Aspergillosis
- 1. SUBMITTED BY AM.RAJHA VIKNESH (12UMB17) III BSC,MICROBIOLOGY
- 2. Submitted to Mrs.s.shahitha Asst professer Dept of microbiology Mcas,rasipuram
- 4. WHAT IS ASPERGILLOSIS? ASPERGILLOSIS IS A GROUP OF DISEASE CAUSED BY THE ASPERGILLUS FUNGUS SOME ASTHMA PATIENTS ARE SENSITIZED TO FUNGI ASPERGILLUS THIS CONDITION IS SEEN IN IMMUNOCOMPROMISED INDIVIDUAL AND PERSONS WITH LEUKAEMIA
- 5. Aspergillus aspergillum, which resembled the genus-characteristic conidia-forming structure of these fungi. Aspergillus is an extremely diverse and widely distributed genus of filamentous ascomycete fungi. It includes over 200 species of mostly asexual fungi found ubiquitously In soil as well as in forage products, food, dust, organic debris, and decomposing vegetation. Being supreme opportunists, the aspergilli have adapted to various chemical, physical, and biological stresses and have repeatedly changed their lifestyle and reproductive mode in the course of evolution.
- 7. Aspergillus While most of them are thought to be saprophytes. The Aspergillum number of species are able to infect wounded plants and animals. The advent of immunosuppressive agents and other medical advances created a new biological niche for aspergilli, the immunocompromised human host.
- 8. Aspergillus fumigatus Aspergillus fumigatus is a fungus of the genus Aspergillus, and is one of the most common Aspergillus species to cause disease in individuals with an immunodeficiency. A. A.fumigatus, a saprotroph widespread in nature, is typically found in soil and decaying organic matter, where it plays an essential role in carbon and nitrogen recycling. B. A. fumigatus is a well-known pathogenic fungus that is responsible for more than 80% of aspergillosis, especially in immunocompromised patients.
- 9. Caustive fungi of Aspergillosis Aspergillus fumigatus in microscopic view
- 10. CLASSIFICATION OF ASPERGILLOSIS INVASIVE ASPERGILLOSIS: * Acute (<1 month course) * subacute/chronic necrotising (1-3mon). CHRONIC ASPERGILLOSIS: (>3MON) *Chronic cavity pulmonary *Aspergilloma of lung *Chronic fibrosing of lung *Chronic invasive sinusitis *Maxillary (sinus)aspergillomma
- 11. CLASSIFICATION OF ASPERGILLOSIS ALLERGIC: *Allergic bronchopulmonary(ABPA) *Extrinsic allergic (broncho)alveolitis(EAA) *Asthma with fungal sensitisation *Allergic aspergillus sinusitis(eosinophilic fungal rhinosinusitis)
- 12. Clinical features in aspergillosis ASPERGILLOMA: Here a fungal ball grows within and is usually restricted to an existing lung cavity For example,Due to an old tuberculosis or bronchiectasis. In this type of colonising aspergillosis surgical removal is necessary it causes massive hemoptysis
- 13. Clinical features in aspergillosis INVASIVE ASPERGILLOSIS: This first causes pneumonia and later disseminates to involve other organs, For Ex: the brain , kidneys or heart Patients who develop this type of disease,which may be fatal,are usually immunocompromised or debilitated due to prolonged treatment with antibiotics,steroids and cytotoxic drugs.
- 14. Clinical features in aspergillosis SUPERFICIAL INFECTION: Superficial infections of the external ear(otomycosis) the eye (mycotic keratitis) and nasal sinuses
- 15. SECONDARY INFECTION CHEMOTHERAPHY PATIENTS TRANPLANT AND STEROID USING PATIENTS CYSTIC FIBROSIS AIDS CHRONIS OBSTRUCTIVE PULMONARY DISEASE(COPD) CHRONIC GRANULOMATIS DISEASE(CGD) SEVERE ASTHMA WITH FUNGAL SENSITIVITY(SAFS)
- 16. symptoms Fatigue Fatigue can signal many things. Here are some tips to help you decipher why you're wiped out and to regain your energy. Headache Most headaches aren't caused by a serious illness, but some could be a sign of a life-threatening condition. Runny nose Runny nose: What's causing your sniffles? Shortness of breath Shortness of breath can be frightening. Most of the time, a heart or lung condition is the cause. Unexplained weight loss Unexplained weight loss: Symptom — Overview covers possible causes of unexplained weight loss.
- 17. LAB DIAGNOSIS MICROSCOPY: In LCB wetmount, Specimen: Exudates For ex: sputum
- 18. LAB DIAGNOSIS Interpretation: Demonstrate of septate hyaline hyphae
- 19. LAB DIAGNOSIS Gomori methenamine silver staining: The processed tissue is used as specimen for gomori methenamine silver stain This gives the fungal walls a gray black colour
- 20. LAB DIAGNOSIS Immunoperoxidase stain : Immunostaining was performed on formalin fixed, paraffin wax embedded tissue using the streptavidin-biotin method and compared with conventional haematoxylin and eosin, periodic acid- Schiff, and Gomori-Grocott stains. Results of immunostaining were semiquantitatively analysed with regard to both intensity of staining and number of positively staining micro-organisms.
- 21. LAB DIAGNOSIS Immunoperoxidase staining using the monoclonal antibody EB-A1 performs well on routinely processed tissue sections and permits detection and generic identification of Aspergillus species, although it was no better than conventional histopathology in identifying the presence of an infection
- 22. LAB DIAGNOSIS ISOLATION BY CULTURE: In sabouraud dextrose agar,A.fumigatus produce velvety to powdery surface and dark green Coloured Incubation period: 3-4 days incubation at 25ᶱ - 37ᶱc
- 23. LAB DIAGNOSIS SEROLOGY: precipitating antibodies to aspergillus antigens can be demonstrated by counter –current immunoelectrophoresis,immunodiffusion and ELISA Antibodies are usually absent in the sera of healthy individuals . They can be detected in majority of patients with allergic aspergillosis and approximately the same proportion of those with pneumonia or invasive disease
- 24. LAB DIAGNOSIS SKIN TEST: Skin test reactions which develop after the intradermal injection of Aspergillus species antigens are important criteria to establish a diagnosis of allergic broncho pulmonary aspergillosis Test are two based on the time of immune response: *dual immediate-after 15 minutes *Arthus type-after 4-6 hrs
- 25. LAB DIAGNOSIS Collection of BAL:(broncho aleveolar lavage) Bronchoalveolar lavage (BAL) is a medical procedure in which a bronchoscope is passed through the mouth or nose into thelungsand fluid is squirted into a small part of the lung and then collected for examination. BAL is typically performed to diagnose lungdisease. In particular, BAL is commonly used to diagnose infections in people with immune system problems, pneumonia in people on ventilators, some types of lung cancer, and scarring of the lung (interstitial lung disease).
- 26. BAL
- 27. LAB DIAGNOSIS Galactomannan test: Invasive aspergillosis occurs in about 10% of stem cell transplant patients and 5% ofsolid organ transplant patients. Diagnosis often is difficult and antifungal therapy is usually initiated empirically, based upon fever and abnormal findings on chest CT. Typically the diagnosis is not proven by histopathology or culture. If treatment is targeted for invasive aspergillosis, and the patient has zygomycosis or another mold infection, it may not be effective. Thus, tests to assist in the accurate diagnosis of invasive aspergillosis may improve outcome.
- 28. LAB DIAGNOSIS Also, a test that assists in early diagnosis may improve outcome by permitting treatment before the infection becomes irreversible . Furthermore, a test that indicates that invasiveaspergillosis is unlikely may alert the physician to modify therapy or to pursue additional diagnostic procedures. The test is primarily used for monitoring immunosuppressed patients for development of galactomannan antigenemia, as an early marker for invasive aspergillosis. The test also is usedfor diagnosis of suspected cases of invasive aspergillosis.
- 29. LAB DIAGNOSIS The sensitivity for diagnosis on pulmonary invasive aspergillosis may be improved by testing bronchoalveolar lavage (BAL)specimens. Although the assay has its limitations, it is useful and complements other diagnostic method In hemotologic patients withinvasive aspergillosis the galactomannan test can make the diagnosis in a noninvasive way. False positive aspergillus galactomannan test have been found in patients or intravenous treatment with some antibiotics or fluids containing gluconate or citric acid as some transfusion platelets or parentral nutrition
- 30. LAB DIAGNOSIS Imaging test. A chest X-ray or computerized tomography (CT) scan — a type of X-ray that produces more-detailed images than conventional X-rays do — can usually reveal a fungal mass (aspergilloma), as well as characteristic signs of invasive and allergic bronchopulmonary aspergillosis. On chest xray and CT scan ,pulmonary aspergillosis manifests halosign and later an air crescent sign
- 31. LAB DIAGNOSIS X ray: x ray used to recognise the area of inflammation and the cloudiness Represents the hemopytic activity
- 32. LAB DIAGNOSIS CT scan: This computer tomography report is also reveal the aspergillosis
- 33. Pathogenicity Aspergillus spores are ubiquitous in nature and also a normal flora. It turns into opportunistic fungi when an individual is immunocompromised this makes platform for aspergillus to create mycoses
- 34. Pathogenicity The spore enter the human through nostrils and reaches the lungs In lungs it gets multiplied and cause suffocationin breathing. When it get severe the ball like sputum structure will expelled from mouth or nose. It can able to grow in bonemarrow and alveoli of lungs
- 35. Pathogenicity
- 36. Antigenic structure of A.fumigatus A. fumigatus has 23 allergenic proteins. Thermoto proteins have diversity of functions e.g.ribotoxin,heat shock protein) IgE can bind to multiple sites within a specific protein
- 37. Lovastatin: Toxins detract from the quality of human life, some of the products of Aspergillus metabolism have made positive contributions to the human health as drugs. aflatoxin: It cause human liver cancers. Acute human afl atoxin poisoning, however, is rare and usually only occurs when starvation forces people to subsist on moldy foods.
- 38. SPECIAL CASE This species is only known to reproduce by asexual means, but there has been accumulating evidence for recombination and gene flow from population genetic studies, genome analysis, the presence of mating-type genes and expression of sex-related genes in the fungus. Here we show that A. fumigatus possesses a fully functional sexual reproductive cycle that leads to the production of cleistothecia and ascospores, and the teleomorph Neosartorya fumigata is described. The species has a heterothallic breeding system; isolates of complementary mating types are required for sex to occur.
- 39. SPECIAL CASE We demonstrate increased genotypic variation resulting from recombination between mating type and DNA fingerprint markers in ascospore progeny from an Irish environmental subpopulation. The ability of A. fumigatus to engage in sexual reproduction is highly significant in understanding the biology and evolution of the species. The presence of a sexual cycle provides an invaluable tool for classical genetic analyses and will facilitate research into the genetic basis of pathogenicity and fungicide resistance in A. fumigatus, with the aim of improving methods for the control of aspergillosis. These results also yield insights into the potential for sexual reproduction in other supposedly ‘asexual’ fungi.