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Zygomycetes and friends.
Fungal fun for EVERYONE!!!!!! U of L SOM med/micro.
Terms in this set (14)
-60% of reported cases of zygomycosis, 90% of rhinocerebral infections.
-10-15% of zygomycosis, especially cutaneous and gastrointestinal
Rhizomucor, Absidia, Mucor, Cunninghamella species.
-Smaller lesser clinically relevant Zygomycetes species.
-Can collectively cause mucormycosis.
Zygomycetes: Growth and reproduction.
-Grow as filamentous molds always.
-Larger diameter hyphae (than aspergillus), non-septate nature that branch at 90 degrees.
-Undergo asexual sporulation in a sporangium.
-Do not grow well at 37 degrees.
-Live in environment on living and dead organic matter.
-Release sporangiospores into the outdoor air throughout the year.
-Inhalation of spores.
-Traumatic implantation as well as ingestion have also been documented.
-Diabetics (uncontrolled) who have ketoacidosis are at risk.
-Neutropenic cancer patients.
-Long time users of steroids.
-People who are malnourished or in iron overload also at risk.
Zygomycetes: Clinical manifestations: Rhinocerebral zygomycosis.
-Most common presentation.
-Nose, eyes, sinus, brain, and even meninges.
-Fever, facial and eye pain, bulging of eyes.
-Black necrotic regions noted in or around face (must be surgically removed)
Zygomycetes: Clinical manifestations: Pulmonary zygomycosis.
-Presents with fever, cough, chest pain, and shortness of breath.
-Angioinvasion possible, cavitates and infarcts with hemoptysis.
-Can be seen on xray.
Zygomycetes: Clinical manifestations: Disseminated zygomycosis.
-Seen after lung involvement.
-Can spread to any organ system but most often CNS.
-Can lead to infarction and multi-organ failure.
Zygomycetes: Clinical manifestations: Cutaneous zygomycosis.
-Infection at site of unclean wound.
-Necrotic lesions can involve all layers of the skin and even underlying muscle.
-Can also be secondary to angioinvasion.
Zygomycetes: Clinical manifestations: GI zygomycosis
-Necrotic ulcers with ischemia and gangrene of stomach, ileum or colon.
-Patients present with abdominal pain or distention, nausea, vomiting and diarrhea. The disease may mimic an intra-abdominal abscess.
-Biopsy, sputum, lavage samples. Sputum no very helpful.
-Direct microscopic exam (observe 90 degree non septate hyphae. Cannot tell different brands of zygomycetes apart.)
-Culture (fast growing molds but not often positive.
-No serological test exists.
-Must be AGGRESSIVE.
-Surgery, control neutropenia, antifungal therapy.
-Very resistant to most azoles and echinocandins.
-Posaconazole new drug, very effective.
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