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