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Opportunistic

Mycoses
TRUE OPPORTUNISTIC
PATHOGENS PATHOGENS

Morphology Dimorphic fungi Almost not dimorphic

Geographical Endemic; All over the world


region Restricted to several
regions
Population Normal individuals Immunocompromised
infected Immunocompromised
Disease Fungi
Aspergillosis - Aspergillus sp.
Candidosis - Candida sp.
Cryptococcosis - Cryptococcus neoformans
Mucormycosis - Mucor, Rhizopus
(Phycomycosis, Zygomycosis)
Fusaryomycosis - Fusarium
Geotrichosis - Geotrichum
Torulopsiosis - Torulopsis glabrata
Penicilliosis - Penicillium
Aspergillosis
Aspergillosis:

A. fumigatus
A. flavus
A. nidulans
A. niger
A. terreus
1. Allergic Aspergillosis
2. Fungus Ball of the lung – Aspergilloma
3. Aspergillosis of the lung
- acute invasive
- chronic necrotizing
4. Invasive Aspergillosis:
• Infection of paranasal sinuses
• CNS Aspergillosis
• Ocular Aspergillosis
• Endocarditis and Myocarditis
• Ostoemyelitis
• Cutaneous
• Others
Penicilliosis
Penicilliosis marneffei
Mucormycosis
1. Rhinocerebral mucormycosis
2. Thoracic mucormycosis
3. Gastrointestinal mucormycosis
4. Cutaneous
5. Disseminated

Rhizopus
Absidia
Mucor
Cumminghamella
Pneumocystis carinii
Cysts of Pneumocystis carinii in lung tissue, Gomori methenamine
silver stain method. The walls of the cysts are stained black and
often appear crescent shaped or like crushed ping-pong balls. The
intracystic bodies are not visible with this stain.
Pneumocystis carinii pneumonia (PCP) is an opportunistic
infection that occurs in immunosuppressed populations,
primarily patients with advanced human immunodeficiency
virus infection. The classic presentation of nonproductive
cough, shortness of breath, fever, bilateral interstitial infiltrates
and hypoxemia does not always appear. Diagnostic methods of
choice include sputum induction and bronchoalveolar lavage.
The drug of choice for treatment and prophylaxis is
trimethoprim-sulfamethoxazole, but alternatives are often
needed because of adverse effects or, less commonly,
treatment failure. Adjunctive corticosteroid therapy improves
survival in moderate to severe cases. Complications such as
pneumothorax and respiratory failure portend poorer survival.
Prophylaxis dramatically lowers the risk of disease in
susceptible populations. Although PCP has declined in
incidence in the developed world as a result of prophylaxis and
effective antiretroviral therapy, its diagnosis and treatment
remain challenging.
Diagnosis

P. carinii cannot be routinely cultured and is identified by


stains demonstrating the cyst wall or the trophozoite. Before
the emergence of AIDS, PCP was diagnosed by open lung
biopsy. Less invasive procedures--sputum induction and
bronchoalveolar lavage--are now the methods of choice12.