Mycoses

1. MYCOSES
MAJID MOHIUDDIN

2. SUPERFICIAL MYCOSES
• 1. Pityriasis (Tinea) versicolor (Malassezia
furfur)
• 2. Tinea Nigra – Hortaea/Exophiala werneckii
• 3. White Piedia – Trichosporon
• 4. Black piedra – Piedraia

3. SUPERFICIAL CAUSITIVE CLINICAL DIAGNOSIS TREATMENT
MYCOSES ORGANISMS SYNDROME
(TYPE)
1. TINEA Malassezia furfur Small hypo Skin Topical azoles
VERSICOLOR (Yeast like fungus) (or) hyper scraping Selenium
(PITYRIASIS represent pigmented Direct sulfide shampoo
Imidazole
VERSICOLOR) phialoconidia macules observation
ointments
Chronic, mild, Exposure Miconazole &
infection of of Wood’s clotrimazole
stratum lamp. shampoo
corneum Hot soak bath

4. SUPERFICIAL CAUSITIVE CLINICAL DIAGNOSIS TREATMENT
MYCOSES ORGANISMS SYNDROME
(TYPE)
2. TINEA NIGRA Hortaea werneckii/ Irregular Microscopic Whitfield’s
exophiala werneckii examination ointment,
pigmented
Superficial macules of skin miconazole
Black fungus
scraping nitrate in a cream
Phaeophypho Cladosporium No scaling
culture base
mycosis (or) invasion of Imidazole &
(branched, septate
hyphae, arthroconidia hair follicles triazole
& elongate budding Non Sulfur
cells) contagious ointments
Tincture of
iodine
terbinafine

5. SUPERFICIAL CAUSITIVE CLINICAL DIAGNOSIS TREATMENT
MYCOSES ORGANISMS SYNDROME
(TYPE)
3. WHITE Trichosporon: Hairs of the Culture in Topical azoles
PIEDRA T. inkin, T.asahii, groin & axillae mycological Improve
T.beigelii, White to media hygiene
Shaving of
T.mucoides brown welling without
cycloheximide.
infected hairs
along the air
Dolipore septum strand.
hyphae
Or budding yeast
like cells

6. SUPERFICIAL CAUSITIVE CLINICAL DIAGNOSIS TREATMENT
MYCOSES ORGANISMS SYNDROME
(TYPE)
4. BLACK ASCOMYCETES – Small, dark Branch Hair cut
PIEDRA Piedraia hortae or nodules – pigmented Proper and
hortai surround the hyphae regular washing.
hair shafts Culture
scalp Begin as
yeast like
colony then
hyphae

7. CUTANEOUS MYCOSES
CUTANEOUS CAUSITIVE CLINICAL DIAGNOSIS TREATMENT
MYCOSES ORGANISMS SYNDROME
DERMATO- TRICHOPHYTON Ectothrix Direct Tropical Azoles
PHYTOSES EPIDERMOPHYTON Endothrix microscopic (micronazole,
MICROSPORUM Favic Skin, hair clotrimazole,
econazole, etc)
patterns /nail sample
Macro and micro Terbinafine and
Culture on haloprogin
conidia scrappings Whitfield
Arthroconidia
ointment
(benzoic &
salicyclic acids)
optical agent.

8. DERMATOPHYTOS CAUSITIVE CLINICAL
IS ORGANISMS SYNDROME
TINEA CAPITIS Trichophyton Small scalling
(Scalp ringworm) Microsporium patches to entire
scalp
Scalp, eyebrows
& eyelashes
TINEA BARBAE Beard
TINEA CORPORIS E. floccosum Annular rings
(Ring worm) Trichophyton with scaly centers
Microsporium
TINEA CRURIS Epidermophyton Moist groin area
(Jock itch) T. rubrum
TINEA PEDIS T.rubrum/mentagrop Toes then nails
(Athlete’s foot) hytes becomes yellow
E.fluccosum and brittles
TINEA UNGUIUM T. rubrum Nails thickned,
(Onychomycosis) discolored &
brittle

9. SUBCUTANEOUS MYCOSES
• Main
Lymphocutaneous sporotrichosis
Chromoblastomycosis
Eumycotic mycetoma
Subcutaneous zygomycosis
Subcutaneous phaeohyphomycosis
• Additional
Lobomycosis
Rhinosporidiosis

10. SUBCUTANEOUS CAUSITIVE CLINICAL DIAGNOSIS TREATMENT
MYCOSES ORGANISMS SYNDROME
1. Sporothrix Skin by truma Culture of  Oral
LYMPHOCUTANEOUS schenckii – Small nodule pus / tissue potassium
SPOROTRICHOSIS thermophilic – ulcerate Immunologi iodide
dimorphic Then cally – Itraconazole,
Mold – narrow, discharge pus exoantigen terbinafine
hyaline, septate – test /potassium
condiophores iodide
Yeast – spherical, Fluconazole
oval (or) elongated Local
application of
heat

11. SUBCUTANEOUS CAUSITIVE CLINICAL DIAGNOSIS TREATMENT
MYCOSES ORGANISMS SYNDROME
2. Pigmented Legs & arms/ Histopathol  antifungal
CHROMOBLASTOMYC septated shoulds, neck, ogic findings theraphy
OSIS (dematiaceous) truck, face, of chestnut Itraconazole &
(Chromomycosis) fungi ears. brown, terbinafine
Chronic, musiform
Fonsecaea, pruritic, cells. Posaconazole
Cladosporium, progressive, with
Exophiala, resistant to flucytosine
Cladophialophora treat.
Rhinocladiella Verrucous
Phialophora lesions to flat
plagues
Form muriform cells Cauliflower
(Sclerotic bodies, Medlar
bodies)
like growth

12. SUBCUTANEOUS CAUSITIVE CLINICAL DIAGNOSIS TREATMENT
MYCOSES ORGANISMS SYNDROME
3. Phaeoacremonium Foot & Grains can Amphotericin B,
EUMYCOTIC hand/back be mounted Kitoconazole,
MYCETOMA Curvularia, shoulders & Microscopic itraconazole
Fusarium chest wall also. Antifungal
Madurella, Small, Theraphy
Exophiala, painless,
Pyrenochaeta, subcutaneous
Leptosphaeria nodule/plague -
Scedosporium spp. increase slowly
& enlarge -
Septate disfigured
Chlamydoconidia

13. SUBCUTANEOUS CAUSITIVE CLINICAL DIAGNOSIS TREATMENT
MYCOSES ORGANISMS SYNDROME
4. a)Conidiobolus Chronic Require Itraconazole
SUBCUTANEOUS coronatus a)Rhinofacial biopsy for Oral
ZYGOMYCOSIS b)Basidiobolus area - swelling diagnosis potassium
(Entomophthoromyc ranarum of the upperlips Can culture iodide
osis)
Facial area in & face - alternatively
adults painless Facial
Proximal limbs in b)Disk, reconstruction
children shaped, surgery in case
respectively rubbary of C.coronatus
movable
Mucoraceaous masses –
Zygomycetes, shoulders,
sparse hyphae, pelvis, lips &
fragmented, thighs.
septae

14. SUBCUTANEOUS CAUSITIVE CLINICAL DIAGNOSIS TREATMENT
MYCOSES ORGANISMS SYNDROME
5. Numerous & Solitary Culture Itraconazole,
SUBCUTANEOUS diverse inflammatory Identification with or
PHAEOHYPHOMY Black molds in cyst. of pattern of without
COSIS culture Feet & legs sporulation flucytosine
(Superficial,
Yeast like in tissue. although other Posaconazole
subcutaneous or
deeply invasive Branced septate – body sites Voriconazole
or disseminated) budding yeast like Lessions Terbinafine
grows slowly
Exophiala jeanselmei, and expand
Alternaria, Firm &
Curvularia, painless
Phaeoacremonium,
Bipolaris spp.

15. SYSTEMIC MYCOSES DUE TO
DIMORPHIC FUNGI
• 1. Blastomycosis
• 2. Histoplasmosis
• 3. Coccidiodomycoses
• 4. Paracoccidiodomycosis
(Blastomyces dermatitidis, Coccidioides immitis &
C.posadasii, Histoplasma capsulatum var.
capsulatum & H. Capsulatum var duboisii,
Paracoccidioides brasiliensis & Penicillium
marneffei).
Restricted geographically to specific area.

16. SYSTEMIC MYCOSES CAUSITIVE CLINICAL DIAGNOSIS TREATMENT
ORGANISMS SYNDROME
1. BLASTOMYCES BLASTOMYCOSIS Present as Suptum,pus Itraconazole
DERMATITIDIS Molds in culture - pulmonary , exudates, Ketoconazole
Branced septate disease (or) Urine & Serious cases
Yeast like in tissue. extra biopsis from amphotericin
– single budding pulmonary lessions. B.
yeast like disseminated Microscopic
disease examination
Older culture may Asymptomati Culture
produce c /present as a Seriologic
chlamydospores mild flu like test
illness.

17. SYSTEMIC MYCOSES CAUSITIVE CLINICAL DIAGNOSIS TREATMENT
ORGANISMS SYNDROME
2.COCCIDIOIDOMY Coccidioides Asymptomati Suptum, Itraconazole
COSIS immitis & c pulmonary exudates Serious cases
C.posadasii disease from amphotericin
Molds hyphae – Vally cutaneous B.
arthroconidia – fever/SanJoaqu lession, spinal Azoles,
endosporulating in vally fluid, blood, fluconazole
spherule in tissue. fever/desert Urine &
rheumatism Tissue
biopsis.
Microscopic
examination
Culture
Seriologic
test

18. SYSTEMIC MYCOSES CAUSITIVE CLINICAL DIAGNOSIS TREATMENT
ORGANISMS SYNDROME
3.HISTOPLASMOSIS Histocapsulatum Conidia Suptum, Itraconazole
var Capsulatum, H. develops into scrapings In
capsulatum var yeast cells – from disseminated
duboisii engulfed by superficial disease,
Molds in culture - alvelor lesions, bone treatment with
hyaline septate - macrophages marrow, amphotericin
conidiophore Initial aspirates & B.
Yeast like in tissue. inflammatory buffy coat
– intracelluar reaction blood cells,
budding yeast like because blood films &
granulomatous biopsis from
Mediastinal lessions.
fibrosis Microscopic
examination
Culture
Seriologic
test

19. SYSTEMIC MYCOSES CAUSITIVE CLINICAL DIAGNOSIS TREATMENT
ORGANISMS SYNDROME
4.PARACOCCIDIOID Paracoccidioides Present as Suptum, Itraconazole
OMYCOSIS brasiliensis pulmonary exudates & Ketoconazole
Molds in culture - disease (or) biopsis from &
Branced septate extra lessions. Trimethoprim-
Yeast like in tissue. pulmonary Microscopic sulfamethoxaz
– multiply budding disseminated examination ole
yeast like disease. Culture Serious cases
Seriologic amphotericin
Older culture may test B.
produce
chlamydospores
and conidia