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文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。浅部感染真菌浅部感染真菌n表面感染真菌n皮肤癣真菌皮肤癣真菌n皮下组织真菌感染1 1浅部感染真菌表面感染真菌1文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。2 22文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。表面感染真菌表面感染真菌n n位置：寄居于人体皮肤和毛干的最表层。因不接触组织细胞，很少引起宿主细胞反应n n统称：角层癣菌 n n代表：秕糠马拉癣菌(Malassezia furfur)n n症状：由于此菌能产生对黑色素细胞有抑制作用的二羧酸，使花斑癣局部色素减退，如汗渍斑点，俗称汗斑。n n诱发因素为高温多汗3 3表面感染真菌位置：寄居于人体皮肤和毛干的最表层。因不接触组织文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Malassezia furfurn nTinea versicolor on skin surface(sweat stain)n nThelesionsaresmallhypopigmentedorhyperpigmentedmaculesn nMostcommonsite:back,underarm,upper arm,chest,neck n nMost common in adolescent and young adult males n nAssociated with increased sweating4 4MalasseziafurfurTineaversico文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。PityriasisversicolorshowinghyperpigmentedlesionsinaCaucasianandhyphopigmentedlesionsinanAustralianAborigine5 5Pityriasisversicolorshowing文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Culture of Malassezia furfur on Dixons agar(contains glycerol mono-oleate)6 6CultureofMalasseziafurfuro文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Piedraia hortae(何德毛结节菌何德毛结节菌)n nIt usually affected the scalp hairn nThe nodules are darker in color,harder,and more firmly attached to the hairsn nBlack Piedra7 7Piedraiahortae(何德毛结节菌)Itusu文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Piedraia hortaeformsahardsuperficialpigmentednodulearoundthehairshaft(在毛干上形成硬的黑色结节，如沙粒状)8 8Piedraiahortaeformsahards文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Fungal otitis externan nFungal infection of the external auditory canaln nCaused by several species of Aspergillus(most often A.niger),but Candida albicans is also capable of infecting this siten nThe major symptoms are itching and feeling of fullness in ear9 9FungalotitisexternaFungalin文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。101010文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。皮肤癣真菌皮肤癣真菌n n引起皮肤浅部感染n n皮肤癣是人类最多见的真菌病n n统称：皮肤癣菌，大约40多个种，分属于3个属n n嗜角质蛋白，37不能生长，侵犯部位：角化的表皮，毛发，指（趾）甲n n病理变化：由真菌增殖及代谢产物刺激宿 主引起1111皮肤癣真菌引起皮肤浅部感染11文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。致病性 指（趾）甲指（趾）甲 皮肤皮肤 毛发毛发毛癣菌属毛癣菌属 +表皮癣菌属表皮癣菌属 +-+-小孢子癣菌属小孢子癣菌属 -+-+一种皮肤癣菌可在不同部位引起病变相同部位的病变也可由不同的皮肤癣菌引起1212致病性指（趾文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。131313文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。TineapediscausedbyT.rubrum.Sub-clinicalinfection(left)showingmildmacerationunderthelittletoeandmoresevereinfection(right)showingextensivemacerationofalltoewebspacesTineaistransmittedviathefeetbydesquamatedskinscalesinsubstrateslikecarpetandmatting.1414TineapediscausedbyT.rubru文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。手足癣治疗原则n n水疱型温和搽剂和霜剂水疱型温和搽剂和霜剂n n角化过度型先角质剥脱剂，再用抗真角化过度型先角质剥脱剂，再用抗真菌霜剂菌霜剂n n浸渍糜烂型粉剂收干，抗继发感染，浸渍糜烂型粉剂收干，抗继发感染，再温和抗真菌再温和抗真菌1515手足癣治疗原则水疱型温和搽剂和霜剂15文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Tinea Unguiumn nusually caused by Trichophyton sp1616TineaUnguiumusuallycausedby文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。甲癣治疗原则n n局部治疗甲涂剂局部治疗甲涂剂n n系统治疗伊曲康唑，特比萘芬等系统治疗伊曲康唑，特比萘芬等n n联合治疗配合拔甲或削甲治疗联合治疗配合拔甲或削甲治疗1717甲癣治疗原则局部治疗甲涂剂17文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Tinea Corporis:caused by caused by M.canisM.canis,following contact with infectious kittensfollowing contact with infectious kittens 1818TineaCorporis:causedbyM.c文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Tinea Cruris(Jock itch):Infection of the groin,mainly seen in menInfection of the groin,mainly seen in men1919TineaCruris(Jockitch):Inf文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Tinea Capitis(scalp ringworm)Tinea favosa发内孢子发内孢子2020TineaCapitis(scalpringworm)文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Tinea Capitis(scalp ringworm)Tinea alba发外孢子发外孢子2121TineaCapitis(scalpringworm)文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Tinea Capitis(scalp ringworm)脓癣脓癣2222TineaCapitis(scalpringworm)文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。头癣治疗原则n n剪发剪发n n洗发洗发n n搽药搽药n n服药服药n n消毒消毒2323头癣治疗原则剪发23文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Candidiasis of skin,mucous membranes and nailsn n Predisposing factorsInfancy,pregnancy,old ageInfancy,pregnancy,old ageDisorders of immune function,e.g.,leukemia,Disorders of immune function,e.g.,leukemia,corticosteroid therapycorticosteroid therapyChemotherapy,e.g.,immunosuppressive,Chemotherapy,e.g.,immunosuppressive,antibioticantibioticEndocrine disease,e.g.,diabetes mellitusEndocrine disease,e.g.,diabetes mellitusCarcinomaCarcinoma2424Candidiasisofskin,mucousme文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。念珠菌性间擦疹念珠菌性间擦疹好发部位：腋窝、乳房下、好发部位：腋窝、乳房下、腹股沟、会阴，多见于婴儿腹股沟、会阴，多见于婴儿及肥胖者。及肥胖者。2525念珠菌性间擦疹好发部位：腋窝、乳房下、25文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。n nCutaneouscandidiasis:includingCutaneouscandidiasis:includingInterdigitalcandidiasisInterdigitalcandidiasis,diapercandidiasis,paronychiaandonychomycosisdiapercandidiasis,paronychiaandonychomycosisn nVulvovaginalcandidiasisandbalanitisVulvovaginalcandidiasisandbalanitisInterdigital candidiasis Candidiaonychomycosisandparonychia2626Cutaneouscandidiasis:includ文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。n nOropharyngealcandidiasis:includingthrush,glossitis,stomatitisandangularcheilitisOralthrush2727Oropharyngealcandidiasis:in文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。皮下组织真菌感染皮下组织真菌感染n n主要有孢子丝菌和着色真菌n n申克孢子丝菌，属腐生性真菌，常因外伤接触带菌的花草等引起感染。此菌可引起孢子丝菌下疳。此菌也可引起深部感染。是一种二相性真菌。n n着色真菌感染发生在暴露部位，称着色真菌病。我国主要有卡氏枝孢霉和裴氏着色芽生菌。2828皮下组织真菌感染主要有孢子丝菌和着色真菌28文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Sporotrichosis此菌可经微小损伤侵入皮肤，然后沿淋巴管分布，引此菌可经微小损伤侵入皮肤，然后沿淋巴管分布，引起亚急性或慢性肉芽肿，使淋巴管形成链状硬结，称起亚急性或慢性肉芽肿，使淋巴管形成链状硬结，称为孢子丝菌下疳。为孢子丝菌下疳。2929Sporotrichosis此菌可经微小损伤侵入皮肤，然后沿文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。n nChromomycosisn nInfections occur in exposed areas,skin lesions become dark,so called chromomycosisn nRepresentive species:Cladosporium carrianii,Fonsecaea pedrosoi,etc.n nAre saprophytic fungi,usually enters the body by trauma3030Chromomycosis30文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。n n经外伤侵入n n丘疹n n结节n n结节融合成疣状或菜花状n n斑痕形成影响淋巴回流n n肢体象皮肿3131经外伤侵入31文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。ChromomycosisChronicverrucouschromoblastomycosisofthehandduetoCladophialophora carrionii3232ChromomycosisChronicverrucous文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Mycetoma 足分枝菌病足分枝菌病n n是由多种放线菌或真菌引起的一种慢性化脓性肉芽肿性疾病，是由多种放线菌或真菌引起的一种慢性化脓性肉芽肿性疾病，主要感染足部，以肿胀、窦道和颗粒为特征。主要感染足部，以肿胀、窦道和颗粒为特征。n ncausedbyfungiarecalledeumycetoma(40%)n nActinomycetomaiscausedbyactinomycetes(60%)n nItischaracterizedbytheformationofabscess,whichcontainlargeaggregatesoffungaloractinomycetefilamentsknownasgrains3333Mycetoma足分枝菌病是由多种放线菌或真菌引起的一种慢文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。n nEumycetomaEumycetoma Dark grainsDark grains Madurella Madurella mycetomatismycetomatis Leptosphaeria Leptosphaeria senegalensissenegalensis Exophiala jeanselmeiExophiala jeanselmei Pale grainsPale grains Fusarium Fusarium sp.sp.AcremoniumAcremonium sp.sp.Scedosporium Scedosporium apiospermum apiospermum n nActinomycetomaActinomycetomaWhite-yellow grainsWhite-yellow grains Actinomadura Actinomadura maduraemadurae Nocardia brasiliensisNocardia brasiliensisYellow-brown grainsYellow-brown grains Streptomyces Streptomyces somaliensissomaliensisRed-pink grainsRed-pink grains Actinomycetoma Actinomycetoma pellettieripellettieri3434EumycetomaActinomycetoma34深部真菌感染深部真菌感染 引起深部感染的真菌包括两大类：致病性真菌与条件致病性真菌 致病性真菌主要有组织胞浆菌、球孢子菌、副球孢子菌和芽生菌，这些真菌均属二相性。多见于美洲，我国极少见。它们侵袭深部组织和内脏以及全身，引起慢性肉芽肿样炎症、溃疡和坏死。条件致病性真菌包括有：念珠菌、隐球菌、曲霉菌与毛霉菌、肺孢子菌等。3535深部真菌感染引起深部感染的真菌包括两大类：致病性真菌与条件致文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Characteristics of systemic dimorphic mycosesn nAre uncommon,Are uncommon,often occurs in often occurs in endemic areasendemic areas n nMost infections are Most infections are asymptomaticasymptomatic or self-limiting or self-limitingn nin immune-compromised hosts,infections are in immune-compromised hosts,infections are often fataloften fataln nThe pattern of infection are similarThe pattern of infection are similar Route of acquisition is inhalation Route of acquisition is inhalation Pulmonary infectionPulmonary infection Disseminated infection(Disseminated infection(Blood,Bone marrow,Brain and Blood,Bone marrow,Brain and CSF,Joint)CSF,Joint)3636Characteristicsofsystemicdi文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Coccidioidomycosisn nCoccidiodes immitis Coccidiodes immitis is is considered to be the considered to be the most most virulentvirulent of fungal pathogens.of fungal pathogens.n nRestricted to hot,semi-arid Restricted to hot,semi-arid areas of SW USA and areas of SW USA and Mexico.Mexico.n nGrows in the soil,but Grows in the soil,but inhalation of a single spore inhalation of a single spore can initiate infection.can initiate infection.In infected tissues,C.immitis appears as a mixture of endospores and spherules.ConidiaSpherules3737CoccidioidomycosisCoccidiodes文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Coccidioidomycosis:A.A.Encounter:Encounter:Mycelium found in dry,dusty soil.Contact by Mycelium found in dry,dusty soil.Contact by inhalationinhalation of arthroconidia of arthroconidiaB.B.Spread:Spread:Most commonly an asymptomatic self limited pulmonary Most commonly an asymptomatic self limited pulmonary disease,but may spread via the blood to skin,soft tissues,bones,disease,but may spread via the blood to skin,soft tissues,bones,joints and meninges.joints and meninges.C.C.Immune Response:Immune Response:T-cell mediated(Th-1)T-cell mediated(Th-1)D.D.Evasion of Defenses:Evasion of Defenses:Resistant to killing by phagocytesResistant to killing by phagocytes-protein rich,hydrophobic outer wallprotein rich,hydrophobic outer wall-alkaline halo associated with urease-alkaline halo associated with urease E.E.Damage:Damage:secreted proteinases break down collagen,elastin secreted proteinases break down collagen,elastin hemoglobin,IgG&IgAhemoglobin,IgG&IgA3838Coccidioidomycosis:Encounter:文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。1.Ethnicity:Filipinos,African Americans,Native Americans at higher risk2.Age:Extremes more susceptible3.Sex:Males more susceptible4.Pregnancy:3rd trimester5.ImmunosuppressionF.Diagnosis1.Exam:Suppurative or granulomatous inflammation2.Histopathology:spherules or endospores seen in sputum,exudates or tissue3.Culture:danger,highly infectious!4.Serology:Complement fixation assay(in cerebrospinal fluid),particle agglutination assay G.Treatment1.Amphotericin B followed by an azoleE.Risk FactorsCoccidioidomycosis:39391.Ethnicity:Filipinos,Afri文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Histoplasmosis (also called(also called cave diseasecave disease)Caused by the dimorphic fungus Histoplasma capsulatumTuberculated macroconidia,grown at 25CIntracellular yeast at 37CHistoplasmosis is characterized by intracellular growth of the pathogen in macrophages and a granulomatous reaction in tissue.These granulomatous foci may reactivate and cause dissemination of fungi to other tissues.4040Histoplasmosis(alsocalledca文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。HistoplasmosisA.A.EncounterEncounter.H.capsulatumH.capsulatum grows in soil,especially soil grows in soil,especially soil contaminated by guano.contaminated by guano.Inhalation of conidia from Inhalation of conidia from the environment is source the environment is source of infection.This is more of infection.This is more likely in endemic areas.In likely in endemic areas.In U.S.these include the U.S.these include the Atlantic Ocean to N.Dakota Atlantic Ocean to N.Dakota(500,000 cases/year in(500,000 cases/year in U.S.),except New England U.S.),except New England&Florida.Most cases occur&Florida.Most cases occur in Ohio Valley and in Ohio Valley and Mississippi Valley)Mississippi Valley)4141HistoplasmosisA.Encounter.H.文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。More HistoplasmosisMore Histoplasmosis1.1.90%of cases are asymptomatic,but in rare cases flu like respiratory 90%of cases are asymptomatic,but in rare cases flu like respiratory symptoms occursymptoms occur2.2.Disseminated histoplasmosis occurs in 1:200 cases and is diagnosed Disseminated histoplasmosis occurs in 1:200 cases and is diagnosed frequently in patients with AIDS living in the central U.S.frequently in patients with AIDS living in the central U.S.3.3.In these cases,the organism spreads In these cases,the organism spreads via bloodvia blood from the lung to from the lung to involve bone marrow,adrenal glands,heart valves and CNSinvolve bone marrow,adrenal glands,heart valves and CNS4.4.Spread can also be associated with underlying lung disease(e.g.,Spread can also be associated with underlying lung disease(e.g.,emphysema).emphysema).B.SpreadC.Immune Response1.Cell-mediated responses are of primary importance2.Activated macrophage can kill yeast cellsD.Evasion of Defenses1.Survival in macrophages elevates pH of phagosomes2.Yeast cells absorb iron(siderophore)and calcium from host3.Alteration of cell surface 4242MoreHistoplasmosis90%ofcas文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Histoplasmosis 1.Direct histology and culture of blood or bone marrow2.Serological testing for antibody and histoplama antigen in blood and urine.E.DiagnosisD.Damage1.Lung-bronchial obstruction and inflammatory sequelae2.Disseminated histoplasmosis-fulminant disease that may result in toxic shock3.CNS-fatal if untreated.4343HistoplasmosisDirecthistolog文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Even More HistoplasmosisF.TreatmentAmphotericin still mainstay of therapy vs.disseminated and severe pulmonary histoplasmosis.Ketoconasole or itraconasole is effective as therapy for self-limited disease(used in AIDS).Ocular HistoplasmosisA small fraction of individuals form scar tissue in the retina many years after the original histoplasmosis infection.Live organisms cannot be recovered from these specimens.The scarring can obscure the macula and lead to loss of central vision.The first signs are small“histo spots”.Advanced disease is treated with laser photocoagulation to limit the proliferation of blood vessels.4444EvenMoreHistoplasmosisF.Tre文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Blastomycosis Granulomatous mycotic infection Granulomatous mycotic infection that predominantly involves lungs that predominantly involves lungs and skin;but can spread to other and skin;but can spread to other organs.Most prevalent in males organs.Most prevalent in males 40-60 years of age and children.40-60 years of age and children.Blastomyces dermatitidis Dimorphic organism originates in the soil and infection ensues by inhalation of spores.Converts to yeast in animal hosts or at 37o in vitro.4545BlastomycosisGranulomatous文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Blastomycosisn nEncounterEncounter:Most cases are in southern,central,and southeastern USA.:Most cases are in southern,central,and southeastern USA.Infection is by inhalation of spores.Infection is by inhalation of spores.n nSpread:Spread:The pulmonary infection is either self-limited or progressive.The pulmonary infection is either self-limited or progressive.Dissemination often occurs to the skin and to the bone-80%of Dissemination often occurs to the skin and to the bone-80%of patients have large skin lesions;a large number also have patients have large skin lesions;a large number also have granulomatous pulmonary lesions.granulomatous pulmonary lesions.n nRisk Factors:Risk Factors:Occupational contact with soil;owning a dog.Living in Occupational contact with soil;owning a dog.Living in endemic area.endemic area.n nEvasion of Defenses:Evasion of Defenses:Escapes phagocytosis by neutrophils and Escapes phagocytosis by neutrophils and monocytes by shedding its surface antigen after infectionmonocytes by shedding its surface antigen after infectionn nDamage:Damage:Consequence of the immune response to the organismskin Consequence of the immune response to the organismskin lesions,respiratory infiltrates.lesions,respiratory infiltrates.n nDiagnosis:Diagnosis:based on clinical findings and microscopic detection of based on clinical findings and microscopic detection of organisms in tissue specimensorganisms in tissue specimens4646BlastomycosisEncounter:Mostc文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。1.1.Amphotericin B is the drug of choice for rapidly progressive Amphotericin B is the drug of choice for rapidly progressive blastomycosisblastomycosis2.2.Itraconazole or Ketoconazole for less severe casesItraconazole or Ketoconazole for less severe casesImmune response1.Alveolar macrophage provide a first line of defense.2.T-cell stimulated PMNs kill Blastomyces cells by oxidative mechanisms.3.Conidia are more sensitive to killing by PMNs because yeast are too big.4.TH-1 response is of primary importanceBlastomycosisTreatment4747AmphotericinBisthedrugof文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Opportunistic fungal infectionsn nOpportunistic mycoses are fungal infections that do not normally Opportunistic mycoses are fungal infections that do not normally cause disease in healthy people,but do cause disease in people cause disease in healthy people,but do cause disease in people with weakened immune defenses(immunocompromised people).with weakened immune defenses(immunocompromised people).Weakened immune function may occur due to inherited Weakened immune function may occur due to inherited immunodeficiency diseases,drugs that suppress the immune immunodeficiency diseases,drugs that suppress the immune system(cancer chemotherapy,corticosteroids,drugs to prevent system(cancer chemotherapy,corticosteroids,drugs to prevent organ transplant rejection),radiation therapy,infections(e.g.,HIV),organ transplant rejection),radiation therapy,infections(e.g.,HIV),cancer,diabetes,advanced age and malnutrition.cancer,diabetes,advanced age and malnutrition.n nThe most common infections are:The most common infections are:n nCandidiasisCandidiasisn nCryptococcosisCryptococcosisn nAspergillosisAspergillosisn nPneumocystiscariniipneumonia(PCP)Pneumocystiscariniipneumonia(PCP)n nPenicillosismarneffeiPenicillosismarneffei4848Opportunisticfungalinfection文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。白假丝酵母菌白假丝酵母菌(Candida albicans)形态：圆形或卵圆形单细胞真菌，革兰阳性繁殖：出芽繁殖，形成假菌丝，在组织易形成芽生孢子培养：普通琼脂、血琼脂与沙保培养基 需氧。室温或 37甚至42生长良好 菌落灰白色或奶油色，表面光滑，带有浓厚的酵母气味。有大量向下生长的营养假菌丝，呈类酵母型。在玉米粉培养基上可长出厚膜孢子n n属于假丝酵母菌属，俗称白念，为酵母型真菌，是条件致病菌属于假丝酵母菌属，俗称白念，为酵母型真菌，是条件致病菌 可引起皮肤、黏膜和内脏的急性或慢性炎症，即念珠菌病，是最可引起皮肤、黏膜和内脏的急性或慢性炎症，即念珠菌病，是最常见的深部感染真菌病，口腔念珠菌病是艾滋病患者最先出现的常见的深部感染真菌病，口腔念珠菌病是艾滋病患者最先出现的继发性感染。继发性感染。n n生物学特性生物学特性4949白假丝酵母菌(Candidaalbicans)形态：圆形文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。假菌丝和厚膜孢子5050假菌丝和厚膜孢子50文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Systemic involvementn nUrinary tract infectionn nPulmonary candidiasis n nEndocarditis n nMeningitisn nCandidaemia(septicaemia)Infancy,old age,pregnancy,prolong antibiotic,HIV/AIDS,diabetes 5151SystemicinvolvementUrinarytr文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。微生物检查：微生物检查：1 1、直接镜检：同时见出芽的念珠菌与假菌丝、直接镜检：同时见出芽的念珠菌与假菌丝、直接镜检：同时见出芽的念珠菌与假菌丝、直接镜检：同时见出芽的念珠菌与假菌丝 2 2、分离培养与鉴定：假菌丝，芽生孢子、分离培养与鉴定：假菌丝，芽生孢子、分离培养与鉴定：假菌丝，芽生孢子、分离培养与鉴定：假菌丝，芽生孢子 芽管形成试验芽管形成试验芽管形成试验芽管形成试验/厚膜孢子形成试验厚膜孢子形成试验厚膜孢子形成试验厚膜孢子形成试验 3 3、白色念珠菌细胞壁甘露聚糖抗原、白色念珠菌细胞壁甘露聚糖抗原、白色念珠菌细胞壁甘露聚糖抗原、白色念珠菌细胞壁甘露聚糖抗原/ELISAELISA 特异性高但敏感性低特异性高但敏感性低特异性高但敏感性低特异性高但敏感性低 4 4、动物试验：小鼠动物试验：小鼠动物试验：小鼠动物试验：小鼠5252微生物检查：1、直接镜检：同时见出芽的念珠菌与假文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Cryptococcus neoformansn n属于隐球菌属，为酵母型真菌属于隐球菌属，为酵母型真菌 传染源是鸽子，人因吸入鸽粪污染的空气而感染传染源是鸽子，人因吸入鸽粪污染的空气而感染 主要引起肺和脑的急性、亚急性或慢性感染。主要引起肺和脑的急性、亚急性或慢性感染。n n生物学特性圆形，有肥厚荚膜（一般厚度是直径的两倍）染色：一般染色法不易着色，墨汁负染，胞内有较大的反光颗粒。出芽繁殖，不形成假菌丝（酵母型菌落）培养特性：沙保或血琼脂培养基，2537生化特性：分解尿素荚膜多糖抗原：AD 和AD 5个血清型，我国约70%属A型5353Cryptococcusneoformans属于隐球菌属，文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。545454文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。致病性n n外源性感染外源性感染外源性感染外源性感染，肺是主要入侵途径，也属于人肺是主要入侵途径，也属于人肺是主要入侵途径，也属于人肺是主要入侵途径，也属于人体正常菌群，引起条件性感染体正常菌群，引起条件性感染体正常菌群，引起条件性感染体正常菌群，引起条件性感染n n原发感染通常在肺部，多数症状不明显，自原发感染通常在肺部，多数症状不明显，自原发感染通常在肺部，多数症状不明显，自原发感染通常在肺部，多数症状不明显，自愈；有的引起支气管肺炎；严重者呈暴发性愈；有的引起支气管肺炎；严重者呈暴发性愈；有的引起支气管肺炎；严重者呈暴发性愈；有的引起支气管肺炎；严重者呈暴发性感染并迅速死亡感染并迅速死亡感染并迅速死亡感染并迅速死亡n n部分患者经血行传播至中枢神经及其它组织，部分患者经血行传播至中枢神经及其它组织，部分患者经血行传播至中枢神经及其它组织，部分患者经血行传播至中枢神经及其它组织，引起肉芽肿性炎症，主要导致慢性脑膜炎引起肉芽肿性炎症，主要导致慢性脑膜炎引起肉芽肿性炎症，主要导致慢性脑膜炎引起肉芽肿性炎症，主要导致慢性脑膜炎n n致病物质：荚膜致病物质：荚膜致病物质：荚膜致病物质：荚膜5555致病性外源性感染，肺是主要入侵途径，也属于人体正常菌群，引起文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。微生物学检查微生物学检查n n负染色镜检n n抗原检查：检查患者血清和脑脊液中新隐荚膜抗原n n分离鉴定 尿素酶或酚氧化酶n n动物试验：小鼠5656微生物学检查负染色镜检56文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。曲霉Aspergillus 烟曲霉 支气管哮喘或肺部感染 毛霉Mucor 腐生菌 脑、肺、胃肠道卡氏肺孢菌Pneumocystis cari
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