MICROBIOLOGY

Introduction to Mycology M05L03

Dr. Pacifico Eusebio Calderon Feb 15, 2018

Outline Dematiaceous fungi

I. Objectives Fungi whose cell walls contain melanin, which imparts a brown to
II. Terms and Definition
III. Fungi black pigment
a. Overview
b. Comparison of Fungi and Bacteria Dimorphic fungi
c. Fungal Structure
d. Fungal Pathogenesis Fungi that have two growth forms, such as a mold and a yeast,
e. Fungal Toxins and Allergies
f. Laboratory Diagnosis of Fungi
which develop under different growth conditions (eg, Blastomyces
IV. Classification of Fungi dermatitidis forms hyphae in vitro and yeasts in tissue)
a. Superficial
b. Cutaneous
c. Subcutaneous Hyphae
d. Endemic Tubular, branching flaments (2–10 μm in width) of fungal cells, the
e. Opportunistic
V. Pharmacology mold form of growth. Most hyphal cells are separated by porous
cross-walls or septa, but in the Order Mucorales, the hyphae are
PPT, Transer Notes, Book (red box), Keywords (broken box) characteristically sparsely septate. Vegetative or substrate hyphae
anchor the colony and absorb nutrients. Aerial hyphae project above
Objectives the colony and bear the reproductive structures.
 Review the basic morphology of fungi
Anamorph
o Hyphae
The mitotic or asexual reproductive state of a fungus. Anamorphic
o Yeast
fungal taxa are identifed on the basis of their asexual reproductive
o Dimorphism
structures (ie, mitospores)
 Discuss the basic biochemistry of fungal structures vs other
organisms Mold
 Discuss the basic mechanisms of antifungal therapy
Hyphal or mycelial colony or form of growth

Terms and Definitions Mycelium

Terms that you must read especially mga nakared para hindi Mass or mat of hyphae, mold colony
masyado alien yung mga words at para narin sa use to sa future
lessons. Lifted all from jawetz to mga terms and definition Teleomorph
The sexual reproductive state of a fungus, which involves
Budding plasmogamy, karyogamy, and meiosis
A common mode of asexual reproduction, typical of yeasts. During
mitosis, the parent cell wall protrudes outwardly and enlarges to Pseudohyphae
form a nascent bud that contains the progeny nucleus. A fungal cell Chains of elongated buds or blastoconidia; the septations between
may produce single or multiple buds. cells are constricted

Conidia Septum
Asexual reproductive structures (mitospores) produced either from Hyphal cross-wall, typically perforated
the transformation of a vegetative yeast or hyphal cell or from a
specialized conidiogenous cell, which may be simple or complex Sporangiospores
and elaborate. Conidia may be formed on specialized hyphae, Asexual structures characteristic of the Order Mucorales; they are
termed conidiophores. Microconidia are small, and macroconidia mitotic spores produced within an enclosed sporangium, often
are large or multicellular. supported by one sporangiophore

Arthroconidia (arthrospores) Spore

Conidia that result from the fragmentation of hyphal cells A specialized propagule with enhanced survival value, such as
resistance to adverse conditions or structural features that promote
Blastoconidia (blastospores) dispersion. Spores may result from asexual (eg, conidia,
Conidia that are produced by budding (eg, yeasts) sporangiospores) or sexual reproduction.

Chlamydospores (chlamydoconidia) Sexual spores

Large, thick-walled, usually spherical conidia produced from During sexual reproduction, haploid cells of compatible strains mate
terminal or intercalary hyphal cells through a process of plasmogamy, karyogamy, and meiosis.

Phialoconidia Ascospores
Conidia that are produced by a “vaseshaped” conidiogenous cell In the Phylum Ascomycota, following meiosis, four to eight
termed a phialide (eg, Aspergillus fumigatus) meiospores form within an ascus.

Transcribed by: Adriano, JD Checked by:DMG Page 1 of 8

MICROBIOLOGY INTRODUCTION TO MYCOLOGY M05 L03

Basidiospores Fungal Structure

In the Phylum Basidiomycota, following meiosis, four meiospores  Two basic forms
usually form on the surface of a specialized structure, a club-shaped o Yeast – single cells, budding
basidium. o Molds – Hyphae and mycelia, mitosis
 Mycelium is a mass or group of hyphaes
Zygospores  Transverse walls – Septate hyphae
In the Order Mucorales, following meiosis, a large, thick-walled  Multinucleated – Nonseptate hyphae
zygospore develops.  Thermal dimorphism
o Room temp (25C-27C) – MOLDS
Yeast o 37C-40C : YEAST
Unicellular, spherical to ellipsoid (3–15 μm) fungal cells that o If nakainfection ka ng fungi sa katawan? Ano expected mo
usually reproduce by budding YEAST OR MOLD? Syempre YEAST dahil body temp
ang katawan natin (37C)
Fungi o If magcuculture ka sa room temp ano expected mo?
Overview Syempre MOLDS. Isipin mo na lng mga nangyayari sa
 Eukaryotic tinapay or sa kape nagkakaroon ng molds
o True nucleus
o 80S ribosomes Fungal Pathogenesis
o Mitochondria  Two types of host response
 Complex carbohydrate cell walls o Granulomatous
o Chitin o Pyogenic response
o Glucan  Some can be detected by using skin test for delayed
o Mannan hypersensitivity reaction
 Ergosterol
o Similar to human cholesterol and one of the main target of Fungal Toxins and Allergies
antifungal therapy  Amanita mushrooms
o If gagamit ka ng drug gagamit sa ergosterol malilito siya o Amanita phalloides (mukang penis
dahil hindi alam kung saan magbibind kung sa fungi ba or sabi ni doc)
sa human ba sooo sideffect niya ay cytotoxicity. o Liver necrosis due to this toxins
o Major membrane sterol  Amanitin
o Imidazole antifungals – inhibit ergosterol synthesis  Phylloidin
o Polyene antifungals – bind more tightly to ergosterol  Aspergillus flavus
than cholesterol o Ingestion of contaminated peanuts and grains causes liver
 Heterotrophic nutrition cancer due to aflatoxin (can cause p53 mutations)
o Require organic carbon  Aspergiullus fumigatus
o Saprophytic or saprobic – living on dead organic o Inhalation of the spores causes
material (D.O.M)  Allergic bronchopulmonary aspergillosis (IgE-
o Parasitic – fungus living on another living organism mediated)

Comparison of Fungi and Bacteria Laboratory Diagnosis of Fungi

 Microscopy of KOH preparation
Feature Fungi Bacteria o 3% potassium hydroxide (from doc cocoy), 10-20% from
the book
Nucleus Eukaryotic Prokaryotic
o Dissolves human cells, allowing visualization
Mitochondria and  Scrape the lesion  Prepare wet mount  add
Present Absent
ER KOH
 Pagdinisolve ang human cells, ano matitira?
Cell membrane
Present Absent Syempre fungi na lng
sterols  Can appear as colorless / hyaline appearance
Cell wall content Chitin Peptidoglycan  Can also appear as Dematiaceous fungi so can
appear as olive green or brownish in color (copper
Spores Reproduction Survival
or bronze color)
Dimorphism Yes No  Sabouraud’s agar
Aerobic or o Ano meron sa agar na to?
Metabolism Aerobic
Anaerobic  Glucose
 Modified peptone (pH 7.0)
o Low pH (acidic) inhibits the growth of bacteria
 Iinhibit mo growth ng bacteria para ang fungi na
lang tutubo sa agar na yun 
 DNA probes for early infection

Transcribed by: Adriano, JD Checked by: DMG Page 2 of 8

MICROBIOLOGY INTRODUCTION TO MYCOLOGY M05 L03

 Test for fungal antigens or antibodies to fungal antigens Eto yung mga classification ng mga mycoses pero overview lng to
 familiarize niyo lng  Sa ibang topic nakafocus mga
Key Fungal Structures Observed in Microscopic Examination classification na to 
of Clinical Specimens
Good to know naman to pero alamin niyo na rin baka magtanong si Superficial Mycoses
doc dito. Baka bigyan tayo ng clinical case na morphology lang  Tinea versicolor
ibibigay tapos kung anong causative agent or specie yun  o “an-an”
o Superficial skin infection of cosmetic importance
Predominant morphology Mycoses o Hypopigmented areas
o Spaghetti and meatballs appearance on 10% KOH
“BHPPS”
 Hyphae yung mga spaghettttti
Blastomycosis
 Yung mga spores (bilog) ay ang mga meatballs
Yeast – single or multiple Histoplasmosis
 Ano appearance pag mas marami ang hyphae kesa
buds Paracoccidiodomycosis
sa spores? BACON AND EGG APPEARANCE 
Penicilliosis
Sporotrichosis

Yeast with capsules Cryptococcosis

Hyalohyphomycosis
 Aspergillus
Hyphae – septate  Fusarium
 Geotrichum
 Trichosporon

Hyphae – septate in skin or Cutaneous Mycoses

Dermatophytosis
nail specimens
Dermatophytoses
Mucormycosis  Aka Ring Worms
 Rhizopus o Mga “buni”
Hyphae – nonseptate
 Lictheimia o Can be found in skin, hair or nail
 Cunninghamella o Infect only superficial keratinized structures
Phaehyphomycosis  3 important dermatophytes
 Bipolaris o Microsporum canis
Hyphae – septate o Trichophyton tonsurans
 Cladosporium
Brownish cell walls o Epiermophyton floccosum
 Curvularia
 Exserohilum  Transmission
o Direct contract
Candidiasis - Species of o Dogs
Yeast and Pseudohyphae
candida o Cats

Yeast and Hyphae in skin Spectrum of Disease

Pityriasis versicolor
scraping  Tinea pedis (athlete’s foot)
 Tinea ungium
Spherules Coccidiomycoses  Tinea corporis
 Tinea cruris (jock itch)
Sclerotic cells  Tinea manum
Chromoblastomycosis
Brownish cell walls  Tinea capitis
 Tinea barbae

Sulfur granules Mycetoma

Subcutaneous Mycoses

Arthroconidia in hair Dermatophytosis Sporothrix schenickii

Conidia in pulmonary cavity
Cysts (asci) in pulmonary
specimens
o Dimorphic fungus that lives on
Hyalohyphomycosis vegetation
 Aspergillus o Occurs most often in gardeners,
 Fusarium especially those who prune roses
o Transmission: Thorn Pick
o AKA known as Rose Gardeners
Pneumocystis
disease

Transcribed by: Adriano, JD Checked by: DMG Page 3 of 8

MICROBIOLOGY INTRODUCTION TO MYCOLOGY M05 L03

Endemic Mycoses
ENDEMIC MGA TO SA AMERICA  take note mga morphology
and location kung saan siya endemic 

Coccidioides immitis
 Arthrospores form spherules filled with endospores
 Granulomata in bones and CNS
 Dissemination in those who have defective Cell-mediated
immunity
 Morphology
o Spherules – Long Arrow Paracoccidioides brasiliensis
o Endospores (mga babies) – short arrow  Endemic in Latin America
o Mukang bayabas or atis o Kung pilinas ay Tuberculosis and Latin America naman
ay paracoccidiodies 
 Infect mostly MEN why mga babae hindi? Study shown
meron biologically inhibitory effect dabil sa female hormones
and depende na rin sa hormonal status
 AKA MAN-HATER FUNGUS
 Chronic pneumonia
 Painful ulcers on mouth and nose
 Morphology
o YEAST yung malaking bilog, BUD yung mga extension
mga bilog
o Ung mga buds (depende sa rami)
 Pag multiple muka siya sailor’s wheel / ship’s
wheel
Histoplasma capsulatum  Pag 1 lang yung yeast at 2 buds muka na siya si
 Endemic in North America and associated with pigeons or bat MICKEY MOUSE
exposure
 Inhaled microconidia develop into budding yeast inside
macrophages
 Spreads to liver and spleen
 Dissemination in those who have defective CMI
 Morphology
o Intracellular yeast (yeast inside macrophages)

Opportunistic Mycoses
AKA: Systemic Mycoses
Pagsinabing opportunistic tandaan niyo malas madalas makukuwa
mo siya pagmahina immune system mo like kung may HIV ka na
meron CD4 count na <200 cells/uL. Usually resistant mga
immunocompetent dito pero hindi lagi ahhhh.

Candida albicans
 Immunocompromised
o Oral thrush
Blastomyces dermatidis o Vulvovaginitis – curd-like discharge
 Chronic pneumonia o Intertrigo
 Ulcerated granulomas o Skin infections – satellite lesions
 Lytic bone lesions (osteomyelitis) o Onychomycosis
 Prostatitis
 Morphology
o Bud looks like a snowman or figure of “8”
o Yeast with a broad-based bud

Transcribed by: Adriano, JD Checked by: DMG Page 4 of 8

MICROBIOLOGY INTRODUCTION TO MYCOLOGY M05 L03

 Immunocompromised
o Esophagitis
o Subcutaneous nodules
o Right-sided endocarditis Rhizopus oryzae and Mucor spp.
 Mucormycosis
o Saprophytic molds with nonseptate hyphae with walls and
branches at right angles
o Rhino-orbital-cerebral infection with eschar formation
o Patients with diabetic ketoacidosis, burns, or leukemia

Candida esophagitis

 Spectrum of disease
o Asymptomatic Lung Infection
o Meningitis
o Encephalitis
o For HIV : most common cause of meningoencephalitis
 Morphology Pharmacology
o Yeast – yung gitnang gitna Alam ko ayaw niyo to pero kailangan parin alamin sabi ni doc cocoy
and doc asdala  niligay ko na rin dito yung topic from pharma 
o Stain used: Black nigrosin stain
alamin niyo especially yung MOA and side effect mga drug 
 So ano istatain mo dito? Yung yeast or yung
background? Syempre BACKGROUND na lng mas
mahirap kasi istain ang yeast mismo  soooo
negative stain siya :)
 Technique called: India Ink stain (negative stain)

Aspergillus fumigatus
 Infections
o Wounds Rundown of antifungals
o Burns
 Drug that directly affect the cell membrane ergosterol
o Cornea
o Like sa sinabi ko kanina hindi siya nagspecifically
o External Ear
nagbibind sa fungi ergosterol mismo pwede rin sa human
o Sinuses
so common S/E is nephrotoxicity
 Aspergilloma (fungus ball) in lung cavities o Amphoterecin
 Allergic bronchopulmonary aspergillosis (ABPA) o Common side effect: Nephrotoxicity
o Asthmatic symptoms with expectoration of brownish o DOC : Systemic Fungal Infection
bronchial plugs
 Drug that inhibits ergosterol synthesis
o Azoles
o Terbinafine

Transcribed by: Adriano, JD Checked by: DMG Page 5 of 8

MICROBIOLOGY INTRODUCTION TO MYCOLOGY M05 L03

o Naftifine o Rash
o Amorolifine o Hepatotoxicity
 Drug that inhibits cell wall synthesis o Drug interactions
o Echinocandins  Narrow antifungal spectrum
 Drug that inhibits microtubules  inhibit mitosis  inhibit  Potent CYP450 inhibitor
cell division  Limited to topical use because of systemic toxicity
o Griseofuluin
 Drug that Inhibit DNA synthesis Itraconazole
o Flucytosine  Drug Class: Antifungal (azole)
 MOA: Fungistatic
Drugs for Systemic Fungal Infections o Inhibitis fungal P450-dependent enzymes blocking
ergosterol synthesis
Amphotericin B  Clinical use
 Drug Class: Antifungal (polyene) o Blastomycosis
 MOA: Fungicidal o Sporotrichosis
o Binds to ergosterol in fungal cell membranes, alters o Dermatophytosis
permeability by forming artificial pores. The pore allows o Chromoblastomycosis
leakage of intracellular ions and macromolecules, o Alternative for infection due to
eventually leading to cell death  Aspergillus
 Clinical Use  Coccidiodies
o Systemic fungal infections  Cryptococcus
 Histoplasma
 Toxicities
o Infusion reactions  Toxicities
 Chills o GI disturbance (vomiting diarrhea)
 Fever o Rash
 Muscles spasms o Hepatotoxicity
 Hypotension
Caspofungin
 Vomiting
 Headache  Similar Drugs: Anidulafungin, micafungin
o Nephrotoxicity (RTA with magnesium and potassium  Drug Class: Antifungal (Echinocandin)
wasting)  MOA: Inhibit B-glucan synthase decreasing fungal cell wall
 Produced by sterptomyces nodosus synthesis
 Clinical Use
Flucytosine o Disseminated and mucocutaneous candidiasis
 Drug Class: Antifungal (Pyrimidine antimetabolite) o Salvage therapy for invasive aspergillosis
 MOA: Fungistatic o Empiric therapy during febrile neutropenia
o Accumulated in fungal cells by the action of permease and  Toxicities
converted by cytosine deaminase to 5-FU, which inhibits o Headache
thymidylate synthase o GI distress
 Clinical Use o Fever
o Cryptococcosis o Rash
o Systemic Candidal Infections o Flushing (histamine release)
o Chromoblastomycosis o Elevated liver enzymes
 Toxicities
o Myelosuppresion Systemic Drugs for Superficial Mycoses
o Alopecia
o Hepatotoxicity Griseofulvin
o Selective toxicity occurs because mammalian cells have  Drug Class: Antifungal (azole)
low levels of permease and deaminase  MOA: Fungistatic
o Interferes with microtubule function. Inhibits synthesis
Ketoconazole and polymerization of nucleic acid
 Drug Class: Antifungal (azole)  Clinical Use
 MOA: Fungistatic o Dermatophytosis
o Inhibits fungal P450-dependent enzymes blocking  Toxicities
ergosterol synthesis o Headache
 Clinical Use o Mental confusion
o Chronic mucocutaneous candidiasis o GI irritation
o Dermatophytosis o Photosensitivity
 Toxicities o Hepatotoxicity
o GI disturbance (vomiting diarrhea) o Disulfiram reaction

Transcribed by: Adriano, JD Checked by: DMG Page 6 of 8

MICROBIOLOGY INTRODUCTION TO MYCOLOGY M05 L03

 Acculumates in keratin
 Potent CYP450 inducer
 C/I in poyphyria

Terbinafine
 Drug Class: Antifungal
 MOA: Fungicidal
o Interfere with ergosterol synthesis by inhibiting fungal
squalene epoxidase
 Clinical Use
o Dermatophytosis
o Onychomycosis
 Toxicities
o GI upset
o Rash
o Headache
o Taste Disturbances
 Accumulates in keratin
 Synthetic allylamine

Topical Drugs for Superficial Fungal Infections

Nystatin
 Drug Class: Antifungal (polyene)
 MOA: Fungicidal
o Binds to ergosterol in fungal cell membranes, forming
artificial pores
 Clinical Use
o Candidiasis (Oropharyngeal, Esophageal, Vaginal)
 Toxicities
o Nephrotoxicity (severe)
 Minimal Mucocutaneous absorption
 Available as swish and swallow preparation
 Available in creams, ointments, suppositories

Clotrimazole
 Similar Drugs: Miconazole, Ketoconazole
 Drug Class: Antifungal (azole)
 MOA: Fungistatic
o Inhibit fungal P450-dependent enzymes blocking
ergosterol synthesis
 Clinical Use
o Mucocutaneous Candidiasis
o Dermatophytosis
o Seborrheic dermatitis
o Pityriasis versicolor
 Toxicities
o None significant when administered topically
 Limited to topical use because of systemic toxicity

Reference
 Dr Cocoy PPT
 Jawetz Microbiology 27th ed.
 Antifungal Pharma Trans (Batch 2020)

Transcribed by: Adriano, JD Checked by: DMG Page 7 of 8

MICROBIOLOGY INTRODUCTION TO MYCOLOGY M05 L03

Appendix

Transcribed by: Adriano, JD Checked by: DMG Page 8 of 8