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Fungus Diseases
• Superficial Mycoses
• Dermatophytoses
• Systemic Mycoses
Diagnosing Fungus Diseases
1. Clinical Clues
2. Culture of Etiologic Agent
3. Appearance in Tissue
1.) Clinical Clues:
b. Histopathology:
Periodic Acid-Schiff is best;
Silver excellent (e.g., GMS);
H & E good for tissue but poor for fungi
3.) Appearance in Tissue (con’t.)
C. neoformans as seen in
culture or in CSF. Note huge
capsule.
b.) Two mycoses have intracellular yeast. One of these is
Histoplasmosis and the other is Penicilliosis.
Histoplasmosis
- Granulomatous disease of lungs and RES which
mimics TB.
- Spread from bird droppings, especially blackbirds,
chickens and bats.
- Worldwide, 10% people China skin test positive (very
high in Sichuan).
- Hard to diagnose, use itraconazole.
Small (3-5 microns)
intracellular yeast of
H. capsulatum
Microscopic of T.
mentagrophytes. Note large
(macroconidium) and small
spores (microconidia).
b.) Aspergillosis and Phycomycosis (Zygomycosis,
Mucormycosis)
Infarct Aspergilloma
Aspergillosis or Phycomycosis?
Aspergillosis: Note
dichotomously branch,
septate hyphae.
Phycomycosis: Larger,
coenocytic hyphae.
c.) Phaeohyphomycosis
Young girl from Beijing with deep abscess. Not cured after
2 years of therapy. On the right is culture of etiologic agent.
d.) Keratomycosis (mycotic keratitis)
Actinomycotic mycetoma
granule. Note small (0.5
microns) filaments.
Onychomycosis caused by
a Candida sp.
Clinical aspects of Candidiasis (con’t)
Placental candidiasis.
Clinical aspects of Candidiasis
(con’t)
Cancer patient who
died of candidiasis.
Numerous white focal
points are candidiasis.