Updated: 2/4/2018

Fungi

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Fungi Table
 
Cutaneous and Subcutaneous Mycoses 
Fungi Disease Treatment
Malassezia furfur
  • Tinea versicolor
  • Miconazole
  • Selenium sulfide
Trichophyton, Microsporum, and Epidermophyton
  • Tineas (ringworm, jock itch, and athlete's foot)
  • Imidazoles
Sporothrix schenckii
  • Sporotrichosis (rose gardner's disease)
  • Itraconazole
Systemic Mycoses 
Histoplasma capsulatum 
  • Histoplasmosis (pneumonia)
  • Fluconazole
  • Amphotericin B
Coccidioides immitis  
  • Coccidioidomycosis (pneumonia, meningitis, and skin/bone infection) 
  • Fluconazole
  • Amphotericin B
Blastomyces dermatitidis
  • Blastomycosis (chronic inflammatory lung disease and skin/bone infection)
  • Fluconazole
  • Amphotericin B
Paracoccidioides brasiliensis 
  • Paracoccidioidomycosis (pneumonia)
  • Fluconazole
  • Amphotericin B
Opportunistic Mycoses 
Candida albicans 
  • Oral thrush
  • Candida intertrigo
  • Vaginitis
  • Disseminated disease in immunocompromised (neutropenia)  
  • Nystatin
  • Amphotericin B
Cryptococcus neoformans
  • Cryptococcosis (meningitis, pneumonia, and skin/bone infections)
  • Amphotericin B
  • Flucytosine
Aspergillus
  • Allergic bronchopulmonary aspergillosis
  • Aspergilloma
  • Invasive aspergillosis
  • Itraconazole
  • Amphotericin B
Mucor and Rhizopus
  • Mucormycosis (rhinocerebral infection)
  • Amphotericin B
Pneumocystis jiroveci 
  • PCP (diffuse interstitial pneumonia)
  • TMP-SMX
 
Fungi Introduction
  • Fungi is a large group of eukaryotic organisms including yeasts, molds, and mushrooms
  • Yeast
    • unicellular fungi
    • reproduce by budding
      • reproduce more slowly than bacteria
    • cells are spherical to ellipsoidal in shape
    • buds that do not separate form long chains of yeast cells called pseudohyphae
      • Candida albicans forms pseudohyphae
  • Molds
    • multicellular colonies
      • composed of clumps of intertwined branching hyphae
    • grow by longitudinal extension
    • produce spores
  • Dimorphic fungi
    • can grow as either yeast or mold depending on the environmental conditions
      • usually grows as a yeast at body temperatures
      • "mold in the cold"
    • examples
      • Histoplasma
      • Blastomyces
      • Coccidioides
      • Sporothrix
Fungal Morphology
  • Spores
    • the reproductive structure of molds
      • adapted for dispersal
    • conidia are asexual fungal spores (Greek: "konia" = "dust")
      • most fungal spores are asexual
      • types of conidia include blastoconidia and arthroconidia
      • coccidioidomycosis and histoplasmosis are transmitted by inhalation of asexual species
  • Hyphae
    • long, threadlike, branching, filamentous, tubular structure of a fungus
    • composed of fungal cells attached end to end
    • grow by extending from the ends of the tubules
  • Cell membrane
    • innermost layer around fungal cytoplasm
    • contains ergosterol
      • analogous to cholesterol in humans
      • amphotericin B and nystatin bind to ergosterol
      • ketoconazole inhibits ergosterol synthesis
  • Cell wall
    • surrounds cell membrane
    • contains mostly complex carbohydrates
      • explains calcification in chronic infection
    • fungal cell walls are potent antigens
  • Capsule
    • polysaccharide coating surrounding the cell wall
    • visualized with India ink stain
    • can be an antiphagocytic virulence factor
      • used by Cryptococcus neoformans
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Questions (5)

(M1.MC.15.75) A 34-year-old male from Southern California presents to his primary care physician with a complaint of cough, fever, night sweats, and general malaise. He also reports that he recently developed a rash that is very concerning. He states that he has had these symptoms for a few days and they have failed to resolve. Upon questioning, the patient complains of having to work outside recently to complete repairs on his house, which was damaged in a recent earthquake. The physician states that he believes the patient to have a fungal pneumonia. Which of the following histologic images best represents this patient's infection? Tested Concept

QID: 106718
FIGURES:
1

Figure A

6%

(16/259)

2

Figure B

10%

(26/259)

3

Figure C

11%

(28/259)

4

Figure D

59%

(152/259)

5

Figure E

13%

(33/259)

M 1 E

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