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W h i t eW h i t e s u p e r f i c i a l s u p e r f i c i a l Onychomycosis Onychomycosis ,, Khari Khari
DiseaseDisease in in buffaloes buffaloes Dr.Kedar Karki Dr.Kedar Karki
Senior vet. Officer Senior vet. Officer Central Veterinary Central Veterinary
Laboratory KathmanduLaboratory Kathmandu
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Introduc tion Introduc tion
SinceSince 19831983--19841984,, First First timetime aa mystriousmystriousdiseasedisease waswas reportedreported byby fieldfield veterinarianveterinarian
(Karki(Karki HH..C)C) inin district district of of DarchulaDarchula withwith somesomechalkychalky dust dust comingcoming downdown fromfrom hoof hoof of of animalanimal especiallyespecially duringduring thethe monthmonth of of JanuaryJanuary toto JulyJuly inin specificspecific areaarea somesome kindkind of of
symptomsymptom beginbegin toto appearappear adjoiningadjoining district district withwith samesame symptomssymptoms inin samesame seasonsseasons..
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Introduc tion Introduc tion
A s A s perper symptomsymptom shownshown byby diseaseddiseased animal,animal,thethe entityentity waswas just just forfor thethe shakeshake of of recordrecord
waswas namename KhariKhari oror chaukhorichaukhori inin locallocald i l i t i c e sd i l i t i c e s
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Symptoms of disease when in Sy mptoms of disease when in occur
eoccur
e
Denudation of hair at tail twitch.Denudation of hair at tail twitch.
Rough coat.Rough coat.LethargicLethargic
InappeatanceInappeatance
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Sy mptoms of disease when it Sy mptoms of disease when it occuroccur
Unconscious movement.Unconscious movement.
Fore part leg at scapula region bow shapedFore part leg at scapula region bow shaped
shouldershoulderRest on knee.Rest on knee.
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Sy mptoms of disease when it Sy mptoms of disease when it occursoccurs
Chalky powder drops from hoof.Chalky powder drops from hoof.
Rocker shaped foot, which enables toRocker shaped foot, which enables to
normal movement.normal movement.Mortality in some cases.Mortality in some cases.
A fter change in season disease suppress A fter change in season disease suppress
itself itself
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stiffness of joints, lameness, roughstiffness of joints, lameness, roughcoat, loss of long hair, and hoof coat, loss of long hair, and hoof
sloughing and deformitiessloughing and deformities
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Hoof deformities are a classic signHoof deformities are a classic signpain for the animal;pain for the animal;
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Diagnosis of disease:Diagnosis of disease:
Mainly preMainly pre--history of animal, whetherhistory of animal, whetheranimal had been fed the type of plant.animal had been fed the type of plant.
A nalysis of feed fodder in area. A nalysis of feed fodder in area.Parasitological Examination.Parasitological Examination.
Examination of skin scrapings.Examination of skin scrapings.
Blood chemical analysis.Blood chemical analysis.Mycological Examination.Mycological Examination.
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Laboratory Findings.Laboratory Findings.
low blood phosphorus.low blood phosphorus.
Mite.Mite.
Protein deficient in fodder.Protein deficient in fodder.Presence of Blastomyces spp, CandidaPresence of Blastomyces spp, Candida
spp, A bsidia spp., A spergillus spp in hoof spp, A bsidia spp., A spergillus spp in hoof
scrapingscraping
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OnychomycosisOnychomycosis
Onychomycos i sOnyc homy cos i s e ncom passe sencompasse s bo thbo thdermatophytedermatophyte andand nondermatophytenondermatophyte nailnaili n f e c t i o n si n f e c t i o n s
RepresentsRepresents upup toto 3030%% of of diagnoseddiagnoseds u p e r f i c i a ls u p e r f i c i a l f u n g a lf u n g a l i n f e c t i o n si n f e c t i o n s
EtiologicEtiologic agentsagents areare:: Epidermophyton,Epidermophyton,Microsporum,Microsporum, andand TrichophytonTrichophyton fungifungi
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OnychomycosisOnychomycosis
TheThe causativecausative pathogenspathogens of of onychomycosisonychomycosisincludeinclude dermatophytes,dermatophytes, Candida,Candida, andand nonnon--dermatophyticdermatophytic mouldsmoulds.. DermatophytesDermatophytes arearethethe fungifungi most most commonlycommonly responsibleresponsible forforonychomycosisonychomycosis inin thethe temperatetemperate westernwesterncountriescountries;; meanwhile,meanwhile, CandidaCandida andand nonnon--
dermatophyticdermatophytic mouldsmoulds areare moremore frequentlyfrequentlyinvolvedinvolved inin thethe tropicstropics andand subtropicssubtropics withwith aah o t h o t a n da n d h u m i dh u m i d c l i m a t ec l i m a t e ..
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White superficial OnychomycosisWhite superficial Onychomycosis
whitewhite superficialsuperficial OnychomycosisOnychomycosis (WSO),(WSO),andand moremore rarely,rarely, WSOWSO cancan bebe causedcaused bybyspec iesspec ies of of nondermatophytenondermatophyte moldsmolds..TrichophytonTrichophyton mentagrophytes,mentagrophytes, Aspergillus Aspergillusterreus,terreus, Acremonium Acremon ium roseogr iseum,roseogr iseum,F u s a r i u mF u s a r i u m o x y s p o r u mo x y s p o r u m
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PathogenicityPathogenicity
DermatophytosisDermatophytosis (tinea(tinea oror ringworm)ringworm) of of thethescalp,scalp, glabrousglabrous skin,skin, andand nailsnails isis causedcaused bybyaa closelyclosely relatedrelated groupgroup of of fungifungi knownknown asasdermatophytesdermatophytes whichwhich havehave thethe abilityability totoutiliseutilise keratinkeratin asas aa nutrient nutrient source,source, ii..ee.. theytheyhavehave aa un iqueun ique enzymat i cenzymat i c capac i t ycapac i t y
[ k e r a t i n a s e ][ k e r a t i n a s e ] ..
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PathogenicityPathogenicity
TheThe diseasedisease processprocess inin dermatophytosisdermatophytosis isisuniqueunique forfor twotwo reasonsreasons:: Firstly,Firstly, nono livinglivingtissuetissue isis invadedinvaded thethe keratinisedkeratinised stratumstratumcorneumcorneum isis simplysimply colonisedcolonised.. However,However, thethepresencepresence of of thethe fungusfungus andand itsits metabolicmetabolicproductsproducts usuallyusually inducesinduces anan allergicallergic andand
inflammatoryinflammatory eczematouseczematous responseresponse inin thetheh o s t h o s t ..
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PathogenicityPathogenicity
TheThe typetype andand severityseverity of of thethe host host responseresponseisis oftenoften relatedrelated toto thethe speciesspecies andand strainstrain of of dermatophytedermatophyte causingcausing thethe infect ioninfect ion..Secondly,Secondly, thethe dermatophytesdermatophytes areare thethe onlyonlyfungifungi that that havehave evolvedevolved aa dependencydependency ononhumanhuman oror animalanimal infectioninfection forfor thethe survivalsurvival
andand disseminat iondisseminat ion of of the i rthe i r spec iesspec ies..
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Cl inical manifestations:Clinical manifestations:
SomeSome speciesspecies maymay causecause infectionsinfections inin animalsanimals andandmanman followingfollowing contact contact withwith soilsoil.. ZoophilicZoophilic speciesspeciesareare primarilyprimarily parasiticparasitic onon animalsanimals andand infectionsinfections
maymay bebe transmittedtransmitted toto humanshumans followingfollowing contact contact w i t hw i t h t h et h e a n i m a la n i m a l h o s t h o s t ..
ZoophilicZoophilic infectionsinfections usuallyusually elicit elicit aa strongstrong host host responseresponse andand onon thethe skinskin wherewhere contact contact withwith thetheinfectiveinfective animalanimal hashas occurredoccurred ieie arms,arms, legs,legs, bodybodyo ro r f a c ef a c e ..
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OnychomycosisOnychomycosis
Four classic types:Four classic types:
1.) distal subungual onychomycosis:1.) distal subungual onychomycosis:
primarily involves distal nail bed andprimarily involves distal nail bed andhyponychium, with secondary involvement hyponychium, with secondary involvement of underside of nail plate of fingernails andof underside of nail plate of fingernails andtoenailstoenails
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OnychomycosisOnychomycosis
2.) white superficial2.) white superficialonychomycosis(leukonychiaonychomycosis(leukonychiatrichophytica):this is an invasion of thetrichophytica):this is an invasion of thetoenail plate on the surface of the nailtoenail plate on the surface of the nail
It is produced byIt is produced by T.mentagrophytes,T.mentagrophytes, speciesspeciesof of Cephalosporium and Aspergillus, andCephalosporium and Aspergillus, and
Fusarium oxysporumFusarium oxysporum fungusfungus
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OnychomycosisOnychomycosis
3.) Proximal subungual onychomycosis: involves3.) Proximal subungual onychomycosis: involvesthe nail plate mainly from proximal nail foldthe nail plate mainly from proximal nail fold
It is produced byIt is produced by T. rubrum & T. megniniiT. rubrum & T. megninii andand
may be an indication of HIV infectionmay be an indication of HIV infection 4.) Candida onychomycosis involves all the nail4.) Candida onychomycosis involves all the nail
plate; it is due toplate; it is due to Candida albicansCandida albicans and is seen inand is seen inpts with chronic mucocuataneous candidiasispts with chronic mucocuataneous candidiasisA ssociated paronychia A ssociated paronychia
A djacent cuticle is pink, swollen, and tender A djacent cuticle is pink, swollen, and tender
Fingernails > toenailsFingernails > toenails
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BLASTOMYCOSISBLASTOMYCOSIS
EtioEtio:: Blastomyces dermatitidis Blastomyces dermatitidis
LocationLocation:: America, Africa, Asia America, Africa, Asia
MicrMicr.:.: Yeasts at 37Yeasts at 37°°CC----bud is bud is attached to the parent cell by attached to the parent cell by a broad base a broad base
Hyphae and conidia at 25Hyphae and conidia at 25 °°CC
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BLASTOMYCOSISBLASTOMYCOSISPathogenesisPathogenesis
Inhalation of infectious particles Inhalation of infectious particles
Primary cutaneous inoculationPrimary cutaneous inoculation
Infiltration of macrophages and Infiltration of macrophages and neutrophils and granuloma formationneutrophils and granuloma formation
Oxidative killing mechanisms ofOxidative killing mechanisms of
neutrophils and fungicidal activity ofneutrophils and fungicidal activity ofmacrophages macrophages
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LASTOMYCOSISLASTOMYCOSISClinical findingsClinical findings
ASYMPTOMATIC INF.ASYMPTOMATIC INF.
PULMONARY INF.PULMONARY INF.
CHRONIC CUTANEOUS INF.CHRONIC CUTANEOUS INF.Subcutaneous nodule, ulcerationSubcutaneous nodule, ulceration
DISSEMINATED INF.DISSEMINATED INF.
Skin, bone, GUT, CNS, spleenSkin, bone, GUT, CNS, spleenPRIMARY CUTANEOUS INF.PRIMARY CUTANEOUS INF.
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BLASTOMYCOSISBLASTOMYCOSISDiagnosisDiagnosis--II
SamplesSamples:: Sputum, tissue Sputum, tissue
1.1. Direct micr.ic examDirect micr.ic exam:: KOH, H&EKOH, H&E
Yeast cells; bud is attached to Yeast cells; bud is attached to the parent cell by a broad base the parent cell by a broad base
2.2. CultureCulture:: Mould at 25Mould at 25°°CCConversion to yeast on anConversion to yeast on an
enriched medium at 37enriched medium at 37°°CC
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Typical colony morphology of Typical colony morphology of Blastomyces dermatitidisBlastomyces dermatitidis..
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Typical colony morphology of Typical colony morphology of Blastomyces dermatitidisBlastomyces dermatitidis..
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CandidiasisCandidiasis
Cutaneous involvement Cutaneous involvement
often associated with skin that is kept moist and whereoften associated with skin that is kept moist and whereabrasions occurabrasions occur
interdigitalinterdigital -- between the fingers (occupational hazard of between the fingers (occupational hazard of salad chefs, waiters, fruit canners, bartenders, etc.)salad chefs, waiters, fruit canners, bartenders, etc.)
groin, axillary regions (underarms), umbilicus (navel), feet groin, axillary regions (underarms), umbilicus (navel), feet and nailsand nails
bacteria may be involved in a secondary invaderbacteria may be involved in a secondary invader
nail infectionsnail infections -- onychomycosisonychomycosis diaper rash may be caused by a species of diaper rash may be caused by a species of CandidaCandida
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Treatment Treatment
Liver tonic.Liver tonic.
mineral mixtures.mineral mixtures.
IMMUNOMODUL ATERS.IMMUNOMODUL ATERS.toxin binder.toxin binder.
protein rich diet.protein rich diet.