Fungi
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Medical Classification
Cutaneous: Infects superficial keratinized structures (hair, nails, skin).
Subcutaneous: Infects subcutaneous skin and is introduced by skin trauma.
Systemic: Usually cause lung infections which are asymptomatic and self-limiting, but these fungi may sometimes cause disseminated disease in which the organisms grow in other organs and may result in death.
Opportunistic: Opportunistic fungi fail to induce disease in most immunocompentent people but can do so in those with impaired host defenses.
| Fungi (memorize) | Medical classification (memorize) |
|---|---|
| Malassezia furfur | Cutaneous |
| Microsporum species, Trichophyton species, Epidermophyton fluccosum | Cutaneous |
| Sporothrix schenckii | Subcutaneous |
| Coccidioides immitis | Systemic |
| Paracoccidiodes brasiliensis | Systemic |
| Histoplasma capsulatum | Systemic |
| Blastomyces dermatitidis | Systemic |
| Cryptococcus neoformans | Opportunistic |
| Candida albicans | Opportunistic |
| Aspergillus fumigatus, Aspergillus flavus, Aspergillus niger | Opportunistic |
| Mucor species | Opportunistic |
| Pneumocystis carinii | Opportunistic |
Morphology
| Fungi (memorize) | Morphology (memorize) |
|---|---|
| Malassezia furfur | Dimorphic: “spaghetti n’ meatballs” with KOH stain |
| Microsporum species, Trichophyton species, Epidermophyton fluccosum | Branched hyphae with KOH; secretes keratinase |
| Sporothrix schenckii | Temp sensitive dimorphic; found on rose thorns; silver stain or KOH |
| Coccidioides immitis | Temp sensitive dimorphic; inhaled from soil in desert areas of SW USA |
| Paracoccidiodes brasiliensis | Temp sensitive dimorphic; inhaled from soil in Latin America |
| Histoplasma capsulatum | Temp sensitive dimorphic; silver stain; intracellular; inhaled from bird droppings in Mississippi river valley |
| Blastomyces dermatitidis | Temp sensitive dimorphic; silver stain; inhaled form soil in Mississippi river valley |
| Cryptococcus neoformans | Yeast with thick polysaccharide capsule; India-Ink stain; inhaled from pigeon droppings |
| Candida albicans | Yeast and pseudohyphae: “spaghetti n’ meatballs”; normal skin, GI and mouth inhabitant; KOH or silver stain |
| Aspergillus fumigatus, Aspergillus flavus, Aspergillus niger | Branching hyphae ; inhaled from environment |
| Mucor species | Molds in soil ; branching hyphae |
| Pneumocystis carinii | Classified as a yeast from molecular analysis, but clinically considered a protozoa; silver stain |
Clinical
Sporothrix schenckii -> Sporotrichosis
Coccidioides immitis -> Coccidioidomycosis
Paracoccidiodes brasiliensis -> Paracoccidioidomycosis
Histoplasma capsulatum -> Histoplasmosis
Blastomyces dermatitidis -> Blastomycosis
Cryptococcus neoformans -> Cryptococcosis
Candida albicans -> Candidiasis
Aspergillus fumigatus, Aspergillus flavus, Aspergillus niger -> Aspergillosis
Mucor species -> Mucormycosis
Pneumocystis carinii -> Pneumocystis carinii pneumonia (PCP)
| Fungi (memorize) | Clinical (memorize) |
|---|---|
| Malassezia furfur | Pityriasis versicolor: Hypo or hyper pigementation of skin |
| Microsporum species, Trichophyton species, Epidermophyton fluccosum | Dermatophytosis: Tineas: corporis (ringworm), cruris, pedis, capitis, ungium |
| Sporothrix schenckii | Ulcerating nodules along lymphatic tracts |
| Coccidioides immitis | Asymptomatic; pneumonia; disseminated |
| Paracoccidiodes brasiliensis | Asymptomatic; pneumonia; disseminated |
| Histoplasma capsulatum | Asymptomatic; pneumonia; disseminated |
| Blastomyces dermatitidis | Asymptomatic; pneumonia; disseminated |
| Cryptococcus neoformans | Meningitis; pneumonia; skin lesions |
| Candida albicans | Normal host: Thrush, vaginitis, diaper rash; Compromised host: esophageal candidiasis; disseminated |
| Aspergillus fumigatus, Aspergillus flavus, Aspergillus niger | Allergic reactrion; aspergilloma (fungus ball); invasive; aflatoxin |
| Mucor species | Rhinocerebral disease; pulmonary |
| Pneumocystis carinii | PCP: Common in late stage AIDS patients |
Treatment
| Fungi (memorize) | Treatment (memorize) |
|---|---|
| Malassezia furfur | Dandruff shampoo (selenium sulfide), Topical imidazole |
| Microsporum species, Trichophyton species, Epidermophyton fluccosum | Imidazole, Griseofulvin |
| Sporothrix schenckii | KI, Amphotericin B, Itraconazole |
| Coccidioides immitis | Amphotericin B, Fluconazole |
| Paracoccidiodes brasiliensis | Itraconazole |
| Histoplasma capsulatum | Itraconazole, Ketoconazole, Amphotericin B |
| Blastomyces dermatitidis | Itraconazole, Ketoconazole, Amphotericin B |
| Cryptococcus neoformans | Amphotericin B, Fluconazole |
| Candida albicans | Fluconazole, Ketoconazole, Amphotericin B |
| Aspergillus fumigatus, Aspergillus flavus, Aspergillus niger | Amphotericin B, Surgery, Corticosteroids |
| Mucor species | Amphotericin B, Surgery |
| Pneumocystis carinii | TMP-SMX |
