2 A Yeast

Yeasts

Round to oval, single cells which reproduce by budding

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Yeasts

SELECTED GENERA

Candida

Cryptococcus

Candidiasis

Candida albicansNon-albicans species

Ecological Niche

Candida albicans

Endogenous

(mouth, gut, vagina)

Infections with Candida usually occur when there is some alteration in:

Cellular immunity (Immunocompromised) Normal Flora (Prolonged antibiotics) Physiology (Cardiac surgery, catheter)

CANDIDIASIS

Skin Vaginitis Urinary tract Mucous membranes Septicemia Endocarditis Pneumonia

CANDIDIASIS

The fourth most common nosocomial bloodstream infection.

GEOGRAPHIC OCCURENCE

WORLDWIDE

Clinical SpecimensCandida

Sputum Scrapings from lesions Blood smears Vaginal discharge Urine Feces Nail clippings

SEROLOGY There have been several antibody

detection test, but none are significant.

Beta-Glucan measurement is now showing promise

Therapy

Nystatin Vaginitis Cutaneous

Fluconazole * Itraconazole

Cryptococcosis

Cryptococcus neoformans

Cryptococcosis

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

Typical clinical course Inhalation Mild pneumonia Vision, lethargy, headache Delirium, nuchal rigidity, coma Over a period of months Death if not treated

Spherical 5-10 microns Narrow- base Surrounded by polysaccharide

capsule

Virulence factors1. Anti-phagocytic

polysaccharide capsule2. Antioxidant melanin3. Ability to grow at 37 C

Ecological Niche

• Pigeon droppings

• Chicken droppings

Isolation of Cryptococcus neoformans from environmental sites in South Carolina

Number Examined

Number Positive

Percent Positive

SITES 79 51 65

SAMPLES 299 137 45

Cryptococcusportal of entry

Inhalation

inoculation

Specimen of choice

Cerebrospinal fluid

Clinical Specimens

Cryptococcosis

•CSF•Sputum•Pus•Biopsy material•urine

Serological Tests

Cryptococcosis

• Indirect fluorescent antibody• Tube Agglutination• Latex Agglutination (measures antigen)

Drugs of Choice

Cryptococcosis

•Amphotericin B plus 5-Flucytosine

•Amphotericin B plus Fluconazole

2 A Yeast

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