MYCOLOGY

Fairy Ring
Mushrooms
Fungus – Singular
Fungi – Pleural

Mycology: Study of fungus and fungal diseases.

The word mycology from Greek Word Mykes, means
mushroom- a fungus Which was first recognized
microorganism.

Mycoses: Fungal disease is called mycosis.

Other name is Mycotic disease or fungal disease.

Definition of Fungus: It is a eukaryotic cell- may be

unicellular or multicellular, contain chitin (N-acetyl-
glucosamine) in cell wall and ergo-sterol in the cell
membrane.
Characteristics of fungus:

• An eukaryotic cell which may be unicellular or

multicellular
• The cell wall contain chitin surrounding the cytoplasm
instead of peptidoglycan. Caspofungin act on chitin.
• Cell membrane contain ergosterol. (Human cell contain
cholesterol).
Amphoterecin-B and Azole act on ergosterol.
• Reproduce by formation of spores (sexual or asexual).
• Fungi are a heterogeneous group of microorganisms
characterized by absence of chlorophyll.
• Most are obligate aerobe, some are facultative
anaerobes, but none are obligate anaerobe.
• Fungi are poor antigen.
 
 
 Difference between Bacteria and Fungus: 
Bacteria Fungus

Cell wall contain peptidoglycan Cell wall contain chitin

Cell membrane does not contain Cell membrane contain
sterol sterol
(except Mycoplasma).
Spore- Spore-
a) Spore are formed in adverse a) Spore are formed for
situation or unfavorable condition as reproduction.
a protective mechanism for survival.
b) They are resistant form for b) They are not resistant
bacteria form For fungus
c) They are endospore c) Fungal spore are exospore
d) One bacteria from one spore d) Multiple fungus from
single spore
Classification of fungus:

Fungus may be classified on two basis-

Morphological – based upon size and shape
Clinical- based on anatomical site involved
 
Morphological classification:
 On the basis of morphology of the fungus there
are 4 types:
Yeast fungus
Yeast like fungus
Mould fungus
Dimorphic fungus
 
.
Yeast fungus: Oval or round shaped.
They are unicellular and they reproduce by budding.
Example- Cryptococcus neophormans
Capsule – some yeasts (e.g. Cryptococcus)
may have capsule.
Yeast like fungus:
They are oval or round shaped, unicellular &
reproduce by budding. Budding are capable of
reproducing more budding which join together to form
pseudo hyphae.
Example- Candida albicans
Mould fungus:
They grow as long branching filaments. They are
multicellular and each filament is known as hyphae.
Hyphae (Singular-hypha) may be septate or aseptate.
Mold may reproduce either sexually or asexually.

Example- Dermatophytes, Penicillium, Aspergillus.

Dimorphic fungus:
The fungus which exist in both yeast and mould
form in different temperature -are called
dimorphic fungus. That is fungus which exists as
yeast at 370C and mould at 250C are called
dimorphic fungus.
 
Example- Histoplasma capsulatum
Blastomyces dermatitidis
Coccidioides immitis
Paracoccidioides braciliensis
 
B) Clinical classification:
On the basis of anatomical site involved.
 
1) Superficial fungal agents
2) Cutaneous fungal agents
3) Subcutaneous fungal agents
4) Systemic or deep fungal agents
5) Opportunistic
 
Superficial fungal agent:
 
They infect the outer most layer (Stratum corneum of
epidermis) of the skin.

Examples: 1. Malassezia furfur

2. Exophila werneckii
Exophila werneckii- It is a mould fungus and disease
produced by them known as Tinia nigra. It produces
light brown blackish macular area on the palmer or
planter stratum corneum.
 
3. Piedraia hortae 
Disease produced by them known as Black
Piedra. Hard black nodules are formed around the scalp
hair.
 
4. Trichosporon beigelii
 
They produce White piedra, a softer, white to
light brown nodules are found on axillary, pubic, beard
and scalp hair.
Malassezia furfur:
 

Causes: Pityriasis versicolor. (It is not dimorphic

fungus).
 
Predisposing factors for Pityriasis versicolor:
a) Hormonal change
b) Hot & humid climate
c) Excessive sweating
d) Availability of nutrition (fatty acid from
sebaceous glands).
 
Pathogenesis: 
The Malasseria furfur is a normal flora of the skin.
All age groups may be affected but young adults
affected more due to hormonal change, more fatty
acid secreted from sebaceous glands. The fungus
may multiply and produce lesions in the skin
which may be hypo or depigmented.
 
Clinical features of Pityriasis versicolor: 
In most of cases they are
asymptomatic. The lesion may
be depigmented or
hypopigmented with slightly
itching and scaling.
 
Lab Diagnosis:
Collection of specimens: Skin scraping
 
A) Direct microscopic examination:
One drop of 20% KOH is taken on a glass slide; a portion
of the collected material is transferred to the drop of
KOH & cover with a cover slip & kept for one hour.
Then examined under microscope.
 
Findings of examination:
Cluster of yeast cells & short, stout, septate fungal
hyphae which may be curved and occasionally
branched are to be found.
 
 
 
 
B) Culture of the specimens:

Since the fungus is lipophilic. Before

inoculation, the fungal media is covered with
a layer of olive oil.
Microscopic exam. Is enough for diagnosis
of pityriasis versicolor.
Culture is not usually done.
2. Cutaneous fungal agents:
It infects the epidermis of the skin & its appendages. It utilize
skin keratin as nutrition.
(1) Dermatophytes (Ringworm)
(2) Candida species (Yeast infection)

Dermatophytes:
Dermatophytes has three genera-
Microsporum- (Not reported in
Bangladesh)
M. gypseum
M. canis
They cause the fungal infection of the skin and
hair.
 2. Trichophyton-
T. rubrum ( 80%- found in Bangladesh)
T. mentagrophytes (8-10% found in Bangladesh)
They cause fungal infection of skin, nail and hair.

3. Epidermophyton (Some found in Bangladesh)

E. floccosum.
They infect mainly skin and nail.
Disease produce by dermatophytes:
Tinea or Ring worm (clinical name). But mycologically it
is known as dermatophytosis.
Mode of Transmission:
• Direct contact with dermatophytic lesion of
human or animal.
• By contact with contaminated fomites with
dermatophytes.
 
Predisposing factor of dermatophytosis:
• Minor injury in the skin and skin appendages
• Hot and humid climate
• Moist and warm area of the body, as groin,
axilla, interdigital spaces, intramamary fold
• Excessive sweating. 
 
 
 
 
Pathogenesis of dermatophytosis:
After being deposited of fungal spores in
suitable area of the body, they multiply under
suitable condition and migrate centrifugally.
Thus giving an appearance of ring. 

Clinical features of dermatophytosis:

 Intense itching & formation of papules &
vesicles in cases skin. In case of nail, the nail
become soft, brittle, broken and later on
become thickened.
In case of hair, the infected hair becomes
broken, resulting in localized alopecia.
Lab. Diagnosis-
Specimen collection-
Skin- Skin scraping are done from margin of lesion.
Nail- Nail clipping
Hair- Infected twisted hair, broken hair are plucked by forceps with
hair follicle and from margin of the scalp lesion (Hair plucking).
Microscopic examination:
A drop of 20% KOH/NaOH is taken on a glass slide. A small
portion of collected material is transferred to the drop of KOH
( KOH dissolve skin keratin) and covered with a cover slip.

Time for dissolution of keratin:

-For hair (<5mm long) : 5-10 min
-For skin: 20-30 min
- For nail: 24 hours
Findings:
1. Branching septate hyphae- Suggestive of dermatophyte
2. Aseptate fungal hyphae- suggestive of nonpathogenic saprophytic

fungus.
3. Branching septate hyphae with arthospore- definitely dermatophyte.

Comments: Septate branching hyphae with or without arthospore.

3. Culture:

Selective media: Sabourauds dextrose agar (SDA) + antibiotic (Chloram

phenicol or Tetracycline to prevent bacterial growth) + antifungal agent
(cyclohexamide at low conc. Which will not inhibit the growth of dermatophyte
but inhibit the growth of other saprophytes).

Temparature of incubation: Room temperature (220C to 250C).

Duration of incubation: 3-4 weeks. As they are slow growing. Usually

grows after 10 days.
Candida:
Candida species:
1 Candida albicans- Causes 90% of candidiasis.
2.Candida tropicalis
3. Candida pseudotropicalis
4. Candida guilermondi
5.Candida stellatoidea

Candida albicans:
The disease produce by C. albicans
. is called candidiasis.
Candida albicans is an opportunistic fungus which can cause
systemic candidiasis in immunocompromised patients. However
candida albicans can cause superficial or local candidiasis in
healthy individual when local immunity is some how disturbed or
depressed.
A) Local or superficial candidiasis:
Oral thrush: Mainly occurs in infants and AIDS patients. However
oral thrush may occur in other age groups having following
predisposing factors----
• Prolonged broad spectrum antibiotic therapy
• Prolonged corticosteroid therapy
• Anticancer therapy
• Immunosuppressive drug therapy

Vaginal candidiasis: Predisposing factors for Vaginal

Candidiasis.
• Oral contraceptives
• Diabetes mellitus
• Broad spectrum antibiotics.
  
B) Cutaneous candidiasis: Mainly occurs in moist and warm
areas of the body that is axilla, groin, interdigital space, intramamary
folds, soft tissue around the nails.
 
 
Lab diagnosis:
Collection of specimens:
A) In mucous membrane—Swab is taken from the lesion
B) In skin--- Skin scraping are taken
C) In systemic candidiasis—Specimens are collected
according to the site of infection- as sputum is collected in
pulmonary candidiasis.
Microscopic examination:
The collected material is dissolved by 20% KOH and kept for
1 hour. Then examination done by microscope.
Findings: Yeast cells which shows budding and pseudohyphae.
Culture:
 
Culture:
Culture done in Sabourauds agar media and C. albicans
is confirmed by the following tests
Sugar fermentation test
Sugar assimilation test
Germ tube test- commonly done.
0.5 ml of human serum taken in a test tube. Now the
culture growth of the Candida species is inoculated in
the serum. The tube is incubated at 370C for 2-3 hours.
Now a drop of serum is transferred on a clean glass
slide. Cover with cover slip and examined under
microscope.
 
Findings: In case of C. albicans there will be tube like
out growth from the yeast cell.
 
 
 
Subcutaneous fungal agents:
1.Rhinosporidium seeberi- found in our country. (Rhinosporidiosis)
2. Madurella mycetomatis- reported in Bangladesh (Cause
mycetoma).
3. Sporothrix schenkii- not yet reported in Bangladesh.
4. Cladosporium carrionii- causes Chromoblastomycosis.

Mycetoma:
Old name of the disease is Madura foot.
It is a chronic granulomatous infection that usually involves the
lower extremities but may occur in any part of the body. The
infection is characterized by swelling, purplish discoloration, tumor
like deformities of the subcutaneous tissue, and multiple sinus
tracts that drain pus containing yellow, white, red or black
granules. The infection gradually progresses to involve the bone,
muscle or other contiguous tissue and ultimately requires
amputation in most cases.
Two types of mycetomas are described;
actinomycotic (bacterial) mycetoma, which is caused
by species of the aerobic actinomycetes, including Nocardia,
Actinomadura & streptomyces; and
eumycotic (fungal) mycetoma, caused by a
heterogenous groups of fungi having septate hyphae.

Etiologic agents of eumycotic mycetoma include:

Madurella mycetomaties, Pseudallesscheria boydii,
Curvularia, Acremonium and many other genera.
Lab. Diagnosis:
Characteristics discharge from the sinus.
The discharge contains granules that is crusted,
dissolved in 20% KOH and gram stained.
 
Findigs:
Plenty of branching fungal hyphae. In case of
bacterial cause width of hyphae is .5 to 1 micro
meter. In fungus its width is about 5 micro meter.
 
Culture:
In Sebaurauds dextrose agar and blood agar.
 Systemic-
a) Primary: Coccidioides immitis
Histoplasma capsulatum
Blastomyces dermatitidis
Paracoccidioides brasiliensis
 
 
b) Opportunistic: Candida albicans & other candida

species
Cryptococcus neoformans
Aspergillus fumigatus
Species of Rhizopus, Absidia,
Mucor
 
 
 
DEUTEROMYCOTINA (Fungi Imperfecta)
 
Group of imperfect fungi that lack a sexual
reproductive cycle (teleomorph)
 
Characterized by their asexual reproductive
(Anamorphic) structures, primarily conidia
Posses septate hyphae
 
Examples – Candida, Epidermophyton,
Coccidioidis, Paracoccidioidis etc
 
Dermatophytid (“id”) reactions
 
These inflammatory conditions do not contain fungi
in the lesions but are an allergic reactions to a
dermatophyte infection. The individual may become
hypersensitive to constituents or products of the
fungus and may develop allergic manifestations
elsewhere on the body most often on the hands.
“id” reactions often appear to be precipitated by
treatment of dermatophytosis.
 
The commonest forms are acute vesicular eczema of
the hands or feet.
Generally such patients have very strong delayed type
skin test reactions to dermatophyte antigens but the
immunological basis of the Dermatophytid
reaction is unknown.
 
Pathogenesis of fungal disease:

Hypersensitivity
-Allergy
Mycotoxicosis
-Production of toxin
Mycetismus (mushroom poisoning)
-Preformed toxin
Colonization and invasion Infection
 
Antifungal drug-

Primary antifungal drugs-

1. Amphoterecin B
2. Azole
3. Griseofulvin
4. 5-flurocytosine
5. Allylamines
6. Terbinafine (Lamisil)
7. Echinocandins
–Caspofungin
Thank You