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Mycology (Dimorphic Fungus, Tinea, Mycetoma, Candida)

Feb 17, 2023


Mycology, which is the study of fungi, is an important topic in microbiology. Fungal infections are becoming increasingly common, making mycology a highly relevant topic for the NEET PG exam.

Moreover, fungal infections can often mimic bacterial or viral infections, which makes it all the more essential to have a strong understanding of mycology in order to avoid misdiagnosis.

Let’s learn more about this important NEET PG exam topic of microbiology through this blog.

ENT Residency

Morphological Classification

  • Yeast - Cryptococcus neoformans
  • Yeast like - Candida (Yeast, yeast like hyphae, pseudo hyphae)
  • Molds - Aspergillus, Rhizopus

Dimorphic Fungus

  • Mold– 25° C
  • Yeast - 37° C

Dimorphic Fungal Disease

  • Histoplasmosis            
  • Sporotrichosis
  • Blastomycosis
  • Coccidioidomycosis
  • Paracoccidioidomycosis
  • Penicilliosis

Types Of Spores

Sexual Spores

  • Zygospores
  • Ascospores
  • Basidiospores

Asexual Spores

  • Arthroconidia
  • Blastomyces
  • Chlamydospores

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Based On Location

Superficial Mycosis

  • Tinea versicolor
  • Tinea nigra
  • Dermatophytes

Subcutaneous Mycosis

  • Mycetoma
  • Rhinosporidiosis
  • Chromoblastomycosis
  • Sporotrichosis

Systemic Mycosis / Deep Mycosis

  • HSBCP2 (All dimorphic fungal diseases)
  • Candida
  • Cryptococcus

Lab Diagnosis

Culture Media

  • SDA (Sabouraud’s dextrose agar) → Universal fungal culture media
  • pH = 5.4 – 5.6
C:\Users\Naveena Anu\Downloads\SDA (1).png

Fungal Stains

  • Negative staining (Eg: Cryptococcus) capsule
    • Indian ink stain
    • Mucicarmine stain
    • Nigrosin
  • GMS (Gomori Methenamine Silver)
    • Eg: Pneumocystis Carinii (Green colour)
  • LPCB (Lactophenol Cotton Blue)
  • H&E (Haematoxylin + Eosin)
  • Calcofluor white – Fungal Fluorescent stain  

Important Information

  • Wet mount with 10% KOH - to see fungal elements

Also Read: HELMINTHOLOGY : Structure, Classification, Growth, and Development : NEET PG Microbiology


T. Versicolor (Pityriasis Versicolor)

C:\Users\Naveena Anu\Downloads\pityriasis versicolor.png
  • Caused by Malassezia furfur / M. globosa
  • Spaghetti & meatball appearance 
  • Fried egg colonies (lipophilic fungus) on SDA
  • Golden yellow fluorescence

T. Nigra

  • Exophiala werneckii

Piedra (Hair nodules)

  • Trichosporon beigelii
  • Black
  • Piedra Hortae


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  • Lab Diagnosis
    • Culture growth on SDA + LPCB
TrichophytonPencil shapedNumerous
MicrosporumSpindle shapedLess 
EpidermophytonClub / boat shapedAbsent microconidia
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T. Capitis

  • Favus
    • T. Schoenleinii(Trichophyton)
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  • Kerion
    • Painful boggy swelling
    • T. Mentagrophytes, T. Verrucosum

T. Cruris

  • Dhobi itch or jock itch

T. Pedis

  • Athlete’s foot 

MYCETOMA (Madura foot)

  • Triad
    • Sinus
    • Swelling
    • Granules (Discharging)
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  • Numerous sinus & swelling
  • Colour of granules – Yellow / white except in – Actinomadurae pelletieri where they have red granules
  • Responds to antibiotic
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  • Single sinus & swelling
  • Black -Madurella mycetomatis
  • White – Acremonium, Pseudallescheria boydii
  • Amputation
  • C:\Users\Naveena Anu\Downloads\Eumycetoma final.jpg


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  • Caused by Rhinosporidiumseeberi
  • Aquatic protist – protozoa
  • B/ L nasal polyp
  • On Polyp biopsy 
    • Spherule
    • Within spherule there are endospores
C:\Users\Naveena Anu\Downloads\Rhinosporidiosis_spherules.jpg
  • Non cultured on SDA
  • Treatment – Surgical removal


  • Colourful fungus
  • Dematiaceous fungus
  • Eg
    • Alternaria
    • Bipolaris
    • Curvularia
    • Phialophora
    • Cladosporium
    • Exophiala werneckii
  • Thorn prick / wood worker → Verrucous lesion
  • On tissue biopsy + H & E staining
    • Medlar bodies
    • Brown coloured sclerotic bodies
    • Copper penny / muriform appearance


  • Sporothrix schenckii
  • Rose gardener’s disease
  • Lymphocutaneous spread
  • Increased incidence in and around valentine’s day
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  • Dimorphic
    • Mold-Flower like sporulation
    • Yeast- Cigar shaped yeast cell (Narrow based budding)
    • Asteroid yeast cell


  • Darling’s Disease
  • Mimics TB (when involves lungs)
  • Histoplasma capsulatum
C:\Users\Naveena Anu\Downloads\Histoplasma capsulatum.jpg
  • Aerosols - Pulmonary involvement
  • Blood 
  • Visceral involvement
  • Mold - Tuberculate macroconidia
  • Yeast - Narrow based budding


C:\Users\Naveena Anu\Downloads\blastomycosis.jpg
  • North American’s disease / Gil Christ disease
  • Yeast cell → Figure of ‘8’ appearance or broad-based budding yeast cell
  • Can happen in HIV + person


C:\Users\Naveena Anu\Downloads\coccidio barrel shaped.jpg
  • Caused by coccidioides immitis
    • San Joaquin Valley Fever 
    • Desert Rheumatism
  • Mold-Arthroconidia arrangement (Rectangular)
  • Yeast - Spherule with endospore


  • South American disease / LUTZ mycosis
  • Yeast cell - Mickey mouse appearance / Mariner’s wheel appearance
C:\Users\Naveena Anu\Downloads\paracoccidiomycosis.jpg


  • Penicillium marneffei
  • Found in HIV +ve
  • Brick reddish colour pigment
  • Brush conidial arrangement
C:\Users\Naveena Anu\Downloads\penicillin marneffi colony.jpg


Candida albicans

  • Reynold braude Phenomenon (Germ tube formation)
  • reynold braude phenomenon
  • Chlamydospore formation on corn meal agar (Nutrient deficient media)
  • Chlamydospore formation on corn meal agar

C. Krusei

  • Inherent resistant to azoles

C. Auris

  • Worldwide infection in Immunodeficient individuals
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Candida Albicans

  • Diseases
    • Oral thrush
    • Oesophageal candidiasis
    • Vaginal candidiasis (Curdy white discharge)
    • Onychomycosis (Nail folds)
    • Candidemia
    • Candiduria
    • Meningitis
  • Predisposing factor 
    • Steroids use,immune deficient individuals, neutropenic patients > HIV +ve
    • CMC (Chronic mucocutaneous candidiasis) (T cell disorders)
  • Lab Diagnosis
    • Cultured on SDA → creamy & pasty colonies
    • SDA-cannot differentiate Cryptococcus and candida
    • Chrome agar → colourful fungus
    • PCR for C. Albicans
    • For invasive candidiasis → β D glucan assay


C:\Users\Naveena Anu\Downloads\cryptococccus.png
  • Trust yeast
  • In immune deficient (HIV +ve)
  • Transmission by 
    • Pulmonary infections
    • Blood 
    • Meninges (Meningitis)

C. Meningitis

  • Lab Diagnosis
    • Blood & CSF
      • Cultured on SDA
      • Smooth mucoid creamy colonies (SDA cannot differentiate Cryptococcus and Candida)
    • Phenyl oxidase enzyme in Cryptococcus – responsible for melanin production
    • On Niger seed agar – Brown black colonies are seen
    • Latex card agglutination Test for Cryptococcal Antigen
    • PCR for C. Neoformans
    • Capsulated organism (Polysaccharide) - Indian ink staining (negative stain)
    • Polysaccharide capsule → Virulence factor
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  • Treatment
    • DOC Cryptococcal meningitis - Lysosomal amphotericin B (LAMB)+ Flucytosine


  • Seen in Terminally ill patients
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  • Rhizopus
  • Absidia
  • Mucor
    • Rhinocerebral Zygomycosis is a fulminant disease
  • Lab Diagnosis
    • Tissue biopsy - H & E stain
      • Aseptate hyphae
      • Obtuse angled
    • Biopsy material on SDA
    • Culture growth + LPCB

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Different Zygomycetes


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  • Absidia – Inter nodal rhizoids arrangement
  • Mucor - No rhizoids


C:\Users\Naveena Anu\Downloads\mucormycosis.png
  • Mucormycosis is commonly seen in
    • DM
    • Frequent blood transfusion
    • Chronic dialysis


  • Common in DM, Immunodeficient

A. Fumigatus

  • Leads to allergic bronchopulmonary aspergillosis
  • Associated with aspergilloma (Fungal balls)
  • Oculomycosis
  • Otomycosis
  • On SDA Greenish colour colonies in SDA

A. Niger

  • Blackish crust from ear
  • On SDA - Black coloured colonies

A. Flavus

  • produces aflatoxin which leads to hepato cellular Carcinoma
  • Lab Diagnosis: On Tissue Biopsy + H & E Staining
    • Septate hyphae
    • Dichotomous branching
    • Mostly Angle 45º
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Important Information

  • Ergotoxicosis
  • Claviceps purpurea seed along with edibles.
  • St. Anthony’s fire or St. Vitus dance

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