Date: 7 May 2013
A four day A. fumigatus culture on malt extract agar (above). Light microscopy pictures are taken at 1000x mag., stained with lacto-phenol cotton blue (right).
Copyright:
With thanks to Niall Hamilton.
Notes:
Colonies on CYA 40-60 mm diam, plane or lightly wrinkled, low, dense and velutinous or with a sparse, floccose overgrowth; mycelium inconspicuous, white; conidial heads borne in a continuous, densely packed layer, Greyish Turquoise to Dark Turquoise (24-25E-F5); clear exudate sometimes produced in small amounts; reverse pale or greenish. Colonies on MEA 40-60 mm diam, similar to those on CYA but less dense and with conidia in duller colours (24-25E-F3); reverse uncoloured or greyish. Colonies on G25N less than 10 mm diam, sometimes only germination, of white mycelium. No growth at 5°C. At 37°C, colonies covering the available area, i.e. a whole Petri dish in 2 days from a single point inoculum, of similar appearance to those on CYA at 25°C, but with conidial columns longer and conidia darker, greenish grey to pure grey.
Conidiophores borne from surface hyphae, stipes 200-400 µm long, sometimes sinuous, with colourless, thin, smooth walls, enlarging gradually into pyriform vesicles; vesicles 20-30 µm diam, fertile over half or more of the enlarged area, bearing phialides only, the lateral ones characteristically bent so that the tips are approximately parallel to the stipe axis; phialides crowded, 6-8 µm long; conidia spherical to subspheroidal, 2.5-3.0 µm diam, with finely roughened or spinose walls, forming radiate heads at first, then well defined columns of conidia.
Distinctive features
This distinctive species can be recognised in the unopened Petri dish by its broad, velutinous, bluish colonies bearing characteristic, well defined columns of conidia. Growth at 37°C is exceptionally rapid. Conidial heads are also diagnostic: pyriform vesicles bear crowded phialides which bend to be roughly parallel to the stipe axis. Care should be exercised in handling cultures of this species.
Images library
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Patient MB X rays and CT scans. Chronic calcified maxillary sinusitis, patient had a palate defect.A. fumigatus cultured.
Images A&B Plain X rays antero-posterior and lateral, pre-operatively of Pt MB aged 76 who presented with unilateral nasal stuffiness and difficulty getting dentures fitted. She had hda these symptoms for many years. A large irregular calcified mass can be seen replacing the right maxillary sinus.
Images C D & E Coronal CT scan images of Pt MB showing a completely obstructed nasal cavity bilaterally and loss of internal nasal architecture. On the right side is large lamellar calcified lesion embedded in the extensive inflammatory material. Loss of bony margins is seen in numerous locations. This material was all removed surgically and showed mostly necrotic debris with Charcot-Leyden crystals and a few eosinophils and degenerate fungal hyphae. Aspergillus fumigatus was cultured from the material, especially infero-laterally on the right.
Image F Photograph through the mouth post-operatively showing the palate and a large defect in its right side. Through the defect can be seen the interior of the right maxillary sinus and nasal cavity with the inferior turbinate just visible.
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Aspergillus keratitis. Severe aspergillus infection with large area of corneal ulceration and deep stromal involvement
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Sequence of images showing ocular surface change which unusually predisposed to severe fusarium keratitis in an elderly woman. Successful treatment involved full thickness corneal transplantation shown 2 weeks and then 2 years after surgery.
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Sequence of images showing ocular surface change which unusually predisposed to severe fusarium keratitis in an elderly woman. Successful treatment involved full thickness corneal transplantation shown 2 weeks and then 2 years after surgery.
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Sequence of images showing ocular surface change which unusually predisposed to severe fusarium keratitis in an elderly woman. Successful treatment involved full thickness corneal transplantation shown 2 weeks and then 2 years after surgery.
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Sequence of images showing ocular surface change which unusually predisposed to severe fusarium keratitis in an elderly woman. Successful treatment involved full thickness corneal transplantation shown 2 weeks and then 2 years after surgery
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Aspergillus keratitis. Shrunken eye as a consequence of this infection