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Medical Mycology
Study of medically relevant fungi
139
Biology
Undergraduate 4
02/01/2011

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Term
Kingdom Fungi...
What is the suffix for all phyla?
Definition
-mycota
Term
Kingdom Fungi...
What is the suffix for all classes?
Definition
-mycetes
Term
Kingdom Fungi... What is the suffix for all families?
Definition
-aceae
Term
Kingdom Fungi... What is the suffix for all orders?
Definition
-ales
Term
plasmogamy
Definition
union of the cytoplasm
results in N+N cells
Term
karyogamy
Definition
fusion of the nuclei
results in diploid cells
Term
dikaryon
Definition
fungal stage after plasmogamy and before karyogamy, when the cells are in an N+N state
Term
cenocytic hyphae
Definition
hyphae that are non-septate (ie don't have septa)
Term
ergosterol
Definition
sterol existing in cell membranes to make the membrane less rigid (unique from cholesterol in mammals)
Term
mycosis
Definition
fungus invades human tissue
Term
mycotoxicosis
Definition
illness caused by ingesting the metabolites of fungi, but not the fungus itself
Term
mycetismus
Definition
illness caused by ingesting a toxin containing fungus
Term
mycoallergies
Definition
sensitivity of the immune system to funal spores and metabolites
Term
superficial mycoses
Definition
infections of the hair shaft or dead outer layer of skin (stratum corneum)
Term
cutaneous mycoses
Definition
infection of the skin, hair, or nails
Term
subcutaneous mycoses
Definition
chronic localized infections of the skin and subcutaneous tissues
Term
deep mycoses
Definition
fungal infections of the body caused by dimorphic fungal pathogens- infection generally starts in the lungs then spreads throughout the body. Also called systemic mycoses
Term
mycorrhizae
Definition
mutualistic association with the roots of plants. The fungus gains sugars made by the plant, while the fungus increases the surface area for plant absorption of water and nutrients. 90% of plants have mycorrhizae
Term
lichens
Definition
mutualistic associations of fungi with algae or cyanobacteria
Term
endophytes
Definition
fungi that gain nutrients by living inside the cells of plants, while producing chemicals to deter other animals from eating the plant. Mutualistic relationship
Term
Polyenes
Definition

antifungal drug class that binds to ergosterols, forming pores in and disrupting the cell membrane.

 

Includes Amphotericin B and Nystatin

Term
Amphotericin B
Definition
An antifungal in the polyene class. Binding to ergosterol causes leakage of cytoplasmic contents. At high doses, will bind to cholesterol in mammalian cells, and be toxic. May only be administered intravenously in hospitals.
Term
Nystatin
Definition
An antifungal drug in the polyene class. Forms pores in the cell membrane by binding to ergosterols. May only be used topically because it is toxic when administered systemically.
Term
Azoles
Definition
A class of antifungal drugs that inhibits ergosterol synthesis, making the cell membrane less stable. Any given azole may inhibit a different step in ergosterol synthesis. In general, are less toxic to patients than polyenes.
Term
Nikkomycin
Definition
An antifungal that competes with chitin for binding of chitin synthase. This blocks chitin synthesis and results to weakened cell walls susceptible to osmotic lysis. (not yet licensed for use)
Term
Echinocandins (Cancidas)
Definition
A class of antifungals that inhibit the enzyme necessary for glucan synthesis. This leads to weakened cell walls susceptible to osmotic lysis. (not yet available for use)
Term
Pradimicins
Definition
A class of antifungals that bind mannose molecules together in an insoluble complex, removing them from the cell wall. This makes the cell wall weak and susceptible to leakage of critical cell components. (not yet available for use)
Term
Griseofulvin
Definition
An antifungal that may be used systemically to fight dermatophyte infections. This drug works by disrupting the mitotic spindle. While there is little toxicity to humans, the treatment course must last for weeks, months, or even years.
Term
Flucytosine
Definition
An antifungal drug that inserts into fungal RNA causing inhibition of both DNA and RNA synthesis, and cause translation mistakes. Fungi can develop resistance to this drug, so it is most effective when used along with Amphotericin B.
Term
Sordarins
Definition
An antifungal drug class that inhibits elongation factors during protein synthesis. This stunts the growth and functioning of the fungal cell.
Term

[image]

Which phylum does this belong to?

Definition
Chytridiomycota
Term
Chytridiomycota
Definition
Fungal phylum that has motile sexual and asexual spores, indicating an aquatic ancestor. Considered to be the most primitive of the fungi.
Term
Zygomycota
Definition

Phylum of fungi creating both sexual and asexual spores.

 

Sexual: zygospores in a zygosporangium when two hyphae meet and mate

 

Asexual: spores are contained in sporangia which form at the ends of hyphae

Term

[image]

Which phylum does this belong to?

Definition

Zygomycota

 

Showing the sexual state- zygosporangium

Term

[image]

What phylum does this belong to?

Definition

Zygomycota

 

Showing the asexual state- sporangium

Term

[image]

Which phylum does this belong to?

Definition

Ascomycota

 

Showing the sexual state- asci (singular- ascus)

Term

[image]

Which phylum does this belong to?

Definition

Ascomycota

 

Showing the asexual state- conidia

Term

[image]

Which phylum does this belong to?

Definition

Basidiomycota

 

Depicting basidiospores borne on a basidium. 

Typically, this phylum does not make asexual spores.

Term
Cleistothecium
Definition
A type of fruiting body of the Ascomycota. A closed structure containing circular asci. "Cleisto"= closed
Term
Apothecium
Definition
A type of fruiting body in the Ascomycota in which asci are located on an open sheath (called hymenium) "Apo"=open
Term
Locule
Definition
A type of fruiting body in the Ascomycota containing several asci, each with their own opening into the environment. Locules are also known as "pseudoperithecia"
Term
Perithecium
Definition
A type of fruiting body in the Ascomycota, in which several asci are contained in one larger sack with a single opening into the environment. "Peri"= around
Term

[image]

What are these structures for?

Definition
All the structures are types of fruiting bodies in the Ascomycota. Each is simply a different method of distributing the sexual spores. (asexual spores are contained in what is known as a conidium)
Term
Blastomycetes: includes what two orders?
Definition
Cryptococcales, Sporobolomycetales
Term
Cryptococccales
Definition
Deuteromycete in the class Blastomycetes
budding yeasts
Term
Sporobolomycetales
Definition
Dueteromycete in the class Blastomycetes
yeasts that form spores that are forcibly discharged
Term
Coelomycetes: includes what two orders?
Definition
Spaeropsidales, Melanconiales
Term
Sphaeropsidales
Definition
Deuteromycete of the class Coelomycetes
produces conidia/spores in pycnidia, which are similar to the perithecia of Ascomycota.
Term
Melanconiales
Definition
Deuteromycete of the class Coelomycetes
produce spores in acervuli, which is a mat of hyphae inside the host tissue that eventually ruptures as conidia grow larger, releasing the spores
Term
Hyphomycetes: Includes what three orders?
Definition
Stilbellales, Tuberculariales, Hyphomycetales (Moniliaceae, Dematiaceae)
Term
Hyphomycetales:
How is this group identified?
Contains what two families?
Definition
Deuteromycetes of the class Hyphomycetes
form conidiophores that are scattered individually
Families Moniliaceae, Dematieaceae
Term
Moniliaceae
Definition
Deuteromycete of the order Hyphomycetales, class Hyphomycetes
spores and hyphae are transparent or light colored.
Term
Dematiaceae
Definition
Deuteromycetes of the order Hyphomycetales, class Hyphomycetes
characterized by dark colored hyphae and spores.
Term
Stilbellales
Definition
Deuteromycetes of the class Hyphomycetes
conidiophores are produced in structures called synemmata or coremia where the conidiophores are grouped/pressed tightly together
Term
Tuberculariales
Definition
Deuteromycetes of the class Hyphomycetes
form sturctures called sporodochia/sporodochium which are thin pads of sterile hyphae
Term
Pityriasis versicolor
Definition
A superficial infection of the stratum corneum
lesions covered with thin scales
Malassezia furfur
found in tropics and subtropics
Treatment: selenium sulfide lotion, tolnaftate or imidazole creams, oral ketoconazole
Term
Malassezia furfur
Definition
lipophillic yeast that causes Pitriasis versicolor.
Also causes folliculitis and catheter-aquired sepsis
Term
Tinea negra
Definition
superficial mycosis affecting the stratum corneum of the palms and soles of feet. Causes black, non-elevated, non-scaly markings.
Is commonly misdiagnosed as malignant melanoma.
Caused by Exophiala werneckii.
Treatment: topical agents like undecylenic acid and imidazole. Oral griseofulvin, topical tolnaftate and ampB are ineffective.
Term
Exophiala werneckii
Definition
Causes tinea negra
Term
Black piedra
Definition
infection of the hair shaft. Characterized by gritty black nodules that may completely surround shaft.
Caused by Piedraia hortae.
Term
Piedraia hortae
Definition
Fungus that causes black piedra infection.
Term
White piedra
Definition
Infection of the hair shaft- typically beard, armpit, and groin.
Forms a "sleeve" around hair shaft, hyphae interwoven throughout.
May be white, red, green, or light brown.
Caused by Trichosporon beigelii.
Term
Actinomyces infections
Definition
Erythrasma, Trichomycosis axillaris, Pitted keratolysis
Term
Dermatophytes
Definition
Fungi that cause cutaneous mycoses- or infections of the keratinized tissue in epidermis, hair, nails.
Three anamorph genera: Trichophyton, Epidermophyton, Microsporum. All three are in the teleomorph genus Arthroderma.
Term
Cutaneous mycoses- types
Definition
Tinea capitis- infection of hair and scalp
Tinea barbae- ringworm in beard region
Tinea corporis- ringworm/infection of the body
Tinea imbricata- an infection of the body that looks like concentric circles
Tinea pedis- ringworm of the foot
Tinea cruris- infection of the groin
Tinea unguinum- infection of the nail and nail bed.
Term
heterothallic
Definition
fungus that needs to mate with another strain to reproduce
Term
homothallic
Definition
fungi that are able to mate with either itself, or another mating type.
Term
Dermatophytes- general treatment
Definition
-topical therapies for tinea pedis, tinea cruris, and tinea corporis:
Azoles, Tolnaftate, terbinafine.
Terbinafine (Lamisil) is the drug of choice.
Term
Dermatophytes- treatment
Tinea unguinum
Definition
Griseofulvin useful but have to continue treatment until healthy nail completely grows in
Terbinafine (Lamisil) is an allylamine that is effective and has few side effects.
Term

[image]

 

What type of growth is this?

Definition

Ectothrix growth in tinea capitis.

 

Arthroconidia are formed on the outside of the hair shaft.

Term

[image]

 

What type of growth is this?

Definition

Endothrix growth in tinea capitis

 

Arthroconidia are formed inside the hair shaft.

Term

[image]

 

What is this fungus and what does it cause?

Definition

Microsporum canis

 

zoophilic fungus found in cats that can also cause tinea corporus or tinea capitis in humans

Term

[image]

 

What is this fungus?

Definition

Microsporum gypseum

 

geophilic fungus that can cause some human infections

Term

[image]

 

What is this fungus?

Definition

Microsporum gallinae

 

zoophilic fungus- commonly infects chickens but is rare in humans.

Term

[image]

 

What is this fungus?

Definition

Microsporum nanum

 

Zoophilic fungus common in pigs but rare in humans

Term

[image]

 

What is this fungus?

Definition

Trichophyton rubrum

 

Anthrophilic fungus (primary host is humans) that is the most widely distributed human fungal pathogen

Term

[image]

 

What is this fungus?

Definition
Trichophyton mentagrophytes
Term

[image]

 

What is this fungus?

Definition
Trichophyton tonsurans
Term

[image]

 

What is this fungus?

Definition

Trichophyton verrucosum

 

special note: develops a structure called chlamydospores in order to survive through bad environmental conditions.

Term

[image]

 

What is this fungus?

Definition

Epidermophyton floccosum

 

The causative agent of athlete's foot

Term
Chromoblastomycosis
Definition
A subcutaneous infection characterized by presence of sclerotic bodies.
Causative agents are very confusing because some can produce different forms of anamorph. Example: Cladosporium carrionii.
Slow growing, may take years to become noticeable.
Treatment: surgical excision, chemotherapy, maybe Lamisil and azoles
Term
Cladosporium carrionii
Definition
An example of a fungus that causes chromoblastomycosis- a subcutaneous mycosis.
Term
Phaeohyphomycosis
Definition
Subcutaneous infection by dematiaceous fungi- in histology can visualize hyphae.
Ranges from skin infection to infection of brain!
Exophiala jeanselmei: example of a causative agent
Term
Subcutaneous mycoses: types
Definition
Chromoblastomycosis, Phaeohyphomycosis, Sporotrichosis, Mycetoma, Pseudallescheriasis.
Subcutaneous mycoses require traumatic implantation.
Term
Sporotrichosis
Definition
Subcutaneous infection characterized by lesions adjacent to lymph nodes. "Rose-pickers disease"
Caused by Sporothrix schenckii.
Clinical presentation may include: osteoarticular sporotrichosis, eye infection (keratitis), systemic infection with CNS invasion, pulmonary sporotrichosis caused by inhalation.
Treatment: Oral potassium iodide, ketoconazole for cutaneous infection
Term
Exophiala jeanselmei
Definition
An example of a causative agent of Phaeohyphomycosis
Term

[image]

 

What is this fungus?

Definition

Sporothrix schenckii

 

The agent that causes sporotrichosis. This is a dimorphic fungus- one of few of medical interest. 

In human tissues, may see different histopathological representations: yeast, "asteroid bodies", "cigar bodies"

Term
Trichosporon beigelii
Definition
The causative agent of white piedra- a superficial mycosis
Term
Mycetoma
Definition
A subcutaneous infection of fungi that grow in tight clusters and create a swelled area. Histopathologically, the fungi appear as "grains" Another sign is pus draining to the surface of lesions.
Agent: caused by many types of fungi and actinomycetes. Example: Madurella mycetomatis.
Treatment: Antibiotic if actinomycete causative agent. Surgical excision in fungal infection- does not respond well to drugs.
Term
Madurella mycetomatis
Definition
Fungus that is one of the causative agents of mycetoma. Particularily common in India.
Term
Pseudoallescheriasis
Definition
A subcutaneous fungal infection caused by Pseudoallescheria boydii (anamorph Scedosporium apiospermun) This fungus may cause any number of problems including meningitis, pneumonitis, endocarditis, and more.
Is difficult to distinguish from aspergillosis but important for treatment.
Fungus produces cleistothecia in teleomorph state but produces conidia of Scedosporium or graphium
Treatment: Ketoconazole is best, is very resistant to AmpB
Term
Pseudallescheria boydii
Definition
Fungus that causes Pseudallescheriasis. Anamorph state is Scedosporium apiospermun. May also produce conidia similar to Graphium.
Term

[image]

 

What is this fungus?

Definition

Scedosporium apiospermun

 

The anamorph form of the causative agent of Psedallescheriasis

Term

[image]

 

What is this fungus?

Definition

Pseudallescheria boydii

 

The teleomorph form of the causative agent of Pseudallescheriasis. Image showing cleistothecia (Ascomycota)

Term
Cyclopeptides
Definition
a mushroom toxin class causing mycetismus. including amatoxins and phallotoxins that attack RNA polymerase in the liver- destroys livr and causes death.
Amanita species, Galerina autumnalis, Conocybe filaris
Term
Monomethyl hydrazine
Definition
a fungal toxin causing mycetismus. destroys red blood cells and attacks CNS.
Gyromitra sp. -false morels
Term
Coprine
Definition

a fungal toxin causing mycetismus when combined with alcohol- because it blocks alcohol dehydrogenase.

Coprinus atrimentarius

Term
Muscarine
Definition
a fungal toxin causing mycetismus. induces perspiration, salivation lacrimation.
Clitocybe dealbata
Term
Ibotenic acid
Definition
a fungal toxin that causes mycetismus. causes intense hallucinations
Amanita muscaria
Term
Psilocybin
Definition
a fungal toxin causing mycetismus. mushroom causes mild hallucinations and induces a trance-like state.
Psilocybe
Term
GI irritants
Definition
There are many fungi that when ingested cause GI irritation. Some examples:
Morchella (don't eat raw!), Chlorophyllum molybdites (common in US)
Term
Vomitoxin
Definition
a Fusarium toxin causing mycotoxicosis. one of the trichothecenes.
Term
Zearalenone
Definition
A Fusarium toxin causing mycotoxicosis. This is mostly a problem in pigs because it can cause genital malformation- is used as an anabolic steroid (estrogen analog) to grow bigger pigs. How much gets into our food?
Term
Trichothecenes
Definition
A class of Fusarium toxins causing mycotoxicosis. Protein synthesis inhibitors by binding to ribosomes.
Examples: Alimentary Toxic Aleukia which is caused by eating molded food.. freeze/thaw cycles.
Yellow rain used during vietnam war on attack on hmong people.
Term
Fumonisins
Definition
A Fusarium toxin causing mycotoxicosis. Causes problems in livestock like pigs and horses. May be correlation to esophageal cancer
Term
Fusarium toxins
Definition
Fumonisins, trichothecenes, Zearalenone, vomitoxin
Term
Satratoxin
Definition
A fungal toxin causing mycotoxiicosis. Similar to trichothecenes but made by Stachybotrys instead of Fusarium. thought to cause "sick building syndrome"
Term
Patulin
Definition
A penecillium toxin that is commmonly associated with apples. It can survive pasteurization processes
Term
Roquefortine C
Definition
A Penicillium toxin causing mycotoxicosis. neurotoxin that causes seizures and is found in many brands of blue cheese worldwide.
Term
Aflatoxin
Definition
An Aspergillus toxin that causes mycotoxicosis. May cause major problems and death in acute cases, is carcinogenic at low levels over long time periods
Term
Ergotism
Definition
Ergot poisoning from Claviceps purpurea causes mycotoxicosis. Causes strange symptoms especially due to vasoconstriction (burning prickling sensations, loss of limbs) some people also suffered hallucinations because ergotamine is metabolized to LSD.
Term
India ink or nigrosin test
Definition
Test to ID capsules around yeast. If capsule present, may be Cryptococcus or Rhodotorula
Term
Germ tube test
Definition
Incubate at 37 degrees
2hr45min: Candida albicans forms germ tubes
3hr: Candida stellatoidea produces germ tubes
Term
Chlamydospore production
Definition
production of a thick walled intercalary or terminal cell- used for surviving in unfavorable conditions
Candida albicans produces
Term
Ascospore production
Definition
after staining, ascospores will be red, others blue.
Saccharomyces cerevisiae, Schizosaccharomyces octosporus, and Hansenula anomala will form ascospores
Term
Urease test
Definition
tests for the presence of urease enzyme
media turns red if urease present
Cryptocccus, Rhodotorula. Certain Candida sp.
Term
Carbohydrate assimilation tests
Definition
test for ability of fungus to utilize a certain sugar as their sole source of carbon aerobically. dextrose, galactose, lactose, sucrose, maltose, and raffinose.
if positive, color changes from purple to yellow
Term
fermentation tests
Definition
tests whether a yeast can ferment certain carbohydrates. positive tests for fermentation results in gas (CO2) production
Commonly used to distinguish between Candida sp.
Term
Rapid nitrate assimilation test
Definition
test to see if yeast can use nitrate as sole source of nutrients. Q-tip with nitrate reduction medium , add alpha-naphthalene and sulfanilic acid. color change on Q-tip to red is a positive test.
positive control= Cryptococcus albidus
negative control= Cryptococcus neoformans
Term
Caffeic acid-ferric citrate disks (CAFC)
Definition
tests for the production of melanin. change to brown pigmentation is positive. No change after 24 hours is negative.
Cryptococcus neoformans is a known positive
Term
Candida albicans screening test
Definition
detects production of L-proline and Beta-galactosamidase. Candida albicans is the only one that has both.
After adding various reagents- color change to pink indicates positive for C. albicans
Term
ChromAgar test
Definition
Differentiates colonies of different species.
Candida albicans is green
Candida tropicalis is steel blue
Candida krusei is rosy
Term
True pathogenic fungi
Definition
Histoplasma, Coccidioides, Blastomyces, Paracoccidioides
Term
Opportunistic fungal pathogens
Definition
Aspergillus, Candida, Rhizopus, Cryptococcus, Pneumocystis, Penicillium marneffei
Term
What causes histoplasmosis?
(anamorph and teleopmorph)
Definition
Histoplasma capsulatum var. capsulatum: worldwide
Histoplasma capsulatum var duboisii: Africa
Histoplasma capsulatum var farciminosum: horse infection
Teleomorph: Ajellomyces capsulatus
Term

[image]

 

What is this fungus and what does it cause?

Definition

Histoplasma capsulatum.

Causes histoplasmosis.

Is a dimorphic fungus.

Term
In what geographic location is histoplasmosis found?
Definition
worldwide
most highly endemic regions of USA are Missouri, Kentucky, Tennessee, Illinois, Ohio
Grows best in soil with high nitrogen content- soil mixed with bird or bat feces
Term
What are starlings?
Definition
Starlings are a species of bird commonly associated with carrying Histoplasma capsulatum
Term
What are the clinical types of histoplasmosis?
Definition
Pulmonary
Cutaneous
Disseminated- including fulminanat and chronic forms
Term
How is histoplasmosis treated?
Definition
Amphotericin B for most forms
Itraconazole for 6weeks to life
Term
How do you catch Histoplasmosis?
Definition
Inhalation of conidia
In rare cases- injection of fungus in lab/autopsy accident
Term
What causes blastomycosis?
Definition
Blastomyces dermatitidis
(teleomorph Ajellomyces dermatitidis)
Term

[image]

[image]

 

What is this fungus and what does it cause?

Definition

Blastomyces dermatitidis

Causes Blastomycosis

Term
Where is blastomycosis found?
Definition
worldwide, but mostly in North America and Africa.
Blastomyces has never been isolated environmentally- only from human or animal infections. but most of therse are within 500m of some waterway
Term
What are the clinical types of blastomycosis?
Definition
Primary pulmonary
cutaneous
systemic (generalized or single organ system)
innoculation
Term
What are the symptoms that Blastomycosis, Histoplasmosis, and Tuberculosis all have in common?
Definition
cough, weight loss, chest pain, night sweats, fever, skin lesions, hemoptysis (coughing up blood)
Term
What are the most common sites of extrapulmonary blastomycosis?
Definition
skin lesions
bone lesions- bone is eaten away
urogenital infection
Term
How is blastomycosis diagnosed?
Definition
"big blue broad based budding yeast blasto"
AccuProbe method- PCR with a fluorescent probe
Term
How is blastomycosis treated?
Definition
Mild infections: Itraconazole or ketoconazole
Severe: Amphotericin B + Itraconazole
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