kul jamur pnybb isna 0910
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JAMUR PENYEBAB I.S.N
Pratami AdityaningsariMikrobiologi FK UY
Jamur p’ybb inf sal nfs :
- Primary pathogens
Blastomyces dermatitidis
Coccidioides immitis
Histoplasma capsulatum
Paracoccidioides brasiliensis
- Oppurtunistic pathogens
Cryptococcus neoformans
Aspergillus sp
Blastomyces dermatitidis
• Kingdom : Fungi
• Phylum : Ascomycota
• Class : Euascomycetes
• Order : Onygenales
• Family : Onygenaceae
• Genus : Blastomyces
Blastomycosis is a chronic granulomatous
and suppurative disease having a primary
pulmonary stage that is frequently followed
by dissemination to other body sites, chiefly
the skin and bone.
Aetiological Agent:
Blastomyces dermatitidis, a soil inhabiting
fungus.
Growth phase
- saprobic fase (miselium b’septa & konidia)
- parasitic fase (yeast b’budding)
Habitat
tanah, potongan/serpihan kayu
Transmission
inhalasi konidia dr tanah/serpihan kayu
tdk dr org - org
Patogenesis
M’hrp konidia m’capai alveoli bereplikasi pd sh 37°C kolonisasi di mks tr.resp yeast komposisi dind.sel yeast b’modifikasi m’hindar dr pengenalan o/ makrofag kolonisasi di jar aliran drh
Faktor virulensi
- Thermal dimorphism
- Dind.sel α-(1,3)-glucan
- Sel p’muk WI-1
Makroskopik
- 25°C
diam kol 0.5-3 cm, permuk lembut spt wol, wrn putih-beige
- 37°C
diam kol 0.5-3 cm, wrn krem
Mikroskopik
- 25°C
hifa b’septa hyalin unisel konidiofor
- 37°C
budding sel blastokonidia btk globular
Manifestasi klinik
• The patient usually presents with cough, fever, night sweats, and general weakness and may be thought to have tuberculosis.
• The sputum may be blood stained and
purulent, again suggesting tuberculosis.
• The cutaneous form of infection presents as
papules which progress to crusty ulceration
• Skin lesions are often multiple and most
commonly appear on the face and limbs.
• They are usually painless and may be mistaken for squamous cell carcinoma
• Atrophic scars develop where there have been old lesions.
• Other lesions can occur in the mucous
membranes of the nose, mouth, larynx, and
vagina
Diagnosis
kultur (saliva, bilas bronkus, biopsi paru)
mikroskopik
histopatologi
radiologi
Antifungi
amfoterisin B, ketokonazole, itrakonazole
Masa inkubasi
21 – 100 hr
pdrt tnp gjl inf paru kronik / inf m’sebar ke
bag tbh lain (kulit, tlg blkg, tr.gen, SSP)
Coccidioides immitis
• Kingdom : Fungi
• Division : Ascomycota
• Class : Euascomycetes
• Order : Onygenales
• Family : Onygenaceae
• Genus : Coccidioides
Disease
Coccidioides immitis causes coccidioidomycosis.
Properties C. immitis is a dimorphic fungus that exists as a
mold in soil and as a spherule in tissue
Fase p’tumbh
- saprobic fase (hifa b’septa, artrokonidia)
- parasitic fase (sferul dgn endospora)
Habitat
tanah kering/gurun psr
Cara penularan
inhalasi artrokonidia
Patogenesis
• In soil, it forms hyphae with alternating
arthrospores and empty cells.
• Arthrospores are very light and are carried by the wind.
• They can be inhaled and infect the lungs.
• In the lungs, arthrospores form spherules that are large, have a thick, doubly refractive wall, and are filled with endospores.
• Upon rupture of the wall, endospores are released and differentiate to form new spherules.
• The organism can spread within a person by direct extension or via the bloodstream.
• Granulomatous lesions can occur in virtually any organ but are found primarily in bones and the central nervous system (meningitis)
• Dissemination from the lungs to other organs occurs in people who have a defect in cell-mediated immunity.
Faktor virulensi
thermal dimorphism
konidia thn fag
# stimulasi Th2
prod urease & prot extrasel
molecular mimicry
Mikroskopis
Makroskopis
Antifungiamfoterisin B, ketokonazole, itrakonazole
• In tissue specimens, spherules are seen microscopically.
• Cultures on Sabouraud's agar incubated at 25 °C show hyphae with arthrospores
• (Caution: Cultures are highly infectious; precautions against inhaling arthrospores must be taken.)
Histoplasma capsulatum
• Kingdom: Fungi
• Phylum : Ascomycota
• Subphylum: Ascomycotina
• Class: Ascomycetes
• Order: Onygenales
• Family: Onygenaceae
• Genus: Histoplasma
Caused by Histoplasma capsulatum• Variety duboisii
– Not as severe of an infection• Variety capsulatum
– Common cause of histoplasmosis
• It grows in soil, particularly if the soil is heavily contaminated with bird droppings, especially from starlings.
• Although the birds are not infected, bats can be infected and can excrete the organism in their guano
• Infection occurs when airborne spores enter a host organism’s respiratory tract
• Inhaled spores are engulfed by macrophages and develop into yeast forms.
• In tissues, H. capsulatum occurs as an oval budding yeast inside macrophages
• The yeasts survive within the phagolysosome of the macrophage by producing alkaline substances, such as bicarbonate and ammonia, that raise the pH and thereby inactivate the degradative enzymes of the phagolysosome
• The organisms spread widely throughout the body; especially to the liver and spleen, but most infections remain asymptomaric, and the small grantdomatous foci heal by calcification.
• With intense exposure (eg, in a chicken house or batinfested cave), pneumonia may become clinically manifest.
Fase p’tumbh
- saprobic fase (hifa b’septa, mikrokonidia,
makrokonidia)
- parasitic fase (budding sel kecil)
• Histoplasmosis first affects the lungs and can spread to other organs, including the brain1.Dormant Stage
2.Acute Stage
3.Chronic Stage
4.Systemic Stage (Disseminated Histoplasmosis)
• Dormant Stage– No symptoms exist– Fungi survives in spore form within the lungs
• Acute Stage– Characterized by short bursts of activity– Symptoms
• Flu• Lung Issues
– Cough– Chest pain– Inflammation of infected areas
• Fever• Chills
• Chronic Stage– Histoplasma capsulatum becomes
established in the body– The fungus goes through alternations of
activity and dormancy
Symptoms• Increase in frequency of previous symptoms• Shortness of breath• Excessive sweating• Liver infection or spleen infection
• Systemic Stage– Occurs as the fungus reaches all parts of the
host organism, including most organs and the central nervous system
Symptoms• Increase in frequency of previous symptoms• Skin and mouth sores, including rashes• Joint and muscle pain• Headache• Neck stiffness
Patogenesis
tanah t’konta kot burung konidia t’hrp alveolus germinasi yeast organ sistemik
Faktor virulensi
thermal dimorphism
thn fag
perub dind sel
Mikroskopik
Makroskopik
Detection• Lung X-Ray• Tissue Samples
– Blood, Bone Marrow, Skin• Cultures
– Blood, Sputum• Testing
– Antigen Testing*– CD4 Count
»Early Detection Saves Lives!Early Detection Saves Lives!
Antifungal Medications– Amphotericin B– Azoles
• Fluconazole• Itraconazole• Ketonazole
Paracoccidioides brasiliensis
• Kingdom: Fungi
• Phylum : Ascomycota
• Subphylum: Ascomycotina
• Class: Eurotiomycetes
• Order: Onygenales
• Family: Ajellomycetaceae
• Genus: Paracoccidioides
Paracoccidioidomycosis
is a chronic granulomatous disease that characteristically produces a primary pulmonary infection, often inapparent, and then disseminates to form ulcerative granulomata of the buccal, nasal and occasionally the gastrointestinal mucosa
The disease in its inception and development is
similar to blastomycosis and coccidioidomycosis.
The only etiological agent, P. brasiliensis
Fase p’tumbh
- saprobic fase (hifa b’septa, konidia)
- parasitic fase (yeast byk budding sel)
Habitat
tanah & sayuran
Patogenesis
• The spores are inhaled, and early lesions occur in the lungs.
• Asymptomatic infection is common.
• Alternatively oral mucous membrane lesions, lymph node enlargement, and sometimes dissemination to many organs develop.
Diagnosis
• In pus or tissues, yeast cells with multiple buds are seen microscopically.
• A specimen cultured for 2-4 weeks may grow typical organisms
Antifungi
amfoterisin B, ketokonazole, itrakonazole,
sulfonamid
Diagnosis : mikroskopis
Makroskopis
Cryptococcus neoformans
• Kingdom: Fungi
• Phylum : Basidiomycota
• Subphylum: Basidiomycotina
• Order: Sporidiales
• Family: Sporidiobolaceae
• Genus: Filobasidiella (Cryptococcus)
• Species: Filobasidiella neoformans
Fase p’tumbh
- saprobic fase = parasitic fase (budding
sel tdk b’kapsul)
Habitat
tanah yg byk kot brg, tanaman & hwn
Cara penularan
inhalasi yeast
Fakt virulensi
kapsul polisakarida
melanin
Gejala klinik
pandangan tdk jls, fotofobia, diplopobia,
korioretinitis, gangg srf mata
Antifungi
amfoterisin B, flukonazol, flusitosin
Diagnosis
Kripto pd klt :
Aspergillus sp
• Kingdom: Fungi
• Phylum: Deuteromycota
• Class: Eurotiomycetes
• Order: Eurotiales
• Family: Trichocomaceae
• Genus: Aspergillus
• Aspergilloma. (Fungus ball)
• ABPA. (Hypersensitivity)
• Aspergillus necrotizing bronchitis.
endo-bronchial mass, obstructive pneumonitis, collapse, hilar mass.
• Invasive Pulmonary Aspergillosis.
Angioinvasive/ hemorrhagic infarcts.
Airway invasive-obstructing.
Fase p’tumbh
- saprobic fase (miselium b’septa, kepala
konidia & konidia)
- parasitic fase (“idem”)
Habitat
tanah, tanaman, air, udara, lada
Cara penularan
inhalasi konidia
Faktor virulensi
ikatan ke fibrinogen & laminin, sekresi
elastase & protease, katalase
Gejala klinikClinical findings could be non-specific.• Some patients may remain asymptomatic.• Most frequent symptom is HEMOPTYSIS 75%.• Less commonly chest pain, dyspnea , malaise.• Wheezing and fever (could also be secondary to
underlying disease, or bacterial super infection of the cavity or aspergilloma itself).
Makroskopis
mikroskopis