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Micro-2|Midterm
Macroscopic morphology:
o slow growth
o white to beige
o colony glabrous, folded or velvety
Microscopic morphology:
o typical budding yeast with
multipolar budding at the
periphery, resembling a mariners
wheel.
o daughter cells are connected by a
narrow base.
o many buds of various sizes can
occur, or there may be only a few
buds giving the mickey mouse
cap to the yeast cell.
Yeast form: Multiple blastoconidia,
budding from single, large yeast
Blastomyces dermatitidis
Blastomycosis
o most prevalent in middle-aged
men, as are other systemic
mycoses, presumably because of
mens greater occupational and
recreational exposure to the soil.
o Primary infection flulike
symptoms
o Pulmonary dse cough, weight
loss, chest pain, and fever
o Progressive
Pulmonary/invasive disease
ulcerative lesions of the skin and
bone.
o aka Gilchrist dse, N.American
blastomycosis, Chicago dse.
Teleomorph: Ajellomyces dermatitidis
This teleomorph does not occur in routine
laboratory because the species is
heterothallic.
Macroscopic morphology:
o slow to moderate growth
o white to dark tan
o Young colonies tenacious
Micro-2|Midterm
Micro-2|Midterm
system dse (patients have been
identified as IV drug users)
found in the environment and have a
predilection for cellulose products
o they have been known to
devastate printed literature and
library holdings and have been
associated with indoor air quality
problems
Cladosporium
an infrequent cause of disease,
Cladosporium sp. are primarily recovered
as Laboratory contaminants
infections are typically confined to the
sinuses or following traumatic inoculation
ubiquitous in nature, this isolate can be
recovered from nearly any location in the
world.
Curvularia
most often implicated in chronic
sinusitis in immunocompetent patients
this fungus is frequently recovered from
grass, leaves, and decaying
vegetations
multicelled conidia are produced on
sympodial conidiophore
Agents of Yeast Infections
These are caused by fungi that usually do not
induce dse and occur almost exclusively in
immunocompromised patients who are often
on treatment with corticosteroids, cytotoxic
drugs, or other immunosuppressive drugs.
Candidiasis
Cryptococcus (Torulosis, European
blastomycosis)
Rhodotorula
Pneumocystis
Candida albicans
Yeast endogenous to our mucous
membrane normal flora
form germ tubes at 37C in serum
form pseudohyphae and true hyphae
when it invades tissues (nonpathogenic
Candida do not)
Diseases/Predisposing conditions:
o Perleche crevices of
mouth/malnutrition
o Oral thrush
o Esophagitis
o Septicemia
o Endocarditis
o Cutaneous infections
o Yeast vaginitis
o Chronic mucocutaneous candidiasis
Diagnosis:
Micro-2|Midterm
X-ray: patchy infiltrative (ground
glass appearance), the lower
lobe periphery may be spared.
COLLECTION, TRANSPORT, AND CULTURING
OF CLINICAL SPECIMENS
Cultivation
Requirements:
1. A battery of media must be used with the
ff. recommendations:
a. Media w/ or w/out blood
enrichment
b. Media w/ or w/out cycloheximide
2. Cultures should be incubated at 30C at
40-50% relative humidity for 30 days
before discarding as negative.
Fungal Culture Media: Primary Recovery
Media
a. BHIA 25C, systemic, yeast phase
b. BHIA w/ antibiotics for dermatophytes
c. BHIA w/ biphasic blood culture bottles
yeast phase, systemic fungi, 35C
d. Dermatophyte Test Medium (DTM)
screening medium for dermatophytes (red
color); indicator: phenol red
e. Inhibitory Mold Agar (IMA) primary
recovery of fungi; dermatophytes
f. Mycosel or Mycobiotic Agar primary
recovery of fungi; dermatophytes
a. Chloramphenicol inhibit
bacteria
b. Cycloheximide inhibit saprobes
g. SABHI agar (Saborauds Dextrose &
Brain Heart Infusion Agar) for
B.dermatitidis and H.capsulatum
h. Saborauds Dextrose Agar (SDA or
SAB) has thiamine, maintenance of
fungal culture
i. Yeast-Extract Phosphate Agar for
pathogenic fungi; H.capsulatum,
B.dermatitidis and C.immitis, except
dermatophytes
Fungal Culture Media: Special Purpose
Media
a. Ascospore Agar determine ascospores
b. Cornmeal Agar Chlamydospores
(C.albicans)
a. 1% glucose differentiate
T.rubrum and T.mentagrophytes
c. Cornmeal Agar w/ Tween 80 and
Trypan blue C.albicans (Chlamydospore
production)
d. Cottonseed Conversion Agar convert
dimorphic fungus from mold to yeast form
o