•Mycotoxins

• Mycotoxins are toxic compounds that are naturally produced as secondary

metabolites by certain types of moulds (fungi).

• The disease cause by mycotoxin is know as mycotoxicoses

• Moulds that can produce mycotoxins grow on numerous foodstuffs such as

cereals, dried fruits, nuts and spices.

• Several hundred different mycotoxins have been identified.

• Mycotoxins appear in the food chain as a result of mold infection of crops

both before and after harvest
• Types of mycotoxins

⮚Produced by: Aspergillus, Penicillium, Fusarium, Alternaria etc.

⮚Common Members of the Mycotoxin Family are:
✔ Aflatoxins, Fumonisin, Ochratoxins, Patulin

• Mold contamination can occur in the field as well as during harvest, processing,
transportation and storage.
• Mycotoxins are highly stable and are difficult to destroy by traditional food
processing conditions
• Signs and Symptoms

• Mycotoxins can cause acute disease manifested by kidney or liver failure or chronic

disease including carcinoma, birth defects, skin irritation, neurotoxicity, and death.

• Three general mechanisms of mycotoxin action are described as mutagenic, teratogenic,

or carcinogenic

• During the mutagenic action, toxin binds to DNA, especially the liver, mitochondrial

DNA resulting in point mutation addition or substitution in DNA and affect liver function

(hepatotoxic).
• Teratogenic action leads to birth defects

• the carcinogenic effect cause irreversible defects in cell physiology resulting in

abnormal cell growth and metastasis.

• In recent years, the importance of mycotoxins has been highlighted for their potential

use as weapon for bioterrorism.

• Swelling of legs and feet, Abdominal pain

• Vomit, Acute hepatitis

• Convulsion

• Carcinoma of live, Fever

• Jaundice, Acute necrosis

▪ 1. Aflatoxin

▪ Aflatoxin is the name for a group of toxins that are produced by two fungi called Aspergillus
flavus and Aspergillus parasiticus.

▪ Aflatoxins occur in different chemical forms; B1, B2, G1, G2, and M1.

▪ The allowable toxin limits are 20 ppb in nuts and meats, corn, and wheat is also 0.5 ppb.

▪ The acute lethal dose for adult human is thought to be 10–20 mg.

▪ The primary target organ for aflatoxin is the liver.. Aflatoxin causes gross liver damage,
resulting in liver cancer (hepatocarcinogen).

▪ It can also cause colon and lung cancer. classified aflatoxin B1 as a group I carcinogen.
2. Ochratoxin

• Aspergillus ochraceus and several other species including Penicillium

spp. produce secondary metabolites called ochratoxin

• Ochratoxin is found in a large variety of foods including wheat,

corn, soybeans, oats, barley, coffee beans, meats and cheese.

• Barley is thought to be the predominant source.

• Ochratoxin is hepatotoxic and nephrotoxic and a potent carcinogen.

▪ 3. Fumonisin

▪ Fumonisin are produced by Fusarium verticillioides, F. proliferatum, and F.

nygamai.

▪ Corns, tomatoes and garlic are the major source of fumonosins.

▪ Fumonisin are highly water soluble and they do not have any aromatic

▪ Fumonisin are highly stable to a variety of heat and chemical processing

treatments.

▪ The toxins are reported to cause esophageal cancers in humans.

• 4. Patulin

• Patulin is produced by Penicillium clariform, P. expansum, P. patulum and

by Aspergillus spp.

• Bread, sausage, fruits (apricots, grapes, peaches, pears, and apples), and
apple juice are the major source for this toxin.

• Patulin is needed in high dosage to show pathogenesis. It is a carcinogenic

toxin and is reported to be responsible for subcutaneous sarcoma.
• Detection of Mycotoxins

• CHROMATOGRAPHIC TECHNIQUES

• •Thin layer chromatography (TLC), Gas chromatography (GC), (HPLC)

• PHYSICO-CHEMICAL METHODS - Capillary electrophoresis (CE)

• BIOLOGICAL METHODS -Biosensors

• IMMUNOLOGICAL METHODS

• Immunoaffinity column-based analysis (IAC) or

• enzyme-linked immunosorbent assay (ELISA)

• Postharvest Control - Grains should be cleaned and dried quickly to less than
10–13% moisture and stored in a clean area to avoid insect and rodent infestation.

• Removal or Elimination of Mycotoxins - removal by filtration and adsorption

onto filter pads, clays, activated charcoal, etc., and removal of the mycotoxin by
solvent extraction

• Inactivation of Mycotoxins - thermal inactivation, photochemical or gamma

irradiation, acids, alkalies, oxidizing agents, and gases like chlorine, sulfur
dioxide, NaNO2, ozone and ammonia, as fermentations and enzymatic digestion

• Removal of Mycotoxins During Food Processing - some mycotoxins can be

detoxified or removed by certain kinds of food processing. For example,
extrusion cooking appears to be effective for detoxifying DON
Mycetoma
Mycetoma
• Specific chronic, granulomatous, inflammatory disease
• It usually involves the subcutaneous tissue
• Most probably after traumatic inoculation of the causative organism
• It has a prolonged, progressive, and indolent course, and, if untreated, it
ultimately leads to destruction of the deeper tissues and bone
• The disease is characterized by tumefaction, draining sinuses
Causative agents
• Caused by true fungi or by higher bacteria of the class actinomycetes
• It is classified as eumycetoma or actinomycetoma
• Natural habitat in soil or plant materials including thorns
• Characteristic for mycetoma is that, upon entering the human body, the
causative agents organize themselves in granules called grains
• These grains can be of different color, size, and consistency, depending on
the causative agents
• Fungal causative agents form black or white grains
Geographical distribution
• Disease is endemic in tropical and subtropical regions

• African continent has the highest prevalence

• Sudan, Somalia, Senegal, India, Yemen, Mexico, Venezuela, Columbia,

Argentina, and other countries
Affected groups
• Mainly found in young adults

• Males are more often infected than females

• Mycetoma is also reported in children and elderly

Diagnosis

• Can be detected by examining surgical tissue biopsy as well the lesion

sinuses discharge

• Grains microscopy is helpful in detecting the characteristic grains, DNA

sequencing
Treatment of mycetoma
• The treatment of mycetoma depends mainly on the,
✔ Etiological agent,
✔ Site of infection,
✔ Extent of the disease

• Massive surgical excisions or amputation of the affected part is/are the

treatment of choice for mycetoma
• Various antifungal agents have been tried
Prevention & Control
• There no preventable or control programmes for mycetoma yet

• Preventing infection is difficult, but people living in or travelling to

endemic areas should be advised not to walk barefooted.
Aspergillosis
• Aspergillus include allergic reactions, lung infections, and infections in
other organs
• Aspergillosis is group of disease caused by Aspergillus fungi

• It is extremely diverse and widely distributed genus of filamentous

ascomycete fungi

• They are found wherever organic debris occurs, especially in soil,

decomposing plant matter, household dust, building materials, some
foods and water

• Daily inhalation of aspergillus spores entre in the body and cause the
disease
• The major portal of entry for Aspergillus spp. Is respiratory tract
• Inhalation of conidiospores can lead to several types of pulmonary
aspergillosis

• Healthy immune system dose not affect by spore but weak immune system
patients like AIDS, Cancer patients, organ transplantation spores may
germinate and cause systemic aspergillosis
⮚Aspergillus spp.
A. Fumigatus – most
common human
pathogen
A. Flavus- human
and plant pathogen
A. niger
⮚Different kind of Aspergillosis
• Chronic aspergillosis - Fungal colony form within the lungs and develop into

“fungal balls” called aspergilomas

• These consist of a tangled mass of hyphae

• Aspergillomas may produce no symptoms or cause only a mild cough at first.

Over time and without treatment, however, aspergillomas can worsen the

underlying chronic lung condition and possibly cause:

• A cough that often brings up blood (hemoptysis), Wheezing, Shortness of

breath, weight loss, Fatigue

• Invasive aspergillosis - From the lung the fungus may spread ,
producing disseminated aspergillosis in a variety of tissue and organ
like brain, kidney, liver, bone or skin

• Mostly caused by Aspergillus flavus, it more common in location like

hospital

• Occurs in highly immunocompromised patients

• Mortality rate of 50% to 100%

• Allergic bronchopulmonary aspergillosis -Infected individuals may
develop immediate allergic response and suffer asthma attacks when
expose to fungal antigens

• Bronchitis resulting from both types I and types II hypersensitivity

• Diagnosis

• Direct examination of pathological specimens

• Isolation and characterization o fungus

• Enzyme immune assay that detect galactomannan

• Treatment with voriconazole and itraconazole

Toxoplasmosis
• Toxoplasmosis is an infection caused by a single-celled parasite called
Toxoplasma gondii.

• It is obligatory intracellular parasites

• It have three morphological forms

✔ Asexual forms- Tachyzoite and bradyzoite

✔ Sexual forms - Oocyst

• Tachyzoite
• Actively multiplying forms
• Crescent shaped
• Acute infection

• Bradyzoite
• Resting stage of parasite
• Chronic disease
• Most common site muscle and brain

• Oocyts
• Sexual form of parasite found only in cats
• It is found throughout the world, more than 40 million people in the
United States may be infected with the Toxoplasma parasite.

• The Toxoplasma parasite can persist for long periods of time in the
body of humans (and other animals), possibly even for a lifetime.

• Natural reservoir of T. gondii is wild rodents, birds and other small

animals
A Toxoplasma infection occurs by one of the following:

• Cats are important factors in the transmission of T. gondii to humans, cats are
the definitive host and are required for completion of sexual cycles

• Shed oocysts of the protist in their feces for several weeks after infection

• It transmitted by eating undercooked, contaminated meat (especially pork,

lamb, and venison) or shellfish (for example, oysters, clams or mussels)

• It is third leading cause of death due to food borne infection

• Mother-to-child (congenital) transmission, might infect the fetus, causing

serious congenital defects
Symptoms of the infection

• Acute toxoplasmosis is accompanied by lymph node swelling with

reticular cell hyperplasia

• Pulmonary necrosis, myocarditis and hepatitis caused by tissue necrosis

are common

• Retinitis ( inflammation of retina of the eye) is associated with necrosis

due to the proliferation of the parasites within retinal cells

• Immunocompromised patients produces unique encephalitis with

necrotizing lesion accompanied by inflammation infiltrates
Treatment

• Prevention and control require minimizing exposure by the following: Do

not eat raw or undercooked raw meat and eggs

• Wear gloves when gardening and during any contact with soil or sand
because it might be contaminated with cat feces that contain Toxoplasma.

• Washing hands after working in the soil, cleaning cat litter boxes
Candidiasis
Overview
• Candidiasis is mycosis
• Caused by the dimorphic fungi Candida albicans and C. glabrata
• Opportunistic fungi
• It can infect gastrointestinal tract, respiratory tract, vaginal area, and
mouth, skin, urinary tract, stomach
• They cause infection particularly in warm and moist areas
• Most infections involve the skin or mucous membranes
• This occurs because C. albicans and C. glabrata are strict aerobes
• Cutaneous involvement occurs when the skin becomes moist or
damaged
Who is at increased risk?

• Babies with a nappy rash.

• People with a metabolic disorder, including diabetics.
• Overweight people.
• Pregnant women, and women who take high-dose contraceptive pills,
eg Ovran.
• People who work in wet conditions.
• People who are HIV-positive or suffer from another type of
immunodeficiency.
1. Oropharyngeal candidiasis or thrus :
Sign and symptoms
• Appears as many small and white flecks that cover the tongue and
mouth
• At the birth, newborns do not have a normal microbiota in the
oropharyngeal area
• A candida infection of the skin appears as a clearly defined patch of
red, itchy skin, often leaking fluid
• Paronychia and onychomycosis : infection of subcutaneous tissue of
nails
2. Intertriginous candidiasis
Sign and symptoms

• Involves those area of the body, usually opposed skin surfaces, that
are warm and moist
• Axillae
• Groin
• Skin folds
• Candidal vaginitis – complication of diabetes, antibiotic therapy ,
pregnancy
Diagnosis
• The diagnosis is most commonly made on the basis of the skin's
appearance and occasionally a skin scrape sample is taken to confirm
the clinical findings
• vaginal mucosa are examined under the microscope; a potassium
hydroxide smear, Gram stain, or methylene blue is useful for direct
demonstration of fungal cells
Treatment
• There is no satisfactory treatment for candidiasis
• Cutaneous lesions can be treated with topical agents such as,- Sodium
caprylate, sodium propionate , gentian violet, nystatin , miconazole,
and trichomycin
• Clotrimazole lonzenges and nystatin are used to treat oropharyngeal
candidiasis
• Ketoconazole, amphotericin B, fluconazole, itraconazole and
flucytosine – can be used for systemic candidiasis
Filariasis
Introduction
• Filariasis is disease called filariae
• Caused by parasitic worms
• Inhabit in the tissue and blood of humans
• Length of the adult worms is 80-100mm
• Width is 0.25-0.30mm
• Males worm being shorter than the female
• The female worms are viviparous and gives larvae called microfilariae
Life cycle
Sign and Symptoms
• People with filariasis are often without symptoms
• but also have lymphatic changes such as thickening of the spermatic
cord and expansion of lymphatic vessels
• Fever
• Kidney damage
• Skin abnormalities
• Elephantiasis
 Diagnosis
1. Basic serology testing: this test used to detection for microfilariae in
peripheral blood
2. A skin biopsy: this test is to diagnose nematode infections that live in
tissues
3. Ultrasonography: used to locate and visualize the movement of living adult
worms of W.bancrofti (Wuchereria bancrofti)in the scrotal lymphatics
4. PCR tests: this test used to detect parasite DNA in humans and vectors in
brugian and bancroftain filariasis, this test are high specificity and
sensitivity
5. Lymphoscintigraphy
6. Immunochromatographic
Treatment
• Diethylcarbamazine (DEC) is an effective drug against microfilariae
and adult worms
• Ivermectin (IVM) this drug effects directly on microfilaria in single
doses and lowers the level of microfilaria in the blood
• Albendazole (ALB) Antihelmintic drug is used to destroy the adult
worms