Saturday, 26 January 2008

PEI SHAN - Fungal pathogens 2nd post

Most possible fungal agents that might be encountered by the soldiers - Beware!!!

1. Dermatophytes
-Epidermophyton


Epidermophyton floccosum
Image from: http://www.mycology.adelaide.edu.au/

-Microsporum

Microsporum fulvum
Image from: http://www.mycology.adelaide.edu.au/

-Trichophyton



Trichophyton concentricum
Image from: http://www.mycology.adelaide.edu.au/



T. mentagrophytes var. interdigitale
Image from: http://www.mycology.adelaide.edu.au/


Trichophyton rubrum downy strain
Image from: http://www.mycology.adelaide.edu.au/

Characteristics: Filamentous fungi invading surface keratinized structures e.g. skin, hair, nails. Hyphae penetrate between cells. (1)

Disease: Tinea (fungal infection), ringowrm, athlete's foot

Transmission: By fungal material on skin scales

Pathogenesis: Skin inflammation, pruritus - sometimes localized hypersensitivity reactions. (1)

Treatment: Topical antifungal agents (griseofulvin)

Prevention: Improved skin care and hygiene


2. Yeasts
Candida Albicans

Candida albicans
Image from: http://www.mycology.adelaide.edu.au/


Characteristics: Dimorphic fungus - occurs as yeast on mucosal surfaces as component of normal flora but forms hyphae when invasive. Produces opportunistic infections in stressed, suppressed and antibiotic0treated individuals. (1)

Disease: Candidiasis, thrush

Transmission: Part of normal flora of skin, mouth and intestine

Pathogenesis: Localised mucocutaneous lesions; invasion of all major organs in disseminated condition (1)

Treatment: Oral and topical antifungals e.g. nystatin, miconazole.


3. Blastomyces Dermatitidis

Image from: http://www.mycology.adelaide.edu.au/

Characteristics: Dimorphic fungus. (4) Invades through lungs, can become widely disseminated in body. (1)

Disease: Blastomycosis

Transmission: Inhalation of airborne spores

Pathogenesis: Fungal infection in lungs. Similar to tuberculosis. (1) Can produce abscesses.

Treatment: Ketoconazole


4. Hyphomycetes
(hyaline moulds)
Aspergillus

Hyaline hyphomycete showing distinctive conidial heads with flask-shaped phialides arranged in whorls on a vesicle. (3)
Image from: http://www.mycology.adelaide.edu.au/

Characteristics: Filamentous fungi causing opportunistic infections in immunocompromised patients. Occur widely in external environment. Invade lungs and blood vessels. (1)

Disease: Aspergillosis

Transmission: Inhalation of airborne stages

Pathogenesis: Causes thrombosis and infarction when blood vessels invaded. Partial blockage of airways from fungal mass. Allergic bronchopulmonary reactions. (1)

Treatment: Amphotericin B


5. Hyphomycetes
(dematiaceous moulds)
Sporothrix Schenckii

Conidiophores and conidia of S. schenckii
Image from: http://www.mycology.adelaide.edu.au/
Characteristics: Dimorphic fungus that occurs in external environment. Invades subcutaneous tissues (1)

Diease: Sporotrichosis

Transmission: Direct fungal contamination of wounds in skin

Pathogenesis: Ulceration or abcess formation in draining lymphatics (1)

Treatment: Potassium iodide, ketoconazole

Prevention: Protection of skin especially covering of wounds
References
1. Book: Medical Microbiology third eition by M., Cedric at. el.
2. Dermatophytes: http://www.cfsph.iastate.edu > Factsheets > pdfs > dermatophytosis.pdf
3. Mycology: http://www.mycology.adelaide.edu.au
4. Blastomyces dermatitidis: http://www.emedicine.com > med > topic231.htm
5. Malassezia furfur: http://www.anaisdedermatologia.org.br > artigo_imprimir_en.php?artigo_id=10192
6. Histoplasma capsulatum: http://wonder.cdc.gov > wonder > prevguid > p0000406 > p0000406.asp
Reported by Pei Shan, Tg02

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