Pictorial supplement to The Fifth Kingdom - Chapter 23

Medical Mycology    (25 pictures)

Please proceed with caution, since
some of the images in this chapter are intimate in a clinical sense,
while others are extremely gruesome,
and a few will excite great pity in the onlooker
- steel yourself for some visual shocks

"He stood up, undid his belt with extreme awkwardness, and dropped his trousers.    'Look!' said Juan. 'It hurts me a lot.  It even hurts at night.'   Two red patches, slightly scaly at the edges, spread widening up his inner thighs and disappeared under his pants.  The fungus had got him." (quoted from In Trouble Again - A journey between the Orinoco and the Amazon by Redmond O'Hanlon).

A 23-year-old bricklayer appeared at hospital with a 3-month history of running sores on his upper lip.  Bald spots were appearing where the hair of his beard had fallen out...  Five months before, he had noted that the muzzle of his dog was infected, and that its hair had fallen out.  Cultures from Man and dog were identified as Trichophyton mentagrophytes, a common cause of skin, hair and nail infections in man and beast.  Ketoconazole (200 mg twice a day for a month) produced a cure, but the moral of the tale is clear: kiss your dog at your peril.  (adapted from Mycena News, newsletter of the Mycological Society of San Francisco, September 1998)


Three rather different groups of fungi actually cause specific diseases. A few fungi (dermatophytes), like the one that got Juan, have evolved a rather specific ability to attack the outer surface of human beings. A few other fungi which cause disease in people are normally soil organisms, but have also adapted to life in the unusual and rather hostile environment of the human body, often responding to this environment by developing a different morphology (thermal dimorphic saprobes). A third group of opportunistic saprobes can attack us only when our defences are down -- when our immune systems themselves are diseased or deficient, or when we artificially suppress them, as we must to prevent the rejection of transplanted organs.

We can divide fungal attacks on our persons into:
(1) cutaneous infections, which involve the outer layers of the skin and cause an allergic or inflammatory response;
(2) subcutaneous infections, usually involving fungi of low inherent virulence which have been introduced to the tissues through a wound of some kind, and which remain localized or spread only by direct mycelial growth; and
(3) systemic infections, which are caused, either by true pathogenic fungi which can establish themselves in normal hosts, or by opportunistic saprobic fungi which could not infect a healthy host, but can attack individuals whose immune system is not working. Both kinds of fungi sometimes become widely disseminated through the body of the host.

Following are some pictures .... for the full text please refer to the book or CD-ROM

 

Cutaneous infections

23-1 tinea capitis Ttonsurans.jpg (6741 bytes) tinea capitis - Trichophyton tonsurans.
23-2 Epidermophyton floccosum B&A.jpg (4921 bytes) Epidermophyton floccosum - before and after treatment.
23-3 Epidermophyton or Trichophyton.jpg (5206 bytes) tinea corporis - Epidermophyton or Trichophyton.
23-4 Tinea cruris Efloccosum.jpg (6840 bytes) tinea cruris (jock itch or crotch rot) - Epidermophyton floccosum.
23-13 Aftate.jpg (10231 bytes) Ad. for a jock itch treatment...
23-14 Cruex.gif (11616 bytes) ...and another.
23-12 Tinactin tolnaftate.jpg (6564 bytes) a treatment for athlete's foot...
23-11 Desenex.jpg (10461 bytes) ...another remedy.
23-5 Trichophyton hand.jpg (7871 bytes) Medical mycology - Trichophyton sp.infection
23-6 Trichophyton foot.jpg (5345 bytes) Medical mycology - Trichophyton sp.infection
23-7 onychomycosis EorT.jpg (5386 bytes) Medical mycology - onychomycosis - Epidermophyton or Trichophyton destroying the toenails.
23-8 buccal candidiasis.jpg (7712 bytes) Medical mycology - thrush or buccal candidiasis - Candida albicans.
23-9 intertrigo Candida.jpg (4439 bytes) Medical mycology - intertrigo - Candida albicans.
23-10 vulvovaginitis Candida.jpg (4750 bytes) Medical mycology - vulvovaginitis - Candida albicans.

Subcutaneous infections

23-15 chromoblastomycosis.jpg (6730 bytes) Medical mycology - chromoblastomycosis
23-16 sporotrichosis.jpg (5859 bytes) Medical mycology - sporotrichosis - Sporotrichum schenckii.
23-17 sporotrichosis.jpg (4207 bytes) Medical mycology - sporotrichosis.

Systemic mycoses

23-18 Histoplasma.jpg (7387 bytes) Medical mycology - spore of Histoplasma capsulatum, cause of histoplasmosis.
23-19 coccidioidomycosis.jpg (6753 bytes) Medical mycology - disseminated coccidioidomycosis - Coccidioides immitis.
23-20 NAmerBlastomycosis.jpg (8262 bytes) Medical mycology - North American blastomycosis - Blastomyces dermatitidis.
23-21 rhinocerebral mucormycosis.jpg (4778 bytes) Medical mycology - rhinocerebral mucormycosis in acidotic diabetics.

Congratulations!  If you got this far, it may mean that you have read the whole book, or at least looked at all the pictures.  If you have, you get to join the "Club des Mycologues".  If you haven't, why not go back and look at everything you missed on earlier browsings...most of the chapters are far less disturbing than this one...   Enjoy!  

see also Jock Itch and other dermatophytes...

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