MIKOSIS

dr. Wilda Mahdani

Bgn Mikrobiologi FK-USK
•Jamur  tumbuhan tidak
berklorofil, bersifat
heterotrof, eukarotik.
•Terdiri dari benang-benang ;
hifa, hifa dapat membentuk
anyaman bercabang-cabang
yang disebut miselium.
•Reproduksi jamur, ada yang
dengan cara vegetatif ada
pula dengan cara generatif.
Klasifikasi
1. MYXOMYCOTINA (Jamur lendir)
2. OOMYCOTINA
3. ZYGOMYCOTINA
4. ASCOMYCOTINA
5. BASIDIOMYCOTINA
6. DEUTEROMYCOTINA (jamur tidak
sempurna)
Candidiosis
Kingdom: Fungi
Phylum: Ascomycota
Subphylum: Saccharomycotina
Class: Saccharomycetes
Order: Saccharomycetales
Family: Saccharomycetaceae
Genus: Candida
Spesies
• C. albicans • C. kefyr
C. ascalaphidarum C. krusei
C. amphixiae C. lusitaniae
C. antarctica C. lyxosophila
C. atlantica C. maltosa
C. atmosphaerica C. membranifaciens
C. blattae C. milleri
C. carpophila C. oleophila
C. cerambycidarum C. oregonensis
C. chauliodes C. parapsilosis
C. corydali C. quercitrusa
C. dosseyi C. sake
C. dubliniensis C. shehatea
C. ergatensis C. temnochilae
C. fructus C. tenuis
C. glabrata C. tropicalis
C. fermentati C. tsuchiyae
C. guilliermondii C. sinolaborantium
C. haemulonii C. sojae
C. insectamens C. viswanathii
C. insectorum C. utilis
C. intermedia
C. jeffresii
• Candida Candida albicans
appears as
large, round,
white or cream
(albicans is
from Latin
meaning
'whitish')
colonies on
agar plates.
• Candida a commensal in our body.
• Its concentration is kept in check by our
immune system.
• Any condition which would lower our
immunity levels  Candidiasis.
• The most common of the candida family
is C. albicans.
Manifestasi Klinis
1. Rongga Mulut: Oral Thrush
2. Esophagus: Esophagitis
3. Vagina: Vaginal candidiasis
4. Skin: Cutaneous candidiasis
Faktor Predisposisi
• 1. pregnant
2. diabetic
3. obese

• 1. Poor hygiene
2. Tight jeans/undergarments
3. Prolonged use of antibiotics
4. Cuts or abrasions in the genital area
The main symptoms are:

1. Intense itching

2. Burning

3. Redness

4. White Patches
Treatment
• Yeast infections is tend to recur.
• The treatment is as simple as applying
an antifungal cream, powders,
suppositories.
• Imidazoles: miconazole, clotrimazole
TIPS
1. Maintain proper/good hygiene. Keep the area near
your vagina dry.
2. Avoid wearing tight clothes or undergarments.
3. Avoid intercourse while undergoing treatment.
Imperative to treat your partner.
4. If you are using a pessary or a diaphragm or any
such contraceptive device, then they should be
scrupulously clean.
5. Complete the full course or your treatment.
Aspergillosis
Kingdom: Fungi
Phylum: Ascomycota
Class: Ascomycetes
Order: Eurotiales
Family: Trichocomaceae
Genus: Aspergillus
 Species
• about 200, including: Aspergillus ochraceus
Aspergillus caesiellus Aspergillus oryzae
Aspergillus parasiticus
Aspergillus candidus
Aspergillus penicilloides
Aspergillus carneus Aspergillus restrictus
Aspergillus clavatus Aspergillus sojae
Aspergillus deflectus Aspergillus sydowi
Aspergillus flavus Aspergillus tamari
Aspergillus fumigatus Aspergillus terreus
Aspergillus ustus
Aspergillus glaucus Aspergillus versicolor
Aspergillus nidulans
Aspergillus niger
• Aspergillus species are highly aerobic.
• Found in almost all oxygen-rich
environments.
• Commonly, fungi grow on carbon-rich
substrates such as monosaccharides
(such as glucose) and polysaccharides
(such as amylose).
• Aspergillus species are common
contaminants of starchy foods (such as
bread and potatoes), and grow in or on
many plants and trees.
• Species of Aspergillus are important
medically and commercially.
• More than 60 Aspergillus species are
medically relevant pathogens.
• For humans there is a range of diseases
such as infection to the external ear,
skin lesions, and ulcers classed as
mycetomas.
• Other species are important in commercial
microbial fermentations.
• For example, alcoholic beverages such as
Japanese sake are often made from rice or
other starchy ingredients (like manioc), rather
than from grapes or malted barley. Typical
microorganisms used to make alcohol, such
as yeasts of the genus Saccharomyces,
cannot ferment these starches, and so koji
mold such as Aspergillus oryzae is used to
break down the starches into simpler sugars.
• Some Aspergillus species cause serious
disease in humans and animals, and
can be pathogenic.
• The most common causing invasive
disease are Aspergillus fumigatus and
Aspergillus flavus. Aspergillus flavus
produces aflatoxin which is both a toxin
and a carcinogen, and which can
potentially contaminate foods such as
nuts.
ASPERGILLOSIS
• Aspergillosis is the group of diseases caused
by Aspergillus.
• The most common subtype among paranasal
sinus infections associated with aspergillosis
is aspergillus fumigatus.
• The symptoms include fever, cough, chest
pain or breathlessness, which also occur in
many other illnesses so diagnosis can be
difficult.
In humans, the major forms of disease:
• Allergic bronchopulmonary aspergillosis or ABPA
(affects patients with symptoms that produce
significant respiratory morbidity such as asthma,
cystic fibrosis and sinusitis).
• Acute invasive aspergillosis (risk increases if patient
has weakened immunity such as some AIDS patients
and those undergoing chemotherapy).
• Disseminated invasive aspergillosis (widespread
through body).
• Aspergillosis of the air passages is also frequently
reported in birds, and certain species of Aspergillus
have been known to infect insects.
Mucormikosis
Kingdom: Fungi
Division: Zygomycota
Class: Zygomycetes
Order: Mucorales
Family: Mucoraceae
Genus: Mucor
 Species
M. amphibiorum
M. circinelloides
M. hiemalis
M. indicus
M. racemosus
M. ramosissimus
• Mucor is a genus of about
40 species of molds
commonly found in soil and
on plant surfaces, as well as
in rotten vegetable matter.
Reproduction
• During asexual reproduction, erect hyphal sporangiophores are
formed. The tip of the sporangiophore swells to form a globose
sporangium that contains uninucleate, haploid sporangiospores.
An extension of the sporangiophore called the columella
protrudes into the sporangium. The sporangium walls are easily
ruptured to release the spores, which germinate readily to form
a new mycelium on appropriate substrates.
• During sexual reproduction, compatible strains form short,
specialized hyphae called gametangia. At the point where two
complementary gametangia fuse, a thick-walled, sphaerical
zygosporangium develops. The zygosporangium typically
contains a single zygospore. Nuclear karyogamy and meiosis
(sexual recombination) occur within the zygospores, which are
thought to be long-lived and resistant to adverse conditions.
They may germinate to form hyphae or a sporangium. Mucor
includes both homothallic (self-compatible) and heterothallic
species.
Clinical significance
• Most species of Mucor are unable to
infect humans and endothermic animals
due to their inability to grow in warm
environments close to 37 degrees
Celsius.
• Thermotolerant species such as Mucor
indicus sometimes cause opportunistic,
and often rapidly spreading, necrotizing
infections known as zygomycosis.
mucor
Coccydiomikosis
Kingdom: Fungi
Division: Ascomycota
Class: Ascomycetes
Order: Onygenales
Family: Onygenaceae
Genus: Coccidioides
Presentation
• The disease is usually mild, with flu-like symptoms
and rashes
• Serious complications include severe pneumonia,
lung nodules, and disseminated disease  skin ulcers
and abscesses to bone lesions, severe joint pain,
heart inflammation, urinary tract problems,
meningitis, and often death.
• It has been known to infect humans, dogs, cattle,
livestock, llamas, apes, monkeys, kangaroos,
wallabies, tigers, bears, badgers, otters and marine
mammals.
• Symptomatic infection (40% of cases) usually
presents as an influenza-like illness with fever, cough,
headaches, rash, and myalgia (muscle pain).
Types
• Coccidioidomycosis may be divided into
the following types:
– Primary pulmonary coccidioidomycosis
– Disseminated coccidioidomycosis
– Primary cutaneous coccidioidomycosis
Diagnostic test
• Microscopic detection of diagnostic cells in
body fluids, exudates, sputum and biopsy-
tissue.
• With specific nucleotide primers C.immitis
DNA can be amplified by PCR.
• It can also be detected in culture by
morphological identification or by using
molecular probes that hybridize with
C.immitis RNA.
• Serologic analysis detecting fungal antigen or
host antibody produced against the fungus.
pengobatan
• There are no published prospective studies
that examine optimal antifungal therapy for
coccidioidomycosis Mild cases often do not
require treatment.
• PO Fluconazole and IV Amphotericin B are
used in progressive or disseminated disease,
or in which patients are
immunocompromised.
• Alternatively, itraconazole, fluconazole or
ketoconazole may be used.
Histoplasmosis
Kingdom: Fungi
Phylum: Ascomycota
Subphylum: Ascomycotina
Class: Ascomycetes
Order: Onygenales
Family: Onygenaceae
Genus: Histoplasma
• DEFINISI
Histoplasmosis adalah suatu penyakit
infeksi yang disebabkan oleh jamur
Histoplasma capsulatum, yang terutama
menyerang paru-paru tetapi kadang-
kadang bisa menyebar ke bagian tubuh
yang lain.
• Histoplasma is a genus of dimorphic
fungi commonly found in bird and bat
fecal material.
• Histoplasma contains a few species,
including—H. capsulatum—the
causative agent of histoplasmosis and
Histoplasma capsulatum var.
farciminosum (old term, Histoplasma
farciminosum), causing epizootic
lymphangitis in horses.
gEJALA
Histoplasmosis bisa ditemukan dalam 3 (tiga) bentuk:

• Histoplasmosis akut.
Pada bentuk yang akut, gejala biasanya timbul dalam
waktu 3- 21 hari setelah penderita menghisap spora
jamur. Penderita akan merasakan sakit disertai
demam dan batuk.
Gejala-gejala tersebut biasanya menghilang dalam
waktu 2 minggu tanpa pengobatan dan kadang bisa
menetap sampai selama 6 minggu.
Bentuk ini jarang bersifat fatal.
• Histoplasmosis diseminata progresif.

Tidak akan terjadi pada orang dewasa yang sehat.

Biasanya terjadi pada anak-anak dan penderita
gangguan sistem kekebalan (misalnya penderita
AIDS).
Gejala-gejalanya, sangat lambat ataupun sangat
cepat, akan bertambah buruk. Hati, limpa dan
kelenjar getah bening membesar.Kadang infeksi ini
menyebabkan ulkus (luka terbuka) di mulut dan
saluran pencernaan.
Dalam beberapa kasus, kelenjar adrenal mengalami
gangguan sehingga timbul penyakit Addison.
Tanpa pengobatan, bentuk ini 90% berakibat fatal.
Bahkan meskipun diobati, pada penderita AIDS bisa
terjadi kematian.
• Histoplasmosis kavitasi kronis.
Bentuk ini merupakan infeksi paru-paru yang timbul
secara bertahap dalam waktu beberapa minggu,
menyebabkan batuk dan kesulitan bernafas.
Gejala-gejala lainnya adalah penurunan berat badan,
malaise (merasa tidak enak badan) dan demam
ringan.
Kebanyakan penderita akan pulih tanpa pengobatan
dalam waktu 2- 6 bulan. Tetapi gangguan pernafasan
bisa bertambah buruk dan beberapa penderita
mengalami batuk darah yang kadang-kadang
jumlahnya banyak sekali. Kerusakan paru-paru atau
masuknya bakteri ke paru-paru pada akhirnya bisa
menyebabkan kematian.
• Histoplasmosis, also known as Darling's
disease, is a disease caused by the fungus
Histoplasma capsulatum. Symptoms of this
infection vary greatly, but the disease
primarily affects the lungs. Occasionally, other
organs are affected; this is called
disseminated histoplasmosis, and it can be
fatal if untreated. Histoplasmosis is common
among AIDS patients because of their
lowered immune system
Types
• Histoplasmosis may be divided into the
following types:
– Primary pulmonary histoplasmosis
– Progressive disseminated histoplasmosis
– Primary cutaneous histoplasmosis
– African histoplasmosis
DIAGNOSIS

• Diagnosis ditegakkan berdasarkan hasil

analisa biakan dari dahak, kelenjar
getah bening, sumsum tulang, hati,
ulkus di mulut, air kemih atau darah.
PENGOBATAN
• Penderita infeksi akut histoplasmosis jarang
memerlukan terapi obat.

• Infeksi disseminata progresif sering memberikan

respon yang baik terhadap pengobatan dengan
amfoterisin B intravena (melalui pembuluh darah)
atau itrakonazol per-oral (melalui mulut).

• Pada bentuk kavitasi kronik, itrakonazol maupun

amfoterisin B bisa memusnahkan jamur, walaupun
kerusakan yang disebabkan infeksi ini menetap
dibawah jaringan parut.
Blastomikosis
• Blastomycosis also known as
"Gilchrist's disease“, is a fungal infection
caused by the organism Blastomyces
dermatitidis.
• Endemic to portions of North America,
blastomycosis causes clinical symptoms
similar to histoplasmosis.
• Blastomycosis was first described by
Thomas Casper Gilchrist in 1894 and
sometimes goes by the eponym
Gilchrist's disease.
• It is also sometimes referred to as
Chicago Disease.
Signs and symptoms
Blastomycosis can present in one of the following ways:

• a flu-like illness with fever, chills, myalgia, headache, and a

nonproductive cough which resolves within days.
• an acute illness resembling bacterial pneumonia, with symptoms of
high fever, chills, a productive cough, and pleuritic chest pain.
• a chronic illness that mimics tuberculosis or lung cancer, with
symptoms of low-grade fever, a productive cough, night sweats, and
weight loss.
• a fast, progressive, and severe disease that manifests as ARDS, with
fever, shortness of breath, tachypnea, hypoxemia, and diffuse
pulmonary infiltrates.
• skin lesions, usually asymptomatic, appear as ulcerated lesions with
small pustules at the margins
• bone lytic lesions can cause bone or joint pain.
• prostatitis may be asymptomatic or may cause pain on urinating.
• laryngeal involvement causes hoarseness.
Treatment
• Itraconazole given orally is the treatment of
choice for most forms of the disease.
• Ketoconazole may also be used.
• Cure rates are high, and the treatment over a
period of months is usually well tolerated.
Amphotericin B is considerably more toxic,
and is usually reserved for
immunocompromised paitients who are
critically ill and those with central nervous
system disease.
• Fluconazole has also been tested on patients
in Canada.
Prognosis
• Mortality 0-2% in treated cases among
immunocompetent patients
• 29% in immunocompromised patients
• 40% in the subgroup of patients with
AIDS
• 68% in patients presenting as acute
respiratory distress syndrome (ARDS)
hISTOPLASMOSIS
• Infection occurs by inhalation of the fungus
from its natural soil habitat.
• Once inhaled in the lungs, they multiply and
may disseminate through the blood and
lymphatics to other organs, including the
skin, bone, genitourinary tract, and brain.
• The incubation period is 30 to 100 days,
although infection can be asymptomatic.
• Diagnosis
• Once suspected, the diagnosis of blastomycosis can usually
be confirmed by demonstration of the characteristic broad
based budding organisms[4] in sputum or tissues by KOH prep,
cytology, or histology. Tissue biopsy of skin or other organs may
be required in order to diagnose extra-pulmonary disease.
Commercially available urine antigen testing appears to be quite
sensitive in suggesting the diagnosis in cases where the
organism is not readily detected. While culture of the organism
remains the definitive diagnostic standard, its slow growing
nature can lead to delays in treatment of up to several weeks.
• However, sometimes blood and sputum cultures may not detect
blastomycosis; lung biopsy is another option, and results will be
shown promptly.
Blastomikosis Kulit
Cryptococcosis
Kingdom: Fungi
Phylum: Basidiomycota

Subphylum: Basidiomycotina

Order: Sporidiales

Family: Sporidiobolaceae

Genus: Filobasidiella (Cryptococcus)

Species: Filobasidiella neoformans

(Cryptococcus neoformans)
• Kriptokokus (Cryptococcus) adalah
suatu genus fungi.
• Kriptokokus tumbuh di biakan sebagai
khamir.
• Bentuk sempurna (seksual) atau
teleomorph disebut Filobasidiella,
tetapi bentuk tidak sempurna (aseksual)
atau anamorph disebut Cryptococcus.
• Nama Cryptococcus tidak benar ketika
digunakan pada konteks medis karena bentuk
tidak efektif adalah bentuk tidak sempurna.
• Cryptococcus neoformans adalah spesies
yang paling penting secara medis.
• Cryoptococcus neoformans diketahui
menyebabkan beberapa bentuk meningitis
dan meningo-ensefalitis pada orang yang
terinfeksi HIV dan AIDS.
 deep
MIKOSIS
SPOROTRIKOSIS
• Sporotrikosis adalah infeksi yang disebabkan
oleh Sporothrix schenckii.
• Biasanya menyerang kulit dan pembuluh
getah bening di sekitarnya, kadang-kadang
mengenai paru-paru dan jaringan lainnya.
• Jamur ini sering ditemukan di semak-semak
bunga mawar, barberi, lumut sfagnum dan
jerami; sehingga yang sering terkena adalah
petani, tukang kebun dan holtikulturis.
GEJALA
• Infeksi kulit dan pembuluh getah bening di sekitarnya, biasanya
dimulai pada jari-jari tangan dengan nodul (benjolan) kecil-
kasar yang secara perlahan membesar dan membentuk sebuah
luka.

• Setelah beberapa hari atau minggu, infeksi menyebar melalui

pembuluh getah bening di tangan dan lengan menuju ke
kelenjar getah bening, membentuk nodul-nodul dan luka.
Biasanya penderita tidak mengalami gejala yang lainnya.

• Infeksi paru-paru dapat menimbulkan pneumonia, dengan nyeri

dada ringan dan batuk, biasanya terjadi pada penderita penyakit
paru-paru seperti emfisema.

• Infeksi juga bisa mengenai tulang, sendi, otot atau mata. Dan
kadang menyerang limpa, hati, ginjal, alat kelaminl atau otak.
DIAGNOSIS
• Diagnosis ditegakkan berdasarkan ditemukannya
Sporothrix pada biakan jaringan yang terinfeksi.

PENGOBATAN
Infeksi pada kulit biasanya menyebar sangat lambat
dan jarang berakibat fatal.
Pengobatannya adalah dengan itrakonazol per-oral
(melalui mulut). Bisa juga diberikan kalium-yodida
per-oral, tapi tidak efektif dan menimbulkan efek
samping seperti ruam dan peradangan mata, mulut
dan tenggorokan.
Untuk infeksi yang meluas, diberikan amfoterisin B
intravena (melalui pembuluh darah).
Kromomikosis
• Chronic fungal infection by 6 species,,,the most
common being Fonsecaea pedrosoi.

Clinical Features
• Chronic fungal infection
• Scaly papule initially:
– often following superficial trauma
– slowly expands into verrucous nodule or plaque
• Location:
– usually distal extremities:
• generally: lower legs
• Rarely:
– dissemination with:
• generalized cutaneous lesions
• lymphangitic nodules
• hematogenous lesions
Pathogenesis
• Six species incriminated:
– Fonsecaea pedrosoi (Phialophora pedrosoi):
– Phialophora compacta (Fonsecaea compacta)
– Phialophora verrucosa
– Cladosporium carrionii:
– Aureobasidium pullulans
– rarely Rhinocladiella aquaspersa (Acrotheca aquaspersa)

• Round, thick-walled, golden brown cells:

– known as:
• sclerotic bodies
• muriform cells
• medlar bodies
– 5–12μm diameter
– in giant cells
– lying free in intraepidermal microabscesses
– usually readily seen in H&E preparations
mycetoma
 formerly known as "actinomycetoma",
see Actinomycosis.

• Chronic, specific, granulomatous fungal

disease.
• It mainly affects the foot; and
Mycetoma pedis is also known as
Madura foot.
• This infection is endemic in Africa, India,
and Central and South America.
Pathogenesis
• agricultural work
• men between 20 and 40 years old
• contacting grains of bacterial or fungal spores that
have been discharged onto the soil
• infection usually involves an open area or break in
the skin
• start in the foot or hand and travel up the leg or arm.
Diagnosis
• Diagnosis of mycetoma is usually accomplished by
radiology, ultrasound or by fine needle aspiration of
the fluid within an afflicted area of the body.
Rhinosporodiosis
• Infection by the fungus Rhinosporidium
seeberi usually affects the nasal and
pharyngeal mucosa, but rarely the skin can
also be affected.
Clinical Features
• Usually polypoid lesions of nasal and
pharyngeal mucosa
• Cutaneous lesions:
– rare
– may result from contiguous spread from mucosal
lesion:
• by autoinoculation
• rarely hematogenous dissemination
lobomikosis
• Lobomycosis is a chronic, localised, subepidermal
infection characterised by the presence of keloidal,
verrucoid, nodular lesions or sometimes by
vegetating crusty plaques and tumours.
• The lesions contain masses of spheroidal, yeast-like
organisms tentatively referred to as Loboa loboi.
There is no systemic spread. The disease has been
found in humans and dolphins and is restricted to the
Amazon Valley in Brasil.
• The initial infection is thought to be caused by
traumatic implantation such as an arthropod sting,
snake bite, or wound acquired while cutting
vegetation.
• The lesions begin as small, hard nodules resembling
keloids and may spread slowly in the dermis and
continue to develop over a period of many years.
• Lesions are usually found on the arms, legs, face or
ears.
Phycomicosis
• Caused by saprophytic molds;found
widely in the environtment
• Transmitted by airborne asexual spores
 invade tissues of patient with
reduced host defences.
• Proliferate in the wall of blood vessels,
particularly of the paranasal sinuses,
lungs, or gut.
Sekian
TERIMAKASIH