIDS and opportunistic fungal diseases: Problem solved or current threat? Aspergillosis, Histoplasmosis, Cryptococcal meningitis, Pneumocystis
• Tuberculosis And TB-like Fungal Diseases: Chronic pulmonary aspergillosis cases after TB
• Cancer And Fungal Infections: Major surgery, Chemotherapy, Radiotherapy, Leukaemia
• Eye Infections (Fungal Keratitis): 10% of keratitis is fungal in temperate, 50% of keratitis is fungal in tropical & sub-tropical climates
• Neglected Tropical Fungal Diseases: Mycetoma, Chromoblastomycosis, Basdobolomycosis, Phanchyphomycosis
• Now Severe: Bacterial and fungal infections in COVID-19 patients: A matter of concern
• COVID-19 Positive patient Gastrointestinal mucormycosis, Ocular Mucormycosis, Pulmonary Mucormycosis, Cutaneous Mucormycosis
• WHO releases first-ever list of health-threatening fungi
• Fungal Pathogens That Are Becoming A Threat To Humanity

  • Cryptococcus Neoformans
  • Aspergillus
  • Candida Albicans
  • Candida Auris
• Common fungal pathogens: C. neoformans, P. jirovecii, C. albicans, H. capsulatum, M. circinelloides, A. fumigatus, C. immitis, T. rubrum
• Major sites of infection: Brain, Mouth, Lungs, Vagina, Circulation, Skin
• Existing challenges: Early diagnosis, Limited antifungal drugs, Cytotoxicity of existing therapeutics, Increasing antifungal resistance, Emerging pathogens
• Superficial mycoses are superficial cosmetic fungal infections of the skin or hair shaft with no living tissue invaded and no cellular response from the host
• Etiologic agents of Superficial/Cutaneous Mycoses

  • Black piedra
  • White piedra
  • Pityriasis versicolor
  • Tinea nigra
  • Candidosis
  • Dermatophytosis
• Dermatophytes are keratinophilic - "keratin loving" and produce extracellular enzymes (keratinases) which are capable of hydrolyzing keratin
• Dermatophyte Genera


  • Microsporum
  • Trichophyton
  • Epidermophyton
• Dermatophytes are classified into 3 genera: Microsporum - hair, skin, rarely nails; Trichophyton - hair, skin & nails; Epidermophyton - skin, nails, rarely hair
• Forms in Tissue Seen by Microscopy


  • Hyphae
  • Yeasts
• Mode of Transmission


  • Human to human
  • Animal to human
• Important Clinical Findings


  • "Ringworm" Ring of inflammatory, pruritic vesicles with a healing center
  • Scaly plaques on trunk; often hypopigmented; often nonpruritic
  • Pustule or ulcer on hands often with nodules on arms
• Laboratory Diagnosis


  • Potassium hydroxide (KOH) prep shows septate hyphae
  • Culture on Sabouraud's agar
  • KOH prep shows mixture of hyphae and yeasts
  • KOH prep shows cigar-shaped yeasts, Culture at 20°C shows hyphae with daisy-like conidia
• The clinical forms of the disease are named according to the site affected: Tinea capitis, Tinea barbae, Tinea corporis, Tinea cruris, Tinea manum, Tinea pedis, Tinea fascie, Tinea ungium
• Tinea capitis is a ringworm of the scalp, eyebrows and eyelashes that occurs in childhood and usually heals spontaneously
• Tinea faciei is a fungal infection that affects the skin on the face, caused by Trichophyton rubrum, Trichophyton mentagrophytes, Microsporum canis
• Ringworm


  Ring-like lesions caused by a fungal infection
• Clinical forms of ringworm

  • Tinea capitis (scalp)
  • Tinea barbae (beard)
  • Tinea corporis (body)
  • Tinea cruris (groin)
  • Tinea manum (hands)
  • Tinea pedis (feet)
  • Tinea ungium (nails)
• Tinea capitis


  • Occurs in childhood, usually heals spontaneously, caused by various Microsporum and Trichophyton species
• Tinea faciei


  • Fungal infection affecting the skin on the face, caused by Trichophyton rubrum, Trichophyton mentagrophytes, Microsporum canis
• Tinea barbae


  • Fungal infection of the hair around the bearded area in men, commonly caused by Trichophyton verrucosum, Trichophyton mentagrophytes, and Trichophyton rubrum
• Tinea corporis


  • Classic "ringworm", elevated, scaly, pruritic lesions with erythematous edge, caused by anthropophilic and zoophilic fungi
• Tinea cruris


  • Acute or chronic fungal infection of the groin, often starts on the scrotum and spreads, caused by Epidermophyton floccosum, Trichophyton rubrum, Trichophyton mentagrophytes, or Candida
• Tinea pedis


  • Acute to chronic fungal infection of the feet, most prevalent of all dermatophytoses, caused by anthropophilic dermatophytes like Trichophyton rubrum and Trichophyton mentagrophytes
• Tinea manuum


  • Ringworm of the palms and interdigits, common among patients with tinea pedis, caused by Trichophyton rubrum and Trichophyton mentagrophytes
• Tinea ungium (onychomycosis)


  • Nails become yellow, brittle, thickened or crumbling, may be caused by dermatophytes or Candida, Trichophyton rubrum most common
• Superficial mycoses


  • Pityriasis versicolor
  • Tinea nigra
  • Black piedra
  • White piedra
• Pityriasis versicolor


  Fungal infection of the epidermis that manifests as hypopigmented or hyperpigmented skin patches, caused by Malassezia globosa or Malassezia furfur