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Dimorphic Fungi

Slow growing fungi that grow as molds at 25-30 and yeast at 35-37 (human body temperature)
The commonly considered dimorphic fungi include:

Sporothrix schenckii
Histoplasma capsulatum
Blastomyces dermatitidis
Paracoccidioides brasiliensis
Coccidioides immitis
Penicillium marneffei

Of special concern, thermally dimorphic fungi can be dangerous to culture in routine

microbiology laboratory settings. Some laboratories recommend transferring young mold
colonies from petri dishes to slants as soon as they appear, limiting the chance of Coccidioides
arthrospore formation and laboratory worker exposure should C. immitis be cultured (Al-Doory
1980). The slow growth and nonspecific gross appearance of these fungi complicate diagnosis.
The following fungi may be confused:
Dimorphic Fungi Mistaken Fungi
Histoplasma capsulatum Chrysosporium
Blastomyces dermatitidis
Sporothrix schenckii Cephalosporium (Acremonium)
Scedosporium apiospermum
Blastomyces dermatitidis

Histoplasma capsulatum: Direct Examination

Small budding yeast
Relatively uniform in size, ranging from 3-5
Single bud attached at narrow base
Often present extracellularly or within macrophages

Histoplasma capsulatum
Hyphal colonies (25-30) appear nondescript, white or slightly pink or brown on
Sabouraud. dextrose agar, and cobweb-like. Mold colonies may be moist and white on
brain heart infusion agar; yeast colonies may be small and yellow on 5% sheep blood
Colonies grow slowly
Several generations of culture may be necessary to convert hyphal form to yeast form
Cyclohexamide inhibits the yeast form
Tuberculate macroconidia and microconidia observed
Sepedonium species must be considered

FIG. 1. Histoplasma in slide culture. Arrows

indicate good examples of tuberculate

FIG. 2. Histoplasma in slide culture. Macroconidia

and microconidia are present here.

Coccidioides immitis
Colonies grow moderately rapidly
Mold colonies on 5% sheep blood agar are typically gray-white, and have a delicate, hair-
like texture; on Sabouraud. dextrose agar colonies evolve from moist, membranous gray
appearance to white and cottony with the appearance of aerial mycelium. Colonies often
darken with age. The reverse is gray or white
Yeast colonies (35-37) may take several generations to obtain and appear moist and
white on brain heart infusion agar
Cyclohexamide inhibits yeast forms
In tissue, large, irregularly sized thick walled spherules ranging in size from 10-50 to as
much as 10-200 are characteristic
Spherules contain small, round endospores (2-4 ) which may be confused with
FIG. 1. High power photomicrograph of
Coccidioides immitis in lung tissue, H&E.

Sporothrix schenckii

Subcutaneous mycosis; found world-wide

Rose gardener's disease
Mold colonies mature rapidly and are white to yellow, wrinkling and folding with
Microscopically hyphae are delicate with small, unicellular, oval to round microconidia
(2-6) developing laterally along hyphae in a sleeve-like pattern
Yeast forms vary in size and shape but may be round, oval, and fusiform; budding forms
are seen

FIG. 1. Sporothrix in slide culture. Note the sleeve-

like way that microconidia cling to the hyphae.
Penicillium marneffei

Endemic in southeast Asia, P. marneffei is known to cause a wide variety of disease

among immunocompromised and, less frequently, immunocompetent patients.
Hyphal colonies appear rapidly and white-tan, velvety, and flat, although distinct spicules
of growth may protrude from the surface of the culture. Red soluble pigment is noted in
maturing colonies, although this finding is not specific for P. marneffei.
The mold form (grown at 25-30) resembles an otherwise typical Penicillium, with
septate hyphae and smooth generally smooth conidia aloft phialides which in turn are
borne by metulae. The conidiophore typically carries 4-5 metulae, each of which bears 4-
6 phialides.
The yeast form (grown at 35-37) are round to oval and are 3-7 in diameter; yeast
reproduce by fission rather than budding.

FIG. 1. Penicillium marneffei yeast form. An

arrow indicates a yeast cell reproducing by fission.

FIG. 2. Penicillium marneffei in slide culture. The

mold form resembles other Penicillium species.

Return to Medically Important Fungi

Copyright 2001, William McDonald, M.D.
Revised: 5 September 2002