Mycology Identification

8/13/2019 Mycology Identification

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Mycology identification

Moulds with holoblastic conidia

Aureobasidium rare infection in immunocompromisedSporothrix schenckii sporotrichosis

Cladophialophora Chromoblastomycosis

Cladosporium Onychomycosis

Skin infection?

Fonsecaea pedrosoi Chromoblastmycosis

Rhinocladiella Rare Pheohyphomycosis

Ramichloridium Pheohyphomycosis

Ochroconis rare S/c or deep infection

Alternaria Cut/depp inf in immunocompromised

Ulocladium rare

Curvularia KeratitisSinusitis

Deep inf in immunocompromised

Bipolaris Deep inf in immunocompromised

Exserohilum Deep inf in immunocompromised

Moulds with enteroblastic conidia

Aspergillus flavus Sinus infection

Disseminated/ Deep infection in immunocompromised

Aspergillus fumigates Localised sinus, lung infectionDissemianated/Deep infection in immunocompromised

Aspergillus glaucus Rare Human disease

Aspergillus nidulans Pale grain mycetoma

Deep infection in immunocompromised

Aspergillus versicolor Rare Onychomycosis

Aspergillus ustus rare Human disease

Aspergillus niger Otomycosis


Aspergillus terreus Onychomycosis

Otomycosis

Deep infection in immunocompromisedA candidus Onychomycosis

Otomychosis

Penicilium marneffei Disseminated inf in HIV, travel/live in SE Asia

Scopulariopsis brevicaulis Onychomycosis


Paecilomyces lilacinus Post surgical endophthalmitisoutbreak


Paecillomyces variotii Rare Deep infection in immunocompromised

Enteroblastic conidia wet mass

Cylindrocarpon rare Human infection

Fusarium dimerum Corneal infection


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Rare Disseminated inf in immunocompromised

Fusarium semitectum Rare Human infection

Fusarium miniliforme Corneal infection

Disseminated inf in immunocompromised

Fusarium oxysporum Corneal infection

Nail infection


Fusarium solani Corneal infection

Nail infection

Localised deep infection


Acremonium strictum Rare Human disease

Acremonium kiliense

rare

Pale grain mycetoma

Disseminated/deep inf in immunocompromised

Lecythospora rare Pheohyphomycosis

Scedosporium prolificans Disseminated/deep inf in immunocompromised

Scedosporim apispermum Pale grain mycetoma

Pneumonia after drowning

Localised deep infection


Colonise CF

Phialophora parasitica S/C or deep phaeohyphomycosis


Phialophora richardsia Rare S/C phaeohyphomycosis

Phialophora verrucosa Common

Rare

Chromoblastomycosis


Phaeoannellomyces werneckii Tinea nigra

Exophiala spinifera S/C or deep phaeohyphomycosis

Exophiala dermatitidis S/C or deep phaeohyphomycosis

Coloniser in CF

Exophiala jeanselmei Black grain mycetoma

Phaeohyphomycosis in IC

Mucorales

Cuninghamella bertholletiae Rare

Absidia corymbifera Mucormycosis in IC

Rhizomucor pusillus rare Mucormycosis

Mucor circinelloides rare

Rhizopus microsporus MucormycosisRhizopus arrhizus common Mucormycosis

Mucor hiemalis Very rare Mostly environmental

Basidiobolus ranarum Chronic s/c inf of trunk and limb

tropical/Africa/SE Asi

Conidiobolus Chronic rhinofacial infectionrain forrest of

Africa and america

Pythium insidisum Rare S/C infection

Apophysomyces elegans Rare mucormycosis

Saksenaea vasiformis rare mucormycosisMortierella


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Tinea

Microsporum, epidermophyton, Trichophyton

Scytalidium hyalinum

Scytalidium has typical colonyfluffy whiteexclude, look for arthrospore

Others should have Aleurispore

A single terminal spore develops at the end of the conidiophores. It get separated and the condiophore retains

a scar. No other spore develops there. The next spore develops from a branch below it. The detached spore

has a large flat base.

Note down

Colour of the colonywhite, cream, brown, purple tinge

Consistencygranular, suede

Edgeglabrous

Backbrown, red, white, yellow, orange

Back- sharply define not sharply definedMicroscopyMacroconidia mostly, sparse

Macroconidiasmooth/rough surface, beak present/absent


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Microconidiashapesmall, large, circular, ovoid, club shaped,

Microconidiabroad base, narrow base

Hyphaelook for spiral hyphae

1. Now look for macroconidia

2. Outer surface has some roughnessthink Microsporum

Rough = Think Microsporum

Smooth

3. Look for a terminal beak in the macroconidia

No beak = M gypseum/fulvum

Terminal beak presentThink M

canis/equinumif macroconidia large (>6 cell)= canis;

if small equinum


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4.If smooth macroconidia (usually less abundant) present - Look at colony

Khaki brown

to greenish

yellow colony

Ideally like this Think Epidermophyton floccosum

Colony may

look like this in young culture.

Causes - tinea pedis, tinea cruris,tinea corporis and onychomycosis

Tr Itraconazole, terbinafine,

Greseofulvin

White cream

or clear

yellow

colony,( even

pink!)

Trichophyton terrestre

contaminant, clinically not relevant

Colony has

some purple

colour

May not show typical feature

Trichophyton rubrum granular form.

Look for macro and microconidia, if

time permits

May cause tinea capitis, corporis or

pedis

5. If mainly microconidia are visible -----


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6. Look for spiral hyphaeMicrosporum persicolor

Trichophyton mentagrophytes

Trichophyton interdigitale

No spiral hyphae

7. If spiral hyphae present, look at microconidia structure and colony

Widebased microconidia +/-branches

Microsporum persicolor

Urease +

Narrow base microconidia , colony has a

granular appearance = T mentagrophytes

AdvUrease +, hair perforation test

(T rubrumurease neg mostly)

Narrow based round shaped microconidia

, suede like colony, reverse may be

cream or if brownnot sharply defined

= T interdigitale


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8. If no spiral hyphae seenlook at the edge of the colonyDoes the colony has yellow glabrous fringe edge? T soudanese, equinum, interdigitale noduler or

erinacei

No fringe edge

T interdigitale, rubrum, interdigitale downy, rubrum

granuler, tonsurans, erinacei

9. If the glabrous edge is presentlook at the back of the colony and ask howlong it is been incubating (also slow growing T soudanese is seen in Africa)

Slow growing (take more then 1 week) T soudanese

Fast growinglook reversedark brown? T equinum

Fast growinglook reversedeep orange? T interdigitale nodular

Fast growinglook reversebright yellow? T erinacei


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10.If no glabrous edgelook at back of the colony, colony colour andmicroconidia

Bright yellow back

T erinacei

Backcream, brown, red;

Look at microconidia and colony

Trichophyton interdigitale, T rubrum, tonsurans

Microconidia small, round

Back of the colony may be brown but not sharply

defined.

Trichophyton interdigitale

Microconidia small, club shaped

Backdark red/brown, sharply defined white edge,

urease neg at 1 week

T rubrum

Microconidia small, club shaped

Backreverse may be cream or if brownnot

sharply defined

T interdigitale downey

Large microconidia, ovoid/club shaped

Colonysome red/purple colour

T rubrum granular

Large microconidia, ovoid/club shaped

Colonybrown/yellow

T tonsurans


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Conidia Conidia grow by are blastic outgrowthlike budding of yeast

Aspergillus Penicillum Phialophora

Other blastic conidia are

Anneloconidia

scopulariopsis/exophiala (annelids marked)

Holoblastic conidiacladosporium

On the contrary if conidia are produced by a prexisting hyphae it is called thalic conidia like

arthro and aleurioconidia

Arthroconidiabrick/square shaped eg. Geotrichum

Aleurioconidia - eg. Microsporum


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Aspergillus Scopulariopsis

Large conidia with flat

scar, paecilomyces has

small condia, minimal

scar

Penicillum

(unlikely as

specimen)

Green colony,

scopulariopsis and

paecilomycis doesnt have

green colony

Exophiala

Annelloconidialook for

septa at the baseno

septa in phialophora

Phialophora Fusarium

(note macroconidia

sometime develops later

may present in low

numbers)

Paecilomyces

(rare)

Acremonium

Long tapering stalk

(phialides, not an

anneloconidia like

exophiala),

macroconidia may be

present

Alternaria Curvularia

Scedosporium

prolificans

(Dark brown oval

conidia from

short annelids

with inflated

base/taperingends)

Scedosporium

apiospermum


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Mycology Identification

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