Fungi of superficial keratinized infection Malassezia furfur（秕糠马拉癣菌）.

Fungi of skin infection The most important are dermatophytes, a group of closely fungi classified into 3 genera: Trichophyton（毛癣菌） Epidermophyton （表皮癣菌0 Microsprum（小孢子癣菌） Invade only skin, hair, and nails.

Fungi of subcutaneous infection Chromomycosis (caused by several species of black molds; Fonsecaea edrosoi, Cladosporium carrionii, Phialophora verrua have been isolated most frequently).

Fungi of deep infection Cryptococcus neoformans Histoplasma capsulatum Coccidioides immites ( 厌酷球孢子菌〕 Blastomyes dermatitides （皮炎芽生菌〕 Paracoccidiodes brasiliensis （巴西副孢子菌〕

Cryptococcus neoformans Oval , budding yeast surrounded by a wide polysaccharide capsule

Cryptococcus neoformans

Cryptococcus neoformans cryptococcosis No human to human transmission Infection follows inhalation of the cell of C. neoformans, which , in nature , are thought to be small , allowing the organism to enter deep into the lung.

Opportunistic Mycoses Candida（假丝酵母菌） Aspergillus （曲霉） Mucor（毛霉） Pneumocystis carinii(卡氏肺孢菌）

Candida albicans

Etiological agents C.albicans C.guilliermondi C.stellatoidea C.krusei C.tropicalis C.glabratat C.parapsilosis C.viswanathii C.kefyr* C.lusitaniae

Clinical categories Cutaneous: intetrigo,paronychia,onychomycosis Mucocutaneous: perleche, thrush, perianal disease Chronic: mucocutaneous candidiasis, guanulomatous disease Systemic: fungemia ,endocarditis,pulmonary infection,urinary tract infection, meningitis, endophthalmitis

Round to oval, single cells which reproduce by budding Yeasts Round to oval, single cells which reproduce by budding

Yeasts Candida Cryptococcus

Candidiasis Candida albicans

Ecological Niche Candida Albicans Endogenous

Infections with Candida usually occur when there is some alteration in: Cellular immunity Normal Flora Physiology

CANDIDIASIS Skin Vaginitis Urinary tract Mucous membranes Septicemia Endocarditis Pneumonia

The fourth most common nosocomial bloodstream infection. CANDIDIASIS The fourth most common nosocomial bloodstream infection.

Clinical Specimens Candida Sputum Scrapings from lesions Blood smears Vaginal discharge Urine Feces

Candida albicans

8-12 MICRONS

Pseudomycelium

GERM TUBES

GEOGRAPHIC OCCURENCE WORLDWIDE

Therapy Amphotericin B Nystatin Ketoconazole Fluconazole Itraconazole

Cryptococcus neoformans Cryptococcosis Cryptococcus neoformans

Cryptococcosis A sub-acute or chronic infection which may affect the lungs or skin but most commonly manifests as a meningitis

Cryptococcus neoformans Ecological Niche Cryptococcus neoformans pigeon droppings Chicken droppings

Specimen of choice Cerebrospinal fluid

GEOGRAPHICAL DISTRIBUTION WORLDWIDE

Clinical Specimens Cryptococcosis CSF Sputum Pus Biopsy material urine

Cryptococcosis Serological Tests Indirect fluorescent antibody Tube Agglutination Latex Agglutination (measures antigen)

Drugs of Choice Cryptococcosis 5-Fluorocytosine Amphotericin B