The Fungus Among Us By: Katherine C. And Marissa W.

MEDICAL Mycology Medical Mycology is the study of fungal infections found in Humans. In this presentation we will be focusing on the Systemic forms of Aspergillus and Candida. In both cases these infections are more likely in occur in people with compromised immune systems. both are opportunistic pathogens, which are fungi capable of producing an infection due to an opportunity created by an altered physiological state.

Are They Even Different? There are two basic types of Fungi, yeasts and moulds. Aspergillus is an example of a mould while Candida is a yeast. When viewing cultures of yeasts under a microscope they will appear circular while moulds will appear linear. Mould YEAST

Systemic Candidiasis Systemic Candidiasis is when a pathogenic species of Candida infects our blood or organs. This is very serious infection because if it is not treated and may lead to organ failure and then death. Candida can infect virtually any organ in the body. Normally non- pathogenic species of candida can be found in mucosal surfaces like the mouth, throat and vagina. Species of non- pathogenic Candida can also be found on skin surfaces although it is rare. Candida is a part of our normal flora and remains in competition with other bacteria. Occasionally when we take antibiotics the bacteria that is in competition with the Candida is killed allowing the Candida to flourish, causing a yeast infection. There are several forms of yeast infections including Vaginitis, Thrush meaning oral which is shown below along with many other kinds. This can be treated with Topical creams, solutions, powders, gels and lotions prescribed by a physician.

How Is it Acquired There are four over lapping forms of Invasive Candidiasis. The first type is Catheter Related Candidiasis. This is attained when a catheter is contaminated with Candida and then is transferred into the body. The second kind is Acute Disseminated Candidiasis, this occurs when candida enters the blood and then spreads to other organs. The third form is Chronic Disseminated Candidiasis which occurs almost always in cases of prolonged cases of bone marrow dysfunction and Neutropenia which occurs during treatment for leukemia. And finally there is Deep Organ Candidiasis which is basically the same as Chronic Disseminated Candidiasis but it does not include the situation of treatment for Leukemia. All of these forms are able to spread to many organs in the body. The picture below shows an abdominal area with lesions on the liver.

Who Is At Risk As we Candida is an opportunistic fungi, it takes advantage of a person with a weakened immunes system. This includes, the elderly, cancer patents, organ transplant recipients, those on immunosuprressive therapy, heroin addicts, people whose use a large variety of antibiotics, and people colonized with candida. In patients on immunosurpressive therapy, Candida is by far the most common cause of infection. The reason why theses people are more susceptible to getting this disease is because their immune systems are impaired and are not able to fight against the fungi.

Is There a Cure? There are several treatments that are approved and accessible. Drug therapy is the most effective treatment for all types of Candidal infections. Amphotericin B is the drug of choice for Invasive Candidal Infections, it is effective and less toxic. Nevertheless during the preparation of Amphotericin B there is a certain unavoidable level of toxicity. Fluconazole is a very good alternative as well as the recently approved Itraconazole. But Itraconazole does not extend to the same level as Fluconazole in anti- candidal therapy.

DIABETICS PULMONARY DISEASE AIDS PATIENTS BONE MARROW TRANSPLANT PATIENTS CORTICOSTEROID USE BURN VICTIMS Who is at risk? Immuno-compromised Patients

SOME INTERESTING FACTS ABOUT ASPERGILLUS -SINCE CITRIC ACID FROM FRUITS IS TOO EXPENSIVE TO ISOLATE, PEOPLE USE ASPERGILLUS NIGER TO GET IT AND PUT IT IN SOFT DRINKS. -ASPERGILLLUS ARYZAE FERMENTS AUTHENTIC SOY SAUCE IN LARGE VATS. THIS IS WHAT GIVES IT ITS DISTINCTIVE FLAVOR. -SOME ASPERGILLUS SPECIES WERE THE CAUSE OF A TURKEY “PLAGUE” IN ENGLAND IN THE 1960’S. THEY CALLED IT “TURKEY X DISEASE” BECAUSE THEY DIDN’T KNOW WHAT IT WAS. THERE IS A CHANCE THAT THIS SAME TOXIN THAT CAUSED THE TURKEY DEATHS (IT WAS IN THEIR PEANUT MEAL FOOD) MAY ALSO BE IN PEANUT BUTTER. -ALTHOUGH IT IS USUALLY IMMUNO-COMPROMISED HUMANS WHO ARE EFFECTED, NORMAL ANIMALS MAY ALSO GET THE FUNGUS.

How can you get it? Aspergillus is everywhere. However ubiquitous it may be, it prefers to live in a sugary, warm, wet area, like most other fungi do. Aspergillus can be found in the air, soil, water and other places. A hospital is a common place to find asperigllus. It may be in a place such as an I.V. or some other catheter. If one of these catheters is used on a patient with a compromised immune system, it is likely that they will acquire aspergillosis.

Here is an example of a fungus under a microscope.

Haven’t heard of aspergillus before? Maybe it’s because few people know about it. That includes doctors. In fact, only 60 clones of genomes have been made and published. Scientists should start thinking more about aspergillosis because more and more people are getting it. More are getting it because one of the factors of susceptibility is an organ transplant. As technology improves, more transplants are being performed. But when a person undergoes a transplant, he or she must be on immunosuppressive drugs so the body does not reject the organ. Therefore, they are at risk of contracting aspergillus.

So what do you do if you get it? As with most other diseases, the trick to recovery is early detection. Many people aren’t diagnosed early, so the drugs they receive aren’t effective. With one of the two effective treatments, only 35% of the recipients improve. Some of the symptoms a person with aspergillosis may experience are fever, cough, chest pain. Some may cough up blood, which may be a sign that surgery is needed. The surgery would be in the lungs. Aspergillus will attack a person with a lung disease that caused cavities in the lung tissue. The fungus will grow like bread inside the lungs. ASPERGILLUS

Special Thanks To: Dr. Dennis Babel, for taking time out from his busy and important job to help us get a better understanding of the exciting world of mycology. Mrs. Susan Speirs, for coming up with the great idea of the Summer Science Institute, which gave the students a great opportunity to enrich their knowledge of science and keep them off the dangerous streets of Grosse Pointe during the summer.