Zygomycosis

Zygomycosis

1. zygomycosis Presented by : Sadia yahya Maryum Amjad khan Aqib jan B asharat

2. Zygomycosis is the fungal disease which is caused by, Mucorales Entomophthorales These are bread mold fungi, belong to , Phylum Zygomycota Family Mucoraceas Group M ucormycetes Order Mucoracease These fungi ( spores) are present throughout the environment. ( Vegetables, Soil, Water, Decaying, leaves). These spores are inhaled by the individuals which caused infection . Primary infected the Lung. Also caused dissemination infection if enter into the blood stream, which commonly affect the lungs, GIT and Skin. caused infection in immunocompromised patients, AIDs and cancer patients, Childs and the most who exposure to the spores of the fungi. INTRODUCTION

3. It also caused disseminated infection if entered into the blood stream spreads which affect the lungs and brain and, in the worst cases, cause pneumonia, infection of the brain, seizures, paralysis, and death. This infection is diagnosed with laboratory tests examining nasal discharges and phlegm, as well as by conducting biopsies of, for example, lung lesions. Treatment includes surgical removal of the infected tissue, if possible, and use of medicines such as high-dose amphotericin B. These fungi live throughout the environment, particularly in soil and in association with decaying organic matter, such as leaves, compost piles, or rotten wood. The disease is not passed person to person. INTRODUCTION…

4. Mainly caused by these two species Mucorales and Entomophthorales Other Species are Rhizopus  species  Mucor  species  Cunninghamella bertholletiae Apophysomyces  species and  Lichtheimia  species. Etiology

5. Zygomycosis can affect nearly any parts of the body, but it most commonly affects the sinuses or the lungs in people who having weakened immune systems. Rhinocerebral (sinus and brain) zygomycosis : It  is an infection in the sinuses that can spread to the brain. This form of zygomycosis is most common in people with uncontrolled diabetes. Pulmonary (lung) zygomycosis : It  is the most common type of zygomycosis in people with cancer and in people who have had an organ transplant or a stem cell transplant . Types of zygomycosis

6. Gastrointestinal zygomycosis :   This can result from ingestion of the fungal spores. This type of zygomycosis is less common among adults and is more common among young children, especially infants <1 month of age. Cutaneous (skin) zygomycosis : This occurs after the fungi enter the body through a break in the skin (for example, after surgery, a burn, or other type of skin trauma). This is the most common form of zygomycosis among people who do not have weakened immune systems. Disseminated zygomycosis  : This occurs when the infection spreads through the bloodstream to affect another part of the body. The brain is the most commonly affected part of the body, but other organs such as the spleen, heart, and skin can also be affected. Types …

7. The symptoms of zygomycosis depend on where in the body the fungus is growing. Zygomycosis is rare and typically affects people with weakened immune systems. pulmonary (lung) zygomycosis Chest pain Cough Coughing blood (occasionally) Fever Disseminated zygomycosis T ypically occurs in people who are already sick from other medical conditions, so it can be difficult to know which symptoms are related to zygomycosis . Patients with disseminated infection in the brain can develop mental status changes or coma . Symptoms of Zygomycosis

8. Abdominal pain Blood in the stools Diarrhea Vomiting blood Blisters or ulcers T he infected area may turn black Pain Warmth E xcessive redness S welling around a wound. Gastrointestinal mucormycosis Cutaneous (skin) zygomycosis Symptoms of Zygomycosis

9. Dark scabbing in nasal cavities Mental status changes Redness of skin above sinuses Sinus pain or congestion One-sided facial swelling Eyes that swell and stick out (protrude) Headache Black lesions on upper inside of mouth Fever Symptoms of  rhinocerebral ( sinus and brain) zygomycosis

10. Inhalation of spores is the most common mode of entry. The spores then germinate to produce hyphae, which invade blood vessels, causing thrombosis and subsequent tissue necrosis. Invasion of the vessels also promotes dissemination of the fungus to other organs. Normal mononuclear and polymorpho nuclear phagocytes are essential to kill Mucorales by generating oxidative metabolites and cationic peptide defensins . Macrophages inhibit spore germination and neutrophils damage hyphae. Various factors increase the risk of acquiring mucormycosis by impairing either quantity of neutrophils, as in chemotherapy-induced neutropenia, or quality of neutrophils, as with corticosteroids and acidosis. Pathogenesis

11. Diabetes, especially with diabetic ketoacidosis Cancer Organ transplant Stem cell transplant Neutropenia (low number of white blood cells) Long-term corticosteroid use Skin trauma (due to surgery, burns, or other skin injuries) AIDS Diabetes (usually poorly controlled) Leukemia and lymphoma Long-term steroid use Poor nutrition (malnutrition) Risk Factors

12. People get zygomycosis by coming in contact with fungal spores in the environment. For example, the lung or sinus forms of the infection can occur after someone inhales the spores from the air. Zygomycosis can develop on the skin after the fungus enters the skin through a cut, scrape, burn, or other type of skin trauma. Is zygomycosis contagious? No. Zygomycosis can’t spread between people or between people and animals . Transmission

13. International The distribution of the various forms of zygomycosis is uniform regardless of age, geography, or race. Mortality/Morbidity The overall mortality rate associated with zygomycosis is approximately 50% and has remained at this level for the past 50 years. Rhinocerebral zygomycosis carries a mortality rate of approximately 85%. Mortality rates are very high because, by the time zygomycosis is suspected and diagnosed, it has frequently spread diffusely and caused extensive tissue destruction. However, the risk of mortality varies depending on the characteristics of the host, the type of infection, the site of infection, and the use of surgical intervention. Sex According to the latest epidemiologic surveys, approximately two thirds of all zygomycosis cases occur in males. Epidemiology

14. M edical history, symptoms, physical examinations, and laboratory tests Specimens: Aspirated material from sinuses Sputum in pulmonary disease Biopsy material Diagnosis

15. The following steps are used for the both types of Zygomycosis 10 or 20% KOH Typically contain thick-walled aseptate hyphae Swollen cells (up to 50 um) and distorted hyphae may be present Culture SDA without cycloheximide at 30°C Rapid growth A diagnosis can also be made by examining a biopsy for granuloma formation and the presence of aseptate hyphae, eosinophils, neutrophils, and fibroblasts. Tissue for culture should be send in a dry sterile container, and biopsies should be fixed and send in formal saline.

16. Sporangium containing sporangiospores

17. Spherical, brown zygospores formed between opposite suspensors. Also, present sporangiola .

18. Typical colony on Sabouraud glucose agar at 25C

19. Hyphae in lung tissue

20. Hyaline sparsely septate hyphae biopsy specimen of palate.

21. Wide, sparsely- septate hyphae and striated sporangiospores

22. Non- septate ( coenocytic ) hyphal strand characteristic of the fungi belonging to the Zygomycetes

23. Zygomycosis is a serious infection and needs to be treated with prescription antifungal medication, usually amphotericin B, posaconazole or isavuconazole . Through a intravenous (amphotericin B, posaconazole , isavuconazole ) by mouth ( posaconazole , isavuconazole ). Often, zygomycosis requires surgery to cut away the infected tissue. Prevention Because the fungi that cause mucormycosis are widespread, the best way to prevent this infection is to improve control of the illnesses associated with mucormycosis . Treatment

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