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Fungi & Mycoses - Coggle Diagram

- - - - Superficial infections (surface of skin)
      - Cutaneous (invasion of outer layers of skin)
      - Subcutaneous (deeper invasion and spreading)
    - - Most are asymptomatic or self-limiting
      - Many have specific regions where they are found
      - Infections in immunocompromised hosts can be fatal
    - - Do not normally cause severe diseases in healthy people
      - Can cause real issues in immunocompromised people
      - Candida albicans (and C. galbrata)
        
        Vaginal and oral thrush, cutaneous infections (diaper rash), systemic infections
        
        Normal flora in humans (only found in humans)
        
        Can enter by GI, upper respratory, oral cavity, vaginal tract
        
        Damage from invasive devices can permit candida to enter bloodstream
        
        Epithelial damage from chemo also enables invasion
        
        Growth
        
        Normally suppressed by other microorganisms found in colonized areas (pH, glucose)
        
        Mostly yeast in vitro, yeast, hyphae and pseudohyphae in body
        
        Causes damage by way of our own immune system responding to it like TB (can contribute to septic shock
        
        Hyphae are too big for phagocytosis, but are damaged by PMNs and extracellular mechanisms
- - - - Miconazole - Imidazole family
      - Fluconazole - Triazole family
      - These inhibit CYP450-dependent enzymes involved in biosynthesis of cell membrane sterols
    - - Amphotericin B
        
        Affinity for membrane ergosterol
        
        makes the cell membranes leaky
        
        Binds to cholesterol with severe side effects (low therapeutic index - bad for us)
      - Nystatin
        
        Topical only
    - - Block ergosterol synthesis
      - Topical use
      - Used for dermatophytes (athlete's foot, etc.)
      - Terbinafine
  - - - Caspofugin
      - Inhibit glucan synthase - essential component of cell wall
      - Limited human toxicity - it's safe
  - - - Inhibits protein synthesis and DNA synthesis
      - Resistance is a problem, so it's not prescribed by itself
      - Activated by fungal cells to 5-fluorouracil