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Also Read: Fungus As Cause Of Chronic Sinusitis
 

April 27, 2004, Clinical Mycology Online

Oral candidosis

• Microscopy of oral smear reveals filaments and/or yeasts
   
• Culture at 37 °C yields organism in 24–48 h
   

Vaginal candidosis

• A high vaginal swab should be taken
   
  • Microscopy reveals yeasts with or without filaments(40% sensitivity)
     
  • Culture at 37 °C yields yeast colonies in 90% of cases
     
  • Susceptibility testing is appropriate in cases of recurrent or recalcitrant infection
     

Cutaneous candidosis

• Microscopy of skin scrapings or swabs revealing yeasts withor without filaments is crucial in confirming infective status
   
• Culture at 37 °C yields yeast colonies after 24–48 h
   

Malassezia infections

• Microscopy: oval budding yeasts and short filaments[Figure 1.] [1]
   
• Culture [1]:
   
  • lipid supplement required
     
  • incubation at 32–34 °C
     
  • small yellow–cream colonies develop within 1 week
     

Mold infections of nails

• Laboratory confirmation and a careful assessment of significance is essential before treatment is commenced [2]
   
• The fungus must be seen on direct microscopic examination and grown in pure culture [Figure 2. Figure 3. Figure 4. Figure 5.]
   
• Cycloheximide-free medium should be used or mold growth will be suppressed; even on this medium, vegetative hyphae or arthroconidia may be seen and not grown so the diagnosis cannot be confirmed unless (as happens rarely) conidia are seen in air spaces, which allows immediate diagnosis
   

Keratomycosis

• Microscopy of corneal scrapings reveals fungal elements
   
• Culture at 28 °C for 2 weeks to isolate causal organism
   
• Significance increases with repeated isolation
   

Otomycosis

• Microscopic examination of debris from the ear canal will reveal branching hyphae, budding cells, or both
   
• Sporing heads may be seen in Aspergillus infections
   
• Isolation in culture allows identification of the infecting organism [Figure 6.]
   

Figure 1: Malassezia sp. Direct microscopy.

Figure 2: Acremonium sp. Conidia at apices of phialides and culture (inset).

Figure 3: Aspergillus versicolor. Fruiting structure and culture (inset).

Figure 4: Penicillium sp. Culture.

Figure 5: Penicillium sp. Fruiting structure.

Figure 6: Aspergillus niger. Fruiting structure and conidia.

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