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 Fungi Disease Treatment 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 Fungi Disease Treatment 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