Systemic mycosisSystemic mycosis

DimorphsDimorphs Internal organsInternal organs CutaneousCutaneous

Primary Primary Secondary Secondary

SaprophytesSaprophytes

Systemic mycosisSystemic mycosis

Tissue stainingTissue staining PAS, H&E, GMS( Gomory Methenamine Silver) PAS, H&E, GMS( Gomory Methenamine Silver)

Blastomyces dermatitidisBlastomyces dermatitidis Yeast, thick wall, linierYeast, thick wall, linier

Histoplasma capsulatumHistoplasma capsulatum Yeast, point, blood or bone marrow, wrightYeast, point, blood or bone marrow, wright

Paracoccidioides brasiliensisParacoccidioides brasiliensis Multiple buddingMultiple budding

Coccidioides immitisCoccidioides immitis Sphrule Sphrule

Systemic mycosisSystemic mycosis

PCRPCR SABHISABHI Blood agarBlood agar 12 week12 week Slide cultureSlide culture Mask, gloves, hood Mask, gloves, hood

Blastomycosis Blastomycosis

Blastomyces dermatitidisBlastomyces dermatitidis Canada, South America, AfricaCanada, South America, Africa Inhalation of conidiaInhalation of conidia Chronic disease in lung DisseminatedChronic disease in lung Disseminated

Skin Bone NoseSkin Bone Nose

MouthMouth

BlastomycosisBlastomycosis

CultureCulture SABHISABHI

• Round or oval conidiaRound or oval conidia• Unicellular & smoothUnicellular & smooth• Shortly conidiophoreShortly conidiophore

BHI, Blood agarBHI, Blood agar• YeastYeast• linier budlinier bud• RoundRound• Big Big

Histoplasmosis Histoplasmosis

Histoplasma capsulatumHistoplasma capsulatum AmericaAmerica Bird & batBird & bat Wind Wind InhalationInhalation SkinSkin

HistoplasmosisHistoplasmosis

90-95% without symptom self limitation90-95% without symptom self limitation Clinical manifestationClinical manifestation

Fever, cough, loose weight, sweatFever, cough, loose weight, sweat Lung, spleen, kidney, liver, skin, eye, CNSLung, spleen, kidney, liver, skin, eye, CNS Blood culture is positiveBlood culture is positive

Amphotricin-B Amphotricin-B

HistoplasmosisHistoplasmosis

CultureCulture SABHISABHI

• Hyphae, macro conidiaHyphae, macro conidia BHI, Blood agarBHI, Blood agar

• YeastYeast Point bud Point bud

Coccidioidomycosis Coccidioidomycosis

SW America desertSW America desert ArthroconidiaArthroconidia

Tolerant to dry & saltTolerant to dry & salt 60% without symptoms60% without symptoms 40% mild Bone40% mild Bone Lung blood SkinLung blood Skin BrainBrain lymph nodlymph nod

CoccidioidomycosisCoccidioidomycosis

Amphotricin-BAmphotricin-B CultureCulture

SABHISABHI• Rectangular arthroconidiaRectangular arthroconidia

SpheruleSpherule Endospore Endospore Blastomyces - C.iBlastomyces - C.i Vaseline germtube + B.dVaseline germtube + B.d

Paracoccidioidomycosis Paracoccidioidomycosis South America, BrazilSouth America, Brazil SaprophyteSaprophyte Water, soil, plantWater, soil, plant Inhalation Inhalation LungLung EatingEating Mouth & gum disseminated systemicMouth & gum disseminated systemic

Enlargement of lymph nod Enlargement of lymph nod

paracoccidioidomycosisparacoccidioidomycosis

Co trimaxazolCo trimaxazol CultureCulture

SABHISABHI• ChlamydioconidiaChlamydioconidia

BHI, Blood agarBHI, Blood agar• Multiple buddingMultiple budding

ship's wheelship's wheel