Classification of medically important

fungi

BY
DR ABDULMALIK A. (MBBS, MWACP,MPH IN VIEW)

A SENIOR REGISTRAR IN THE DEPARTMENT OF MEDICAL

MICROBIOLOGY AND PARASITOLGY
 Outlines
• Introduction
• Characteristics of fungi
• Fungal structure
• Classification
 Intoduction
• Mycology :The study of fungi
• Relatively novel field in medicine
• Mycoses: fungi infections
• Mycotoxins: toxins produced by fungi e.g
aflatoxin of Aspergillus flavus
• Mycotoxicosis: fungi intoxication
 General charcteristic
• Fungi are non-motile, non-photosynthetic, eukaryotic
organism that that lives freely as saprophytes
• About 100,000 species
• Only about 300 species known to be pathogenic
• 50 species cause greater than 90% of fungal infections
of humans & other animals
• They reside in nature and are important in breaking
down and recyclinig organic matter
• They exists as saprophytes, symbionts and parasites in
the environment
• Most pathogenic fungi are exogeneous, their natural
habitats being soil, water and organic debris.
 Characteristics contd
• Fungi exists either as yeasts (grow as single cells) or molds
(grow as hyphae [long filament]) and form a mat
(mycelium)
• Hyphae can be septate or nonseptate
• Nonseptate hyphae are multinucleated
• Dimorphic fungi can exist as yeast or mold
• Severally medically important fungi are thermally
dimorphic
• Most are obligate aerobes, some falcultative anaerobes
but known are obligate anaerobe
• All are saprophytes
• Naturally lives in the environment with the exception of
 Xtics contd
• Some reproduces sexually by mating leading to the
formation of sexual spores
• Sexual spores are ascospores , basidiospores and
zygospores
• The fungi that do not form sexual spores are classified as
imperfect fungi
• Most fungi of medical importance forms asexual spores to
propagate
• Asexual spores are called conidia and they are
arthrospore, blastospores, chlamydospores and
sporangiospore
 Fungal cell structure
• The fungal cell has typical eukaryotic features
including a nucleus with a nucleolus, nuclear
membrane & linear chromosomes.
• The cytoplasm contains an actin cytoskeleton &
organelles such as mitochondria & Golgi apparatus.
• Cell membrane contains sterols; ergosterol.
• Cell wall contains polysaccarides; mannans, glucan &
chitin in close association with proteins.
– Mannoproteins are mannose based polymers on the surface of
the cell & are major determinants of serologic specificity.
– Glucans are glucosyl polymers, some of which form fibrils thereby
increasing the strength of the cell wall.
– Chitin is a long unbranched chain of N –acetylglucosamine. It is
inert, insoluble & rigid and provides structural support to the cell
[Link] is a major component of the cell walls of filamentous
 Classification of fungi
• Fungi are generally classified using three
criteria:
• Taxonomic classification: Based on nature of
sexual/asexual forms and septation of hyphae.
• Morphologic classification: Based on physical
appearance.
• Clinical Classification: Based on tissues they
parasitized and the disease they cause.
 Taxonomic classification
• Sexual spores
Ascospores are formed in a sac called ascus
Zygospores are single large spores with thick walls
Basidiospores are formed externally on the tip of a
pedestal called a basidium
Asexual spores
• Ascomycotina (Ascomycetes)

• Zygomycotina (Zygomycetes)

• Basidiomycotina (Basidiomycetes)
• Deuteromycotina (Deuteromycetes)
Classification based on morphology
• There are two basic morphologies; Yeast and
mould
• Yeasts: They are unicellular organisms which
reproduce by budding (blastoconidia
formation) or binary fission. They grow at
37oC and Form creamy opaque or pasty
colonies on culture media. They grow rapidly
in 24-48 hours, Candida albican,
Cryptococcus neoformans
• Moulds: They have branching thread-like tubular
structures called hyphae . They grow at 25oC and
form a mass of hyphae called mycelia on culture
media. The colonies are fluffy, cottony, woolly or
powdery. They grow slowly requiring about 6
weeks, examples include Aspergilus fumigatus
• Dimorphic: They exist as Yeast or spherules at
35-37oC and in tissue and as Moulds at 25oC and
in the environment. Conversion to the yeast form
appears to be essential for pathogenicity
 Examples of Dimorphic fungi
• Blastomyces dermatitidis
• Coccidioides immitis
• Paracoccidioides braziliensis
• Histoplasma capsulatum
• sporothrix schenkii
• Penicillium marneffei
 Clinical classification
They are classified into 5 major groups;
• Superficial mycoses
• Cutaneous mycoses
• Subcutaneous mycoses
• Systemic mycoses
• Opportunistic mycoses
 Superficial mycosis
• Pityriasis versicolor
– Also tinea versicolor
– A superficial skin infection of cosmetics importance only
– caused by Malassezia furfur
– Lesion are usually hypopigmented macular rashes
– Diagnosis – KOH, spaghetti and meetballs
– Treated with Miconazole, ketoconazole (Nizoral)
• Tinea niagra
– caused by Cladosporium werneckii
– Infection of the keratinized layers of the skin
• Piedra
Spagheti meetball apperance of Malassezia furfur
Tinea versicolor (Spaghetti and meatballs)
 Cutaneous mycosis
• These are fungal infection of the superficial
keratinized tissues (skin, hair, nails).
• The causative fungi are collectively called
dermatophytes and include:

– Epidermophyton spp infect only skin and nail

– Microsporum spp infects hair and skin
– Tricophyton spp may infect hair, skin and nail
Trichophyton –
Cylinder
Microsporum
–Spindle
Epidermophyton
–Club
Dermatophytes can further be classified as
• Zoophilic e.g Microsporum canis,
Trichophyton verrucosum
• Anthropophilic e.g Microsporum audonii,
Trichophyton rubrum, Trichophyton
violaseum, Trichophyton schoenleinii,
Epidermophyton floccosum
• Geophilic e.g Microsporum gypseum
Clinical presentation of dermatophytes
• Infection by dermatophytes are called dermatophytoses
or Tiniasis; we may thus have
• Tinea capitis
• Tinea corporis
• Tinea cruris
• Tinea genitalia
• Tinea pedis
• Tinea incognito
• Tinea barbae
• Tinea fascie
Tinea ungiuim; Tricophyton rubrum
Tinea corporis
Tinea corporis
Tinea pedis
Tinea cruris
 Subcutaneous mycosis
• This occurs via traumatic inoculation of fungal spores.
• Chromoblastomycosis :
– Fonsecaea pedrosoi,
–
• Sporothricosis :
– Sporothrix schenkii.
• Mycetoma :
– Madurella mycetomatis,
 Systemic mycosis
• Fungi in this category cause systemic
diseases. Examples include :
– Histoplasma capsulatum (Histoplasmosis)
– Histoplasma capsulatum duboisii (African
histoplasmosis)
– Coccidioides immitis (Coccidioidomycosis)
– Blastomyces dermatidis (Blastomycosis)
– Paracoccidioides braziliensis
(Paracoccidioidomycosis)
 Opportunistic mycosis
• Candidiasis:
– Candida albicans,
• Normal flora of oropharynx, skin, vagina,
• Cause infection in immunosuppressed; thrush, vaginitis, eosophagitis,
diaper rash, chronic mucocutaneous candidiasis,
• Candida glabrata, Candida krusei, Candida
parapsilosis, Candida tropicalis, Candida gullermondii,
Candida lusitaniae, Candida kefyr
– Candida auris: (New kid}, not easily diagnosed, very
difficult to treat (Pan resistant)
Oral thrush Oropharyngeal candidiasis
Candida albican; large oval Gram positive apperance
• Cryptococcois:
– Cryptococcus neoformans
• Oval budding yeast surrounded by polysaccharrrides
capsules
• Grows widely in nature and in birds droppings
containng soils
• Cryptococcosis especially cryptococcal meningitis
• Most common life threathning fungal disease in AIDSs
• Amphotericin B, flucytosin are drugs of choice
– Cryptococcus gattii
Cryptococcus neoformans
• Aspergillosis:
– Aspergillus fumigatus,
• Causes allergic brochopulmonary aspergillosis (fungus
ball in the lung)
• Also cause infection of the skin, eyes,ears, and other
organs
• Exists only as molds
• Transmitted by airborne conidia
– Aspergillus flavus,
– Aspergillus niger
• Pneumocystosis:
– Pnemocystis jeroveci
• Pneumocystis carinii has been used to descride rat species of
Pneumocystis
• Cause pneumonia in AIDS
• Does not have ergosterol, rather cholesterol
• Does not grow on fungal media
• Antifungal drugs are ineffective
• The drug of choice is co-trimoxazole
• Classification as fungus based on molecular analysis (rRNA
sequencing, mitochondrial DNA analysis and analysis of
various enzymes)
• Penicillosis :
– Penicillium marneffei
• Dimorphic fungus
• Causes tuberculosis-like disease in AIDS
• Grows as mold producing rose colored pigments at
25°C and as small yeast at 37°C resembling Histoplasma
capsulatum
• Bamboo rats as well serve as hosts
• Treatment is amphotericin B
• Mucormycosis :
– Rhizopus,Mucor,Absidia
• Causes Mucormycosis (Zygomycosis, Phycomycosis)
• Exists as moulds
• Widely available in nature
• Transmitted by airborne asexual spores
• Causes infarction and necrosis of tissue distal to blocked vessel
• Susceptible are patients with burns, diabetic ketoacidosis,
leukaemia
• In tissue biopsy they seen as non-septate hyphae
• Treated with liposomal Amphotericin B
Thank you all
questions