National University-Sudan

Faculty: Nursing & Midwifery Sciences

Program: BSc-Nursing & Midwifery Sciences
Course: Microbiology & Proctology/NUR-MICRO-122
Academic Year: 2024/2025
Semester: 2
Batch: 15
CL 7: Introduction to Mycology
CL 8: Fungal Infections
Dr. Omnia.M.Hamid
Medical Microbiologist
omnia.m.hamid@gmail.com
• Definition: Mycology is the branch of biology concerned with the
study of fungi.
• Mycology: the study of fungal infections or mycoses.
• Fungi can cause a range of human diseases (mycoses), from
superficial infections to life-threatening systemic illnesses, especially
in immunocompromised patients.
• Mycoses: fungal infections.
• Cell Wall: Composed of chitin (target for some antifungal drugs).
• Heterotrophic: Obtain nutrients by absorption (saprophytic or parasitic).
• Hyphae and Mycelium: Filamentous growth form; important for tissue invasion.
• Hyphae – tubular filaments.
• Mycelium – a mass of branching, interlinking hyphae.
• Spores: Reproductive structures; important for transmission and identification.
• Numbers: Estimated 2.2 to 3.8 million species.
• Habitats: Found in diverse environments worldwide.
Forms:
• Yeasts: Unicellular fungi.
• Molds: Filamentous fungi.
• Mushrooms.
Structure
• Fungi are eukaryotic organisms, with a
thick chitin-containing cell wall.
• The fungi of medical importance can
be grouped according to their growth
forms which are usually yeast or mold
like
Replication may be
a) Sexual spores by……….. meiosis
b) Asexual spores by……… mitosis
• Metabolically dormant, protected cells, released by the mycelium in enormous
numbers.
• They can be borne by air or water to new sites, where they germinate and
establish colonies.
• Spores can be generated either asexually or sexually
• Fungi are Eukaryotic organisms with thick chitin cell wall .
• The yeast cell wall consists mainly of polysaccharides made up of three sugars
{glucose, mannose, and N-acetylglucosamine}.
• Chitin is essential for yeast survival role in septation
• Plasma membranes differ from most subcellular membranes because they contain
a high fraction of Ergosterols rather than the cholesterol found in mammalian
membranes.
• Classification is complex Based on:
1. Methods of spore production: Sexual or Asexual
2. According to the growth forms fungi could be:
a) Yeasts
b) Filamentous(Molds)
c) Dimorphic
 Yeasts (Candida albicans )
• Round to oval-Unicellular
• Reproduce by budding Filamentous fungi or molds (Dermatophytes)
• May develop pseudohyphae • Multinucleate mass of continuous cytoplasm
confined within a series of tubular filaments
• Reproduce by sporulation

Dimorphic fungi ...fungi that have 2 forms

(Histoplasma capsulatum)
1. Yeast form (parasitic phase)
• found in infected tissue (in vivo) and on blood based media (37°c).
2. Filamentous (mold) form (saprobic phase )
• present on soil (environment), and on artificial media (22-25°c).
Fungi causes 3 types of diseases
1. Infectious (mycoses):
a) Superficial infections
b) Subcutaneous infections
c) Systemic infections
2. Mycotoxicosis: Most important mycotoxin is the carcinogenic aflatoxin
produced by Aspergillus flavus (cancer liver)
3. Allergic Reactions: Caused by inhalation of fungal spores, notably those of
Aspergillus fumigatus.
Yeast Infections Candidiasis
• Candidiasis : infections with Candida species.
• One of the opportunistic fungi that affect immunocompromised individuals
Candida albicans
Clinical features
1. Superficial infection :
a) Mucosal (Thrush) – white patches on mucosa or vagina – esophageal in the
immunocompromised
b) Cutaneous – red weeping areas- diaper rash
c) Chronic mucocutaneous candidiasis – affect face and scalp
d) B. Deep infection:
2. Candidaemia spread to various tissues as eye, endocardium, meninges,
kidney, liver, spleen, and bone
• Epidemiology
• Source usually endogenous
• Cross infection may occur( mother to baby & vis versa)
• For Lab Diagnosis Sample:
• Swab (wound , vaginal , throat ) for
Yeast Infections Cryptococcosis
• Cryptococcus neoformans is found world wide, It is an Opportunistic Fungus
• Habitat: Found in soil contaminated with pigeon droppings.
• Epidemiology: from the environment.
• Route of transmission: usually by inhalation
• Morphology: capsulated budding yeast with spherical cells.
• Clinical features:
• Sub acute or chronic meningoencephalitis
• Sometimes involved with skin, lungs, lymph node, and other organs.
• Pathogenesis Lung granuloma, symptomless, resolve spontaneously, and
haematogenous spread
• Laboratory diagnosis Sample:
• CSF
• Urine
• Other appropriate Body Fluids.
1. Superficial mycosis
a) Mucus membranes with yeast (thrush )
b) keratinized tissue with Dermatophyte (ring worm)
2. Subcutaneous Mycosis
• Due to implantation of spores of environmental fungi (mycetoma)

3. Systemic Mycosis
• Causes widespread disease – serious and fatal – haematogenous
spread ( e.g systemic aspergillosis)
• In healthy individuals – caused by…. dimorphic fungi
• In immunocompromized patients…. Increases incidence of opportunistic
infections
 Causal organisms-dermatophytes:
Trichophyton sp
Microsporum sp
Epidermophyton sp
1. Superficiel Infections
Dermatophytosis
• The dermatophytes are a group of fungi that
infect the keratinized tissue of skin, nail, and hair
• Dermatophytosis or ring worm infection
• It appears as red patches on affected areas of the
skin and later spreads to other parts of the body.
• The infection may affect the skin of the scalp, feet,
groin, beard, or other areas.
• Habitat The keratin layer of human skin Route of transmission:
• Person to person spread (contact)
• Epidemiology: Source human, animal, soil • Fomites
• Contact with animals or soil
Laboratory diagnosis-sample
• Skin or nail scraping – Sellotape
• Stripping of skin or short lengths of plucked hair
2. Subcutaneous infections
a) Mycetoma Affect the foot ‘ madura foot’ a common condition in tropical and
subtropical areas where people go barefoot.
• Casual organism : molds mainly, Madurella mycetomatis .
• Source: soil.
• Route of transmission: fungi implants into subcutaneous tissue following trauma.
• Pathogenesis: cause granuloma infection affect skin, subcutaneous tissue, and bone,
form abscess.
1-Eumycetoma: 2-Actinomycetoma :
Caused by a several mould (filaments) Caused by aerobic filamentous bacteria

fungi (Actinomycetes) gram positive

Etiologic agents are: Etiologic agents are:
• Madurella mycetomatis • Actinomadura madurae
• Madurella grisea • Streptomyces somaliensis
• Pseudallescheria boydii • Nocardia brasiliensis

Grains color  black or white Grains color  yellow, white, yellowish-

brown, pinkish – red.
There is no black
Aspergillus spp : ( Opportunistic fungi )
• Cause of well recognized disease in immunosuppression, leading cause of death due to infection in
patients undergoing allogenic bone marrow transplantation.
• Causal organism: Aspergillus fumigatus (85%).
• Habitat: found in soil and dust – spores are ubiquitous.
• Morphology Hyphae, and conidiospores.
• Clinical features:
A. Allergic bronchopulmonary aspergillosis
• inhaled spores provoke a hypersensitivity reaction, which may be of
B. Aspergilloma (Non-invasive lung infection)
• a fungal ball grows within, an exiting lung cavity, e.g. due to tuberculosis.
C. Invasive aspergillosis: fungus establishes a pneumonia and later disseminates to involve other
organs, e.g. brain, kidney, and heart.
D. Superficial infections: of the external ear ( otomycosis ) and, less commonly, the eye ( mycotic
keratitis ) and nasal sinuses.
 Laboratory diagnosis: samples
• Exudate: sputum, bronchoalveolar
lavage.
• Tissue: biopsy, periodic acid-schiff
stain to reveal hyphae.
Otomycosis-Otitis Externa
Aspergillus niger

Cutaneous Aspergillus flavus infection

1. Pneumocystis infection Causative organism :
Pneumocystis jiroveci
• Clinical significance: causes pneumocystis
pneumonia, an AIDS-defining illness.
• Culture is very difficult
• Laboratory diagnosis: sample:
bronchoalveolar lavage
2. Candidiasis
3.Cryptococcosis
4. Aspergillosis
• Major Classes:
• Azoles, polyenes, echinocandins, allylamines.
• Mechanisms of Action: Targeting fungal cell wall, cell membrane, or
other metabolic pathways.
• Growing problem of antifungal resistance.
• Hygiene: Important for preventing superficial and cutaneous mycoses.
• Environmental Control: Reducing exposure to fungal spores.
• Prophylaxis: Antifungal medications for high-risk patients.