Dermatophytes: Difference between revisions

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== Species and Classification ==
== Species and Classification ==
* Three common genii: ''Epidermophyton'', ''Microsporum'', and ''Trichophyton''

* Three common genii:
** Epidermophyton
** Microsporum
** Trichophyton
* Three categories: anthropophilic, zoophilic, and geophilic
* Three categories: anthropophilic, zoophilic, and geophilic


== Presentation ==
== Presentation ==
* Clinical presentation is usually as '''ringworm'''

** Most active form is in the periphery of the ring
* Clinical presentation is usually ringworm
** Most active form in the periphery of the ring
** Can invade immunocompromised patients, e.g. Majocchi's granuloma and kerion
** Can invade immunocompromised patients, e.g. Majocchi's granuloma and kerion
* Named by anatomic location
* Named by anatomic location
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== Diagnosis ==
== Diagnosis ==

=== Specimen collection ===
=== Specimen collection ===

* Hair: need the root, with sterile forceps
* Hair: need the root, with sterile forceps
* Skin: disinfect with alcohol or sterile water, then scrape the border with a blunt scalpel
* Skin: disinfect with alcohol or sterile water, then scrape the border with a blunt scalpel
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=== Laboratory Testing ===
=== Laboratory Testing ===

* Direct microscopy: KOH (potassium hydroxide) calcofluor of skin scraping, under UV light
* Direct microscopy: KOH (potassium hydroxide) calcofluor of skin scraping, under UV light
* Culture with Littman agar w streptomycin, Sabouraud agar with chloram+gent, Sabouraud agar with CG+cyclohexamide
* Culture with Littman agar w streptomycin, Sabouraud agar with chloram+gent, Sabouraud agar with CG+cyclohexamide
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=== Indentification ===
=== Indentification ===

* Chemical properties
* Chemical properties
** Growth at 37ºC
** Growth at 37ºC

Revision as of 01:32, 31 January 2020

Species and Classification

  • Three common genii: Epidermophyton, Microsporum, and Trichophyton
  • Three categories: anthropophilic, zoophilic, and geophilic

Presentation

  • Clinical presentation is usually as ringworm
    • Most active form is in the periphery of the ring
    • Can invade immunocompromised patients, e.g. Majocchi's granuloma and kerion
  • Named by anatomic location
    • Tinea capitis: head
    • Tinea corporis: body
    • Tinea cruris: groin
    • Tinea unguun: nails

Diagnosis

Specimen collection

  • Hair: need the root, with sterile forceps
  • Skin: disinfect with alcohol or sterile water, then scrape the border with a blunt scalpel
  • Nails: alcohol gauze to clean, then scrape subungual debris

Laboratory Testing

  • Direct microscopy: KOH (potassium hydroxide) calcofluor of skin scraping, under UV light
  • Culture with Littman agar w streptomycin, Sabouraud agar with chloram+gent, Sabouraud agar with CG+cyclohexamide
    • Incubate for 2-3 weeks at 30ºC

Indentification

  • Chemical properties
    • Growth at 37ºC
    • Urease production/urea hydrolysis
    • BCP-MSG reaction (important)
    • Hair perforation test
    • Vitamin requirements with trichophyton agars T1 to T7
    • Growth on polished rice grain
  • Colony features
    • Speed of growth
    • Colour on surface
    • Texture
    • Colour on reverse
  • Microscopic features
    • Macroconidia, microconidia, septae