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Fungii hialini nesepta!i

Zygomycete

mucegaiul pinii

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Zygospori de Rhizopus sp.

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Habitatul zygomicetelor

Fungi prezen!i n mediul ambiant Sol, vegetale, materie organic"n

descompunere (fructe, compost, boabe decereale)

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O important"tr"s"tur"fiziologic"a

majorit"#ii zygomicetelor este capacitatea lorde dezvoltare la 37C, ceea ce explic"

localizarea profund"a infec#iilor cu aceste

microorganisme; unele specii sunt termofile,

putndu-se dezvolta $i la temperaturi mai

ridicate:Absidia corymbifera (52C),

Apophysomyces elegans (42C),Rhizomucor

pusillus (60C).

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(Ribes J et al., Clin Microbiol Rev, 2000; Prabhu R et al., Clin Microbiol Infect 200

!

!

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Sporocist de Rhizopus sp.

spori

columel"

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Rhizopus

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Rhizopus

Sporangiofori singulari sau n grupuri

Rizoizi produ%i la baza sporangioforilor

pigmenta!i n brun Sporange (sporocist) cu o columel"bine

reprezentat"

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Absidia

(Lichthemia)

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Absidia

(Lichtheimia corymbifera) Sporangiofori ramifica!i

Columel"conic"

Septare sub columel"

Rizoizi produ%i la nivel internodal - ntre

sporangiofori

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Mucor

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Mucor

Sporangiofori neramifica!i sau ramifica!i

simpodial (alternativ pe o parte %i cealalt")

Nu produce rizoizi

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Apophysomyces elegans

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Apophysomyces elegans

Sporangiofori solitari, drep!i sau u%or

curba!i

Sporange (sporocist) piriform, necoloratpn"la gri-brun

Apofiz"proeminent", cu form"de clopot

sau plnie

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Cunninghamella

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Cunninghamella

Sporangiofori termina!i cu o columel"sferic"sau u%or

ovoidal"

Mici vezicule pot apare la bifurcarea bra!elor

sporangioforilor Sporangiospori netezi pn"la fin rugo%i

Sporangiosporii sunt produ%i n sporoci%tii secundari

(sporangioli) dezvolta!i pe suprafa!a columelei

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Syncephalastrum

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Syncephalastrum

Sporangiofori adeseori ramifica!i, termina!i

cu o columel"

Merosporangiile nconjoar"columela Sporangiospori rotunzi, dispu%i liniar n

merosporangii

Rizoizii pot fi prezen!i

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Saksenaea vasiformis

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Saksenaea vasiformis

Sporange cu morfologie distinct",

prezentnd o prelungire apical"

Rizoizi bruni prezen!i

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(Ribes J et al., Clin Microbiol Rev, 2000; Prabhu R et al., Clin Microbiol Infect 200

!

!

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Mucorales

Mucorspp.

Absidiaspp.

Rhizopusspp.

Rhizomucorspp.

Oportuni%ti redutabili prognostic infaust

Redutabili contaminan!i n laboratoare

Se izoleaz"frecvent n prelevate clinice

(cutanate, fecale)

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Epidemiologie Transmitere : sporii (dup"dehiscen!a sporangelui)

Produ%i din abunden!"de c"tre fung Particip"la aerocontaminarea

fungic"a mediului ambiant

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Epidemiologie

Contaminarea pacien!ilor :

inhalare

cutanat"(traumatisme)

Ingestie

A 3-a infec!ie fungic"invaziv"(la om):

Aspergiloz"> Candidoz"> Mucormicoze (Zygomicoze)

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Manifest"ri clinice

Maladie acut", cu localiz"ri diverse n func!ie depoarta de intrare %i terenul pacientului

Datorit"tendin#ei de invadare vascular"$i apari#ieisubsecvente a ischemiei, infarctiz"rilor $i

necrozelor, zygomicozele viscerale sunt urgen#emedico-chirurgicale al c"ror prognostic vitalr"mne infaust pentru marea majoritate a

pacien#ilor.

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Manifest"ri clinice Maladie acut", cu localiz"ri diverse n func!ie de

poarta de intrare %i terenul gazdei 5 forme majore de infec!ie:

Rinocerebral"++

Cutanat"

Pulmonar"

Diseminat" Gastrointestinal"

Prognostic sever: evolu!ie fatal"prin trombozaextensiv"a vaselor sanguine

necroza !esuturilor adiacente

(Prabhu etal., Clin Microbiol Infect 2004)

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Zygomicoz"rinocerebral"(Rhizopus oryzae)

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Celulit"- Saksenaea vasiformis

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Zygomicoze la animale

Toate speciile pot fi virtual afectate

Infec!ie rar", dignosticat" post-mortem n majoritatea

cazurilor

Acidoza metabolic" %i imunosupresia sunt factori

predispozan!i Simptomatologie nespecific", dependent" de organul/

!esutul afectat

Leziuni ulcerative post-traumatice (ornitorinci Tasmania)

Leziuni nodulare alb-g"lbui n limfonoduri, ficat, pulmoni,

rinichi

Ulcera!ii n stomac (porcine), prestomace %i abomasum

(bovine)

Placentit"hemoragico-necrotic"%i avort

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Zygomicoze la animale

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Zygomicoze la

animale

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Diagnosticul microbiologic

-Dificil

-Rar stabilit antemortem

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Diagnosticul microbiologic

Aspectul filamentelor pesec!iuni histologice,frotiuri

- Filamente scurte

- neregulate- late (10-20 &m)

- neseptate (+++)

- ramificate n unghi drept

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Diagnostic microbiologic

Cultura- Cre%tere foarte rapid"la 37C,

invadnd toat"placa Petri

- Cultivare dificil"din prelevate

- Sensibilitate redus"a culturii

(Tarrand etal.,Am J Clin Pathol-2003)

+n 52% dintre autopsii

- Permite identificarea genului %i aspeciei.

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Diagnostic microbiologic

Examenul macroscopic- Colonii cu aspect lnos, diafane

cu miceliu aerian u%or vizibil

- Culoare avers:

alb"- gri

gri nchis (sporulare)

- R"mne pal"pe revers.

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Diagnostic microbiologic

Examen microscopic- sporoci%ti u%or vizibili la stereolup"

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Diagnostic microbiologic

Examen microscopic-Filamente ne- (sau rar) septate,

late %i neregulate

-Sporangiofori

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Criterii diagnosticepentru Zygomicoze

Cultur"pozitiv"din situsuri sterile

Izolare repetat"din situsuri nesterile %i num"r

important de colonii

Examen direct pozitiv cu morfologie caracteristic"aforma!iunilor fungice %i necroza !esutului adiacent

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Zygomicoza r"mne o afec!iune dificil de diagnosticat