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Description and Habitats TYPICAL CASE: An uncontrolled diabetic patient comes to ER (may be comatose depending on the state of diabetes) and a cotton-like growth is observed on the roof of the mouth or in the nose. These are the hyphae of the organism. If untreated, the patient will die within a few hours or days. What do you do to help this patient first? Controlling the diabetic state is most important before administering amphotericin. These fungi have a
tendency to invade blood vessels (particularly arteries) and enter the brain
via the blood vessels and by direct extension through the cribiform plate. Rhinocerebral infections are usually
fulminant and frequently fatal.
This is why they cause death so quickly. Macroscopic Features Absidia corymbifera grows rapidly. The rapid growing, flat, woolly to cottony, and olive gray colonies mature within 4 days. The diameter of the colony is 3-9 cm following incubation at 25°C for 7 days on potato glucose agar. The texture of the colony is typically woolly to cottony. From the surface, the colony is grey in color. The reverse side is uncolored and there is no pigment production. Absidia corymbifera is a psychrotolerant-thermophilic fungus. It grows more rapidly at 37°C than at 25°C. Its maximum growth temperature is as high as 48 to 52°C. The growth of Absidia corymbifera is optimum at 35-37°C and at a pH value of 3.0 to 8.0. Microscopic Features Similar to that of the other members of the class Zygomycetes, Absidia corymbifera has wide (6-15 µm in diameter) nonseptate hyphae. A few septa may occasionally be present. Rhizoids are rarely observed. When present, the sporangiophores arise on stolons from points between the rhizoids, but not opposite the rhizoids. The sporangiophores are branched and arise in groups of 2-5 at the internodes. They often produce arches. Sporangiophores carry pyriform, relatively small (20-120 µm in diameter) sporangia. A septum is usually present just below the sporangium in the sporangiophore. The sporangiophore widens to produce the funnel-shaped apophysis beneath the sporangium. The apophysis of Absidia corymbifera is very well-developed and typical. The columella, the tip of the sporangiophore that extends into the sporangium, is semicircular in shape and has a small projection on top. Upon dissolving of the sporangial wall, a short remaining collarette may be observed overlining the apophysis. The sporangiospores are one-celled, hyaline to light black, round to oval in shape, smooth or rarely echinulate on surface and 3-4.5 µm in diameter. They are found in the sporangium and are released to the surrounding when the sporangium ruptures. Laboratory
Precautions General laboratory precautions are required, no special safety measures needed. Susceptibility In vitro susceptibility data reported so far are limited . MIC breakpoints for interpretation of in vitro susceptibility results have not been defined. Similar to the other members of the class Zygomycetes, amphotericin b appears as the sole antifungal drug which is consistently active against Absidia corymbifera . In general, it is resistant to azoles, including the newer derivatives such as voriconazole. flucytosine is also ineffective against Absidia corymbifera . Some strains may yield relatively low MICs of sordarin group of compounds. However, the significance of this finding is unclear.
In vivo response, on the other hand, largely depends on administration of
full-dose amphotericin B therapy as well as extensive surgical debridement
and correction of the underlying predisposing factors (such as
immunosuppression and diabetic acidosis). |
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The mycological information gathered and organized in
this extensive research on different Pathogenic Molds was sourced
out from the list of informative websites below: |
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