{"id":1054,"date":"2017-01-30T22:04:11","date_gmt":"2017-01-30T21:04:11","guid":{"rendered":"http:\/\/www.newslab.sk\/2017\/01\/30\/mykoticke-ochorenia-a-stavy-podmienene-hubami-charakteristika-a-rozdelenie\/"},"modified":"2017-10-04T14:32:06","modified_gmt":"2017-10-04T12:32:06","slug":"mycotic-diseases-and-morbid-conditions-caused-by-fungi-characteristics-and-classification","status":"publish","type":"post","link":"https:\/\/www.newslab.sk\/en\/mycotic-diseases-and-morbid-conditions-caused-by-fungi-characteristics-and-classification\/","title":{"rendered":"Mycotic diseases and morbid conditions caused by fungi &#8211; characteristics and classification"},"content":{"rendered":"<pre><strong><span style=\"color: #ff0000;\">*V\u0161etky tabu\u013eky, grafy a obr\u00e1zky, ktor\u00e9 s\u00fa s\u00fa\u010das\u0165ou \u010dl\u00e1nku, n\u00e1jdete v prilo\u017eenom \r\nPDF s\u00fabore na konci \u0161t\u00fadie.<\/span>\r\n<\/strong><\/pre>\n<p>&nbsp;<\/p>\n<p><strong>\u00da<\/strong><strong>vod<\/strong><\/p>\n<p>Huby ako jednobunkov\u00e9 a\u017e viacbunkov\u00e9 organizmy s\u00fa stabilnou zlo\u017ekou ka\u017edej biocen\u00f3zy. S\u00fa heterotrofn\u00e9, na svoju v\u00fd\u017eivu potrebuj\u00fa organick\u00e9 l\u00e1tky rastlinn\u00e9ho alebo \u017eivo\u010d\u00ed\u0161neho p\u00f4vodu. Pod\u013ea sp\u00f4sobu z\u00edskavania \u017eiv\u00edn je mo\u017en\u00e9 huby deli\u0165 na: <em>s<\/em><em>aprofytick\u00e9, symbiotick\u00e9 <\/em>a <em>p<\/em><em>a<\/em><em>r<\/em><em>a<\/em><em>zitic<\/em><em>k<\/em><em>\u00e9 <\/em>(fakultat\u00edvne a striktn\u00e9 parazity). Z viac ako stotis\u00edc op\u00edsan\u00fdch \u00a0druhov je pribli\u017ene 80 % mikroskopick\u00fdch h\u00fab. Z tohto po\u010dtu je viac ako sto druhov zn\u00e1mych ako agensy vyvol\u00e1vaj\u00face \u013eudsk\u00e9 a zvieracie myk\u00f3zy a nieko\u013eko sto \u010fal\u0161\u00edch predstavuje podmienen\u00e9 \u00a0patog\u00e9ny. Mnoh\u00e9 mikromyc\u00e9ty, doned\u00e1vna pova\u017eovan\u00e9 za komenz\u00e1lne \u010di saprofytick\u00e9, s\u00fa schopn\u00e9 za ur\u010dit\u00fdch podmienok (napr\u00edklad na alterovanom ter\u00e9ne, v imunosupresii) vyvol\u00e1va\u0165 \u010dasto z\u00e1va\u017en\u00e9 ochorenia \u010dloveka a zvierat.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>M<\/strong><strong>ycetizmy<\/strong><\/p>\n<p>Mycetizmy s\u00fa aliment\u00e1rne otravy n\u00e1sledkom po\u017eitia plodn\u00edc vy\u0161\u0161\u00edch h\u00fab (napr\u00edklad muchotr\u00e1vka zelen\u00e1, muchotr\u00e1vka tigrovan\u00e1, kapuc\u0148ovka okrovohnedast\u00e1, z\u00e1vojenka olovov\u00e1). Otravy hubami sa vyskytuj\u00fa predov\u0161etk\u00fdm v \u010dase od augusta do okt\u00f3bra. Klinicky sa konzum\u00e1cia jedovat\u00fdch h\u00fab m\u00f4\u017ee prejavi\u0165 r\u00f4znymi sympt\u00f3mami: nevo\u013enos\u0165ou, vracan\u00edm, k\u0155\u010dovitou boles\u0165ou brucha, hna\u010dkou. V ojedinel\u00fdch pr\u00edpadoch m\u00f4\u017ee d\u00f4js\u0165 a\u017e k zlyhaniu pe\u010dene vy\u017eaduj\u00facemu \u00a0transplant\u00e1ciu (1, 2). Pri podozren\u00ed na otravu hubami je potrebn\u00e9 okam\u017eite vyh\u013eada\u0165 alebo privola\u0165 lek\u00e1rsku pomoc. Terapeuticky cenn\u00e9 je presn\u00e9 zistenie \u010dasu, ktor\u00fd uplynul od po\u017eitia huby. Prv\u00e9 dyspeptick\u00e9 pr\u00edznaky sa objavuj\u00fa zvy\u010dajne po 4 a\u017e 24 hodin\u00e1ch od po\u017eitia, napr\u00edklad muchotr\u00e1vky \u00a0zelenej (obr\u00e1zok 1), ktor\u00e1 je naj\u010dastej\u0161ou pr\u00ed\u010dinou mycetizmu (1).<\/p>\n<p>Cel\u00e1 plodnica obsahuje zmes peptidick\u00fdch jedov, ktor\u00e9 sa delia na dve skupiny: falotox\u00edny a amatox\u00edny. Z toxikologick\u00e9ho h\u013eadiska s\u00fa v\u00fdznamnej\u0161ie amatox\u00edny. Falotox\u00edny sa bu\u010f odb\u00faraj\u00fa v tr\u00e1viacom trakte p\u00f4soben\u00edm \u00a0\u017eal\u00fado\u010dnej \u00a0kyseliny, alebo sa v\u00f4bec nevstreb\u00fa do krvi. Amatox\u00edny \u00a0s\u00fa termostabiln\u00e9 a neodb\u00faraj\u00fa sa ani varom. Let\u00e1lna d\u00e1vka je ve\u013emi n\u00edzka \u2013 0,1 mg\/kg hmotnosti dospel\u00e9ho \u010dloveka. Tieto tox\u00edny sa r\u00fdchlo absorbuj\u00fa z tr\u00e1viaceho traktu, takmer 60 % absorbovan\u00e9ho tox\u00ednu sa vylu\u010duje do \u017el\u010de a prech\u00e1dza cez enterohepat\u00e1lny obeh. Tox\u00edn sa absorbuje hepatocytmi, inhibuje RNA polymer\u00e1zu \u00a0II a preru\u0161uje synt\u00e9zu mRNA \u0161trukt\u00farnych prote\u00ednov, \u010do vedie k celul\u00e1rnej \u00a0nekr\u00f3ze (1, 3). K po\u010diato\u010dn\u00fdm pr\u00edznakom patr\u00ed \u00fanava, \u017eal\u00fado\u010dn\u00e1\u00a0nevo\u013enos\u0165, z\u00e1vraty, bolesti hlavy, pocity chladu a\u017e mrazenia. Nevo\u013enos\u0165 sa stup\u0148uje, nastupuj\u00fa bolesti \u017eal\u00fadka sprev\u00e1dzan\u00e9 siln\u00fdm vracan\u00edm a hna\u010dkami. To vedie k dehydrat\u00e1cii organizmu \u00a0a\u017e obehov\u00e9mu zlyhaniu, \u010do hlavne u det\u00ed m\u00f4\u017ee by\u0165 bezprostrednou pr\u00ed\u010dinou smrti. Po tejto f\u00e1ze zvy\u010dajne m\u00f4\u017ee d\u00f4js\u0165 ku zdanliv\u00e9mu zlep\u0161eniu. V \u010fal\u0161ej f\u00e1ze doch\u00e1dza k zlyhaniu pe\u010dene, obli\u010diek, multiorg\u00e1nov\u00e9mu zlyhaniu a\u017e smrti. Tox\u00edny muchotr\u00e1vky zelenej m\u00f4\u017eu po\u0161kodi\u0165 a\u017e usmrti\u0165 plod tehotnej \u017eeny, preto\u017ee prestupuj\u00fa placent\u00e1rnou \u00a0bari\u00e9rou a vylu\u010duj\u00fa sa aj do matersk\u00e9ho mlieka (4). Z\u00e1kladom terapeutick\u00e9ho \u00faspechu je d\u00f4kladn\u00e9 a \u010do najr\u00fdchlej\u0161ie odstr\u00e1nenie jedovat\u00fdch h\u00fab z tr\u00e1viaceho traktu \u2212 opakovan\u00e9 v\u00fdplachy \u017eal\u00fadka, podanie akt\u00edvneho uhlia, preh\u00e1\u0148adiel, primeran\u00e1 hydrat\u00e1cia, fors\u00edrovan\u00e1 diur\u00e9za, pod\u00e1vanie penicil\u00ednu G (pr\u00edpadne ceftazid\u00edmu) a antidot (napr\u00edklad N-acetylcyste\u00edn a Silybum). Pestrec mari\u00e1nsky \u2212 <em>S<\/em><em>i<\/em><em>lyb<\/em><em>u<\/em><em>m <\/em><em>mar<\/em><em>i<\/em><em>an<\/em><em>u<\/em><em>m<\/em>, je rastlina pripom\u00ednaj\u00faca bodliak, schopn\u00e1 regenerova\u0165 tkanivo pe\u010dene a obnovova\u0165 \u00a0jej spr\u00e1vnu funkciu. Za lie\u010div\u00e9 \u00fa\u010dinky s\u00fa zodpovedn\u00e9 flavolignany, ktor\u00e9 sa s\u00fahrnne naz\u00fdvaj\u00fa silymar\u00edn. Flavolignany s\u00fa schopn\u00e9 inhibova\u0165 v\u00e4zbu alfa-amanit\u00ednu na hepatocyty. Okrem toho podporuj\u00fa regener\u00e1ciu po\u0161koden\u00fdch pe\u010de\u0148ov\u00fdch buniek a p\u00f4sobia ako siln\u00e9 antioxidanty. \u010eal\u0161ou l\u00e1tkou pou\u017e\u00edvanou pri lie\u010dbe otravy amatox\u00ednom je antioxidant cimetid\u00edn \u2212 inhib\u00edtor cytochr\u00f3mu \u00a0P450. Zvy\u010dajne sa pod\u00e1va spolu s penicil\u00ednom \u00a0G. V lie\u010dbe sa tie\u017e pou\u017e\u00edva vitam\u00edn C, ktor\u00fd inhibuje peroxid\u00e1ciu lipidov a sl\u00fa\u017ei ako protektor hepatocytov \u00a0(1, 2, 3). Mimotelov\u00fa \u00a0elimina\u010dn\u00fa \u00a0lie\u010dbu pri neskorom pr\u00edchode \u00a0chor\u00e9ho do zdravotn\u00edckeho zariadenia treba za\u010da\u0165 do 24 \u2013 48 hod\u00edn po ak\u00fatnej otrave. Pri za\u010d\u00ednaj\u00facej hepat\u00e1lnej k\u00f3me sa odpor\u00fa\u010da pou\u017ei\u0165 aj plazmafer\u00e9zu (5). Otravy nejedovat\u00fdmi hubami (rozkladaj\u00facimi sa napr\u00edklad pri zlom skladovan\u00ed) sa prejavuj\u00fa dyspeptick\u00fdmi \u0165a\u017ekos\u0165ami, ktor\u00e9 oby\u010dajne vznikaj\u00fa do 4 hod\u00edn od po\u017eitia. V \u0161t\u00e1diu dyspeptick\u00fdch pr\u00edznakov hroz\u00ed najv\u00e4\u010d\u0161ie nebezpe\u010denstvo z dehydrat\u00e1cie organizmu. T\u00e1 m\u00f4\u017ee zapr\u00ed\u010dini\u0165 hypotenziu, cyan\u00f3zu a\u017e an\u00fariu. Pod\u013ea N\u00e1rodn\u00e9ho toxikologick\u00e9ho informa\u010dn\u00e9ho centra SR tvoria otravy hubami pribli\u017ene 4,5 % zo v\u0161etk\u00fdch hl\u00e1sen\u00fdch intoxik\u00e1ci\u00ed. V\u010faka laborat\u00f3rnym diagnostick\u00fdm met\u00f3dam \u00a0(mikroskopick\u00e9 mykologick\u00e9 vy\u0161etrenie obsahu gastrointestin\u00e1lneho \u00a0traktu \u2013 zvratky, stolica alebo zbytky h\u00fab, vy\u0161etrenie RIA \u2013 r\u00e1dioimunoanal\u00fdza zo s\u00e9ra alebo mo\u010du na d\u00f4kaz pr\u00edtomnosti tox\u00ednu, chemicko-toxikologick\u00e9, hematologicko-hemokoagula\u010dn\u00e9, pr\u00edpadne biochemick\u00e9 vy\u0161etrenie, napr\u00edklad koagula\u010dn\u00e9 \u00a0faktory, fibrinog\u00e9n, \u00a0bilirub\u00edn, elektrolytov\u00e1 anal\u00fdza), nov\u00fdm mo\u017enostiam \u00a0lie\u010dby, ako aj lep\u0161iemu poznaniu zlo\u017eenia tox\u00ednov a mechanizmu \u00a0ich \u00fa\u010dinku na \u013eudsk\u00fd organizmus podstatne klesla \u00famrtnos\u0165 \u00a0pri intoxik\u00e1ci\u00e1ch \u00a0hubami \u00a0(5). Progn\u00f3za \u00a0otravy z\u00e1vis\u00ed od mno\u017estva po\u017eit\u00fdch jedovat\u00fdch h\u00fab a v\u010dasnosti za\u010datia \u00fa\u010dinnej terapie. Na otravy hubami s\u00fa vo v\u0161eobecnosti citlivej\u0161ie deti ne\u017e dospel\u00ed.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>M<\/strong><strong>y<\/strong><strong>k<\/strong><strong>ot<\/strong><strong>oxik\u00f3zy<\/strong><\/p>\n<p>Niektor\u00e9 mikroskopick\u00e9 huby s\u00fa schopn\u00e9 \u00a0produkova\u0165 l\u00e1tky \u2013 sekund\u00e1rne metabolity, ozna\u010dovan\u00e9 ako mykotox\u00edny. Prostredn\u00edctvom rastlinn\u00fdch produktov sa dost\u00e1vaj\u00fa do potravinov\u00e9ho re\u0165azca. V s\u00fa\u010dasnosti je \u0161trukt\u00fary a ovplyv\u0148uj\u00fa \u017eivotn\u00e9 bunkov\u00e9 procesy (proteosynt\u00e9zu, synt\u00e9zu nukleov\u00fdch \u00a0kysel\u00edn). \u00da\u010dinok mykotox\u00ednov \u00a0sa l\u00ed\u0161i pod\u013ea ich chemickej \u0161trukt\u00fary, ako aj pod\u013ea \u0161pecifick\u00e9ho p\u00f4sobenia \u00a0na cie\u013eov\u00e9 miesta \u2013 bunky, bunkov\u00e9 \u00a0\u0161trukt\u00fary alebo procesy \u00a0(8). Jeden \u00a0druh h\u00fab m\u00f4\u017ee \u00a0produkova\u0165 r\u00f4zne mykotox\u00edny. Z h\u013eadiska patologick\u00e9ho \u00fa\u010dinku ich m\u00f4\u017eeme deli\u0165 na nefrotoxick\u00e9, hepatotoxick\u00e9, neurotoxick\u00e9, dermatotoxick\u00e9, genitotoxick\u00e9 a tox\u00edny respira\u010dn\u00e9ho\u00a0 \u00a0traktu. Ochorenia sa m\u00f4\u017eu manifestova\u0165 ako ak\u00fatne alebo chronick\u00e9. Ak\u00fatne mykotoxik\u00f3zy s\u00fa vyvolan\u00e9 pr\u00edjmom vysok\u00fdch d\u00e1vok tox\u00ednu\/tox\u00ednov. M\u00f4\u017eu sp\u00f4sobi\u0165 po\u0161kodenie a\u017e de\u0161trukciu pe\u010dene, obli\u010diek, obehov\u00e9ho, ako aj centr\u00e1lneho \u00a0nervov\u00e9ho \u00a0syst\u00e9mu. V hum\u00e1nnej medic\u00edne s\u00fa zriedkavos\u0165ou. Pri chronick\u00fdch ochoreniach ide o dlhodob\u00fd pr\u00edjem \u00a0n\u00edzkych d\u00e1vok tox\u00ednu\/tox\u00ednov, \u00a0ktor\u00e9 m\u00f4\u017eu ma\u0165 teratog\u00e9nny, mutag\u00e9nny, karcinog\u00e9nny \u00fa\u010dinok, pr\u00edpadne toxicky ovplyv\u0148uj\u00fa\u00a0 krvotvorbu. \u00a0Medzi naj\u010dastej\u0161ie \u00a0tox\u00edny patria: \u00a0aflatox\u00edny, ochratox\u00edny, patul\u00edn, fuz\u00e1riov\u00e9 tox\u00edny, citrin\u00edn a n\u00e1me\u013eov\u00e9 \u00a0alkaloidy. Najviac toxick\u00fd je karcinog\u00e9nny \u00a0aflatox\u00edn B1, ktor\u00fd produkuj\u00fa huby <em>A<\/em><em>s<\/em><em>p<\/em><em>ergillus flavus<\/em>, <em>A<\/em><em>. parasiticus<\/em>. Z \u010fal\u0161\u00edch aflatox\u00ednov s\u00fa to B2, G1 a G2, pri\u010dom ich toxicita aj mutagenita kles\u00e1 v uvedenom porad\u00ed. K ak\u00fatnym prejavom aflatoxik\u00f3zy patria: nekr\u00f3za hepatocytov, poruchy zr\u00e1\u017eanlivosti krvi, bolesti brucha, vracanie, k\u0155\u010de, p\u013e\u00facny \u00a0ed\u00e9m, letargia, k\u00f3ma \u00a0a\u017e smr\u0165. Chronick\u00e9 sublet\u00e1lne d\u00e1vky maj\u00fa nutri\u010dn\u00e9 a imunologick\u00e9 d\u00f4sledky, pri\u010dom v\u0161etky d\u00e1vky maj\u00fa kumulat\u00edvny \u00fa\u010dinok na riziko vzniku \u00a0rakoviny \u00a0(6, 9). Medzi producentov \u00a0sekund\u00e1rnych metabolitov patria aj mnoh\u00e9 fuz\u00e1ri\u00e1 (napr\u00edklad <em>F<\/em><em>. <\/em><em>s<\/em><em>p<\/em><em>or<\/em><em>o<\/em><em>t<\/em><em>r<\/em><em>i<\/em><em>c<\/em><em>h<\/em><em>oi<\/em><em>de<\/em><em>s<\/em>, <em>F<\/em><em>. <\/em><em>v<\/em><em>e<\/em><em>r<\/em><em>t<\/em><em>i<\/em><em>c<\/em><em>ill<\/em><em>ioi<\/em><em>de<\/em><em>s<\/em>, <em>F<\/em><em>. <\/em><em>po<\/em><em>a<\/em><em>e<\/em>), ktor\u00fdch toxick\u00e9 izol\u00e1ty produkuj\u00fa napr\u00edklad trichotec\u00e9ny, zearalen\u00f3n, fumoniz\u00edny. Tieto tox\u00edny je mo\u017en\u00e9 n\u00e1js\u0165 aj v produktoch z cere\u00e1lnych v\u00fdrobkov, v krmovin\u00e1ch, pri\u010dom niektor\u00e9 z nich sp\u00f4sobuj\u00fa ochorenie zn\u00e1me ako toxick\u00e1 aliment\u00e1rna aleukia (T2 tox\u00edn) (10). Ochratox\u00edny produkuj\u00fa niektor\u00e9 kmene <em>A<\/em><em>. ochraceus <\/em>(obr\u00e1zok 2) a <em>P<\/em><em>enicillium <\/em>spp., produkuj\u00fa ich aj \u010dierne aspergily, patul\u00edn druhy <em>P. <\/em><em>p<\/em><em>a<\/em><em>tulum, Aspergillus <\/em>spp., <em>B<\/em><em>yssochlamys <\/em>spp.<\/p>\n<p>Nebezpe\u010dn\u00fdm \u00a0cudzopasn\u00edkom na ra\u017ei, \u017eite a tr\u00e1vach je huba kyjani\u010dka (napr\u00edklad <em>Claviceps \u00a0<\/em><em>p<\/em><em>u<\/em><em>rp<\/em><em>u<\/em><em>r<\/em><em>e<\/em><em>a<\/em>). Kyjani\u010dky sp\u00f4sobuj\u00fa \u00a0tzv. n\u00e1me\u013e obsahuj\u00faci \u00a0ergotov\u00e9 alkaloidy, najm\u00e4 ergotam\u00edny (\u0161trukt\u00farne podobn\u00e9 LSD), ktor\u00e9 s\u00fa vo v\u00e4\u010d\u0161\u00edch d\u00e1vkach nebezpe\u010dn\u00e9 \u00a0a sp\u00f4sobuj\u00fa sympt\u00f3my naz\u00fdvan\u00e9 ergotizmus (hlavne u hov\u00e4dzieho dobytka). Ergotizmus je jednou z najstar\u0161\u00edch zn\u00e1mych \u013eudsk\u00fdch mykotoxik\u00f3z. Pri vaskul\u00e1rnej forme, ozna\u010dovanej \u00a0aj ako such\u00e1 gangr\u00e9na, dominuj\u00fa spazmy drobn\u00fdch ciev indukovan\u00e9 ergotam\u00edn-ergokrist\u00edn alkaloidmi. Medzi pr\u00edznaky\u00a0patr\u00ed olupovanie ko\u017ee, strata perif\u00e9rnej citlivosti, opuchy. Opakovan\u00e9 p\u00f4sobenie tox\u00ednu a v\u00e4\u010d\u0161ie d\u00e1vky m\u00f4\u017eu vies\u0165 a\u017e k odumretiu akr\u00e1lnych \u00a0tkan\u00edv (u\u0161n\u00fd boltec, nos, brada, prsty). K pr\u00edznakom konvulz\u00edvneho ergotizmu patria svalov\u00e9 z\u00e1\u0161klby a k\u0155\u010de, hna\u010dka, parest\u00e9zia, svrbenie, bolesti \u00a0hlavy, nevo\u013enos\u0165, vracanie, halucin\u00e1cie, potenie a hor\u00fa\u010dka, trvaj\u00face po obdobie nieko\u013ek\u00fdch t\u00fd\u017ed\u0148ov, a\u017e du\u0161evn\u00e9 poruchy vr\u00e1tane psych\u00f3zy sp\u00f4sobenej nadmernou stimul\u00e1ciou\u00a0centr\u00e1lneho nervov\u00e9ho syst\u00e9mu. Alkaloidy m\u00f4\u017eu po\u010das lakt\u00e1cie prech\u00e1dza\u0165 z matky na die\u0165a, \u010do sp\u00f4sobuje ergotizmus aj u doj\u010diat. V stredoveku sa ochorenie \u00a0naz\u00fdvalo ohe\u0148 sv\u00e4t\u00e9ho Anton\u00edna \u00a0(11, 12).<\/p>\n<p>&nbsp;<\/p>\n<p><strong>M<\/strong><strong>y<\/strong><strong>k<\/strong><strong>o<\/strong><strong>al<\/strong><strong>e<\/strong><strong>rg<\/strong><strong>i<\/strong><strong>e<\/strong><\/p>\n<p>Mykoalergie s\u00fa hypersenzit\u00edvne reakcie imunitn\u00e9ho \u00a0syst\u00e9mu na antig\u00e9nnu\u00a0 stimul\u00e1ciu mykotick\u00fdm alerg\u00e9nom, respekt\u00edve s\u00fa to stav y z precitlivenosti pri dlhodobej a opakovanej expoz\u00edcii mikroskopick\u00fdm hub\u00e1m v dom\u00e1com alebo pracovnom prostred\u00ed. Fung\u00e1lne alergie m\u00f4\u017eu by\u0165 sp\u00f4soben\u00e9 \u010dasticami h\u00fab alebo ich metabolitmi (mykotox\u00edny, prchav\u00e9 organick\u00e9 zl\u00fa\u010deniny \u2013 alkoholy, aldehydy, ket\u00f3ny, aromatick\u00e9, s\u00edrne zl\u00fa\u010deniny) \u00a0(6, 13). \u00da\u010dinok mikromyc\u00e9t \u00a0ako alerg\u00e9nov \u00a0z\u00e1vis\u00ed od mno\u017estva ich \u010dast\u00edc vo vzduchu, koncentr\u00e1cie \u00a0prchav\u00fdch \u00a0l\u00e1tok, ktor\u00e9 vylu\u010duj\u00fa, d\u013a\u017eky pobytu \u010dloveka v takomto prostred\u00ed a tie\u017e od jeho predispoz\u00edci\u00ed a imunity. Mikromyc\u00e9ty s\u00fa pr\u00edtomn\u00e9 takmer v\u0161ade, pri\u010dom v\u00e4\u010d\u0161ina z nich sa \u013eahko \u0161\u00edri vzduchom. \u010castice h\u00fab v\u00e4\u010d\u0161ie ako 10 \u03bcm sa \u013eahko zachytia v horn\u00fdch d\u00fdchac\u00edch cest\u00e1ch a samo\u010distiacim mechanizmom \u00a0sa odstr\u00e1nia z mak- roorganizmu. \u010ciasto\u010dky men\u0161ie \u00a0ako 3 \u03bcm sa zachyt\u00e1vaj\u00fa v alveol\u00e1ch, kde sa fagocytuj\u00fa, \u00a0potenci\u00e1lne v\u0161ak m\u00f4\u017eu by\u0165 z alveol absorbovan\u00e9 do krvn\u00e9ho \u00a0rie\u010diska. Mykoalergie \u00a0je mo\u017en\u00e9 \u00a0rozdeli\u0165 \u00a0z h\u013eadiska vstupu alerg\u00e9nu do organizmu \u00a0na: inhala\u010dn\u00e9 \u00a0(d\u00fdchacie \u00a0cesty), kontaktn\u00e9 (pri styku s ko\u017eou) a potravinov\u00e9 (vstupom cez gastrointestin\u00e1lny trakt). Samotn\u00e9 \u00a0prejavy s\u00fa r\u00f4zne, \u00a0hlavne v oblasti d\u00fdchac\u00edch \u00a0ciest (upchat\u00fd nos, dr\u00e1\u017edenie nosnej sliznice, n\u00e1dchy, dr\u00e1\u017edenie na ka\u0161e\u013e, sucho, boles\u0165 v hrdle), na ko\u017ei (vyr\u00e1\u017eka, podr\u00e1\u017eden\u00e1 \u00a0ko\u017ea, p\u00e1lenie, svrbenie), slzenie o\u010d\u00ed, \u00a0\u00fanava, \u00a0nevo\u013enos\u0165, boles\u0165 hlav y, z\u00e1vraty. Mnohokr\u00e1t\u00a0 \u00a0tieto \u00a0prejav y s\u00favisia \u00a0aj s problematikou \u00a0kvality vn\u00fatorn\u00e9ho prostredia oby tn\u00fdch, administrat\u00edvnych a in\u00fdch budov \u00a0(vlhko, pra\u0161nos\u0165, zl\u00e1 ventil\u00e1cia). S\u00fahrn zdravotn\u00fdch \u00a0\u0165a\u017ekost\u00ed, nepr\u00edjemn\u00e9ho pocitu a\u017e diskomfortu v s\u00favislosti s pobytom v ur\u010dit\u00fdch budov\u00e1ch sa ozna\u010duje ako tzv. syndr\u00f3m \u00a0chor\u00fdch budov \u2013 sick building \u00a0syndrome \u00a0(SBS) (6). Vl\u00e1knit\u00e9 huby v uzavret\u00fdch priestoroch s\u00fa zvl\u00e1\u0161\u0165 nebezpe\u010dn\u00e9 \u00a0pre \u013eud\u00ed s naru\u0161enou imunitou, chronick\u00fdmi ochoreniami, pre alergikov, doj\u010dat\u00e1 \u00a0a deti. Alergick\u00fd potenci\u00e1l maj\u00fa napr\u00edklad h\u00fdfomyc\u00e9ty rodu <em>A<\/em><em>s<\/em><em>p<\/em><em>e<\/em><em>r<\/em><em>gi<\/em><em>ll<\/em><em>u<\/em><em>s<\/em>, <em>P<\/em><em>e<\/em><em>n<\/em><em>i<\/em><em>cil<\/em><em>li<\/em><em>u<\/em><em>m<\/em>, <em>C<\/em><em>l<\/em><em>a<\/em><em>d<\/em><em>ospo<\/em><em>r<\/em><em>i<\/em><em>u<\/em><em>m<\/em>, <em>A<\/em><em>lt<\/em><em>ernar<\/em><em>i<\/em><em>a<\/em>, <em>F<\/em><em>u<\/em><em>s<\/em><em>a<\/em><em>ri<\/em><em>u<\/em><em>m<\/em>, niektor\u00e9 baz\u00eddiomyc\u00e9ty, kvasinky, zygomyc\u00e9ty \u00a0rodu <em>M<\/em><em>u<\/em><em>c<\/em><em>o<\/em><em>r <\/em>a <em>Rh<\/em><em>i<\/em><em>zopus <\/em>(14). Mykotick\u00e9 \u00a0(fung\u00e1lne, hubov\u00e9) \u00a0antig\u00e9ny m\u00f4\u017eu stimulova\u0165 \u00a0produkciu \u00a0\u0161pecifick\u00fdch \u00a0protil\u00e1tok IgE (tzv. I. typ alergickej reakcie) u atopick\u00fdch jedincov, \u010do spravidla zhor\u0161uje klinick\u00fd priebeh atopick\u00fdch ochoren\u00ed: alergick\u00e1 sinusit\u00edda, bronchi\u00e1lna astma alebo atopick\u00e1\u00a0dermatit\u00edda. Mikromyc\u00e9ty m\u00f4\u017eu tie\u017e vyvol\u00e1va\u0165 IgE nez\u00e1visl\u00e9 alergick\u00e9 reakcie: tvorbu imunokomplexov (III. typ), ako aj reakciu sprostredkovan\u00fa bunkami \u00a0(IV. typ). \u010ci sa reakcia \u013eudsk\u00e9ho organizmu prejav\u00ed ako alergick\u00e1 bronchopulmon\u00e1lna aspergil\u00f3za (ABPA), \u00a0alergick\u00e1 fung\u00e1lna s\u00ednusit\u00edda (AFS \u2212 z\u00e1pal prinosov\u00fdch dut\u00edn), alebo alergick\u00e1 dermatit\u00edda, z\u00e1vis\u00ed od jeho imunologick\u00e9ho stavu, ako aj od expoz\u00edcie mykotick\u00fdm antig\u00e9nom. Diagn\u00f3za \u00a0alergick\u00fdch ochoren\u00ed \u00a0vr\u00e1tane mykoalergi\u00ed je zalo\u017een\u00e1 na klinick\u00fdch sympt\u00f3moch \u00a0pacienta, na stanoven\u00ed reakcie pacienta po jeho expoz\u00edcii konkr\u00e9tnemu antig\u00e9nu (alerg\u00e9nu), na v\u00fdsledkoch ko\u017en\u00fdch testov a <em>in vitro <\/em>testov (napr\u00edklad RAST \u2212 r\u00e1dioalergosorbent \u00a0test, vyu\u017e\u00edvaj\u00faci r\u00e1dioimunoanal\u00fdzu na detekciu \u0161pecifick\u00fdch IgE protil\u00e1tok v krvi) (15).<\/p>\n<p><strong>M<\/strong><strong>y<\/strong><strong>k<\/strong><strong>\u00f3<\/strong><strong>z<\/strong><strong>y<\/strong><\/p>\n<p>Myk\u00f3zy s\u00fa choroby \u010dloveka alebo zvierat sp\u00f4soben\u00e9 najm\u00e4 mikro- skopick\u00fdmi hubami. Predstavuj\u00fa \u0161irok\u00e9 spektrum ochoren\u00ed od superfici\u00e1lnych infekci\u00ed postihuj\u00facich vrchn\u00fa vrstvu ko\u017ee <em>s<\/em><em>tratum corneum \u00a0<\/em>a\u017e po diseminovan\u00e9 infekcie postihuj\u00face mozog, srdce, p\u013e\u00faca, pe\u010de\u0148. Niektor\u00e9 myk\u00f3zy m\u00f4\u017eu by\u0165 sign\u00e1lom zn\u00ed\u017eenia obranyschopnosti organizmu, roz- v\u00edjaj\u00faceho sa z\u00e1va\u017en\u00e9ho zdravotn\u00e9ho stavu pacienta alebo m\u00f4\u017eu komplikova\u0165 in\u00e9 choroby \u00a0(16). K predisponuj\u00facim \u00a0faktorom vzniku z\u00e1va\u017en\u00fdch fung\u00e1lnych infekci\u00ed patr\u00ed neutrop\u00e9nia, chemoterapia, imunosupres\u00edvna terapia, lie\u010dba \u0161irokospektr\u00e1lnymi antibiotikami, invaz\u00edvne z\u00e1kroky, polytrauma. Jedn\u00fdm z rizikov\u00fdch faktorov m\u00f4\u017eu by\u0165 aj kontaminovan\u00e9 ruky o\u0161etruj\u00faceho person\u00e1lu.<br \/>\nMykotick\u00e9 infekcie sa vyskytuj\u00fa vo v\u0161etk\u00fdch svetov\u00fdch p\u00e1smach, postihuj\u00fa \u00a0v\u0161etky rasy, \u013eud\u00ed ka\u017ed\u00e9ho \u00a0veku a pohlavia. Myk\u00f3zy \u00a0klasifikujeme\u00a0 pod\u013ea \u00a0virulencie \u00a0vyvol\u00e1vate\u013ea \u00a0infekcie, cesty z\u00edskania a lokaliz\u00e1cie infekcie. Pod\u013ea virulencie vyvol\u00e1vate\u013ea mykotickej infekcie m\u00f4\u017eeme hovori\u0165 oprim\u00e1rne patog\u00e9nnych \u00a0a opor t\u00fannych hub\u00e1ch. Prim\u00e1rne patog\u00e9ny s\u00fa schopn\u00e9 \u00a0vyvola\u0165 infekciu aj u zdrav\u00e9ho jedinca. \u00a0Oport\u00fanne patog\u00e9ny \u00a0sp\u00f4sobuj\u00fa \u00a0infekcie hlavne u imunitne oslaben\u00fdch jedincov. \u00a0Prim\u00e1rne patog\u00e9nne \u00a0huby sa vysky tuj\u00fa \u010dasto v presne definovan\u00fdch geografick\u00fdch oblastiach (endemick\u00fd v\u00fdskyt), zatia\u013e \u010do oport\u00fanne patog\u00e9ny sa v ysky tuj\u00fa ubikvit\u00e1rne. \u00a0Pod\u013ea cesty z\u00edskania infekcie m\u00f4\u017ee \u00eds\u0165 o exog\u00e9nnu alebo endog\u00e9nnu infekciu. Cesta vstupu exog\u00e9nnych h\u00fab zah\u0155\u0148a vd\u00fdchnutie \u00a0sp\u00f3r, \u00a0inokul\u00e1ciu kut\u00e1nne alebo perkut\u00e1nne \u00a0(pri \u00faraze, chirurgickom, \u00a0in\u0161trument\u00e1lnom alebo inom \u00a0invaz\u00edvnom \u00a0z\u00e1kroku). Endog\u00e9nna \u00a0infekcia vznik\u00e1 predov\u0161etk\u00fdm z koloniz\u00e1cie norm\u00e1lnou \u00a0fl\u00f3rou alebo reaktiv\u00e1ciou predo\u0161lej infekcie. Pod\u013ea\u00a0 \u201eh\u013abky\u201c, do ktorej zasahuje chorobn\u00fd \u00a0proces, ako aj pod\u013ea stup\u0148a po\u0161kodenia tkaniva a odpovede hostite\u013esk\u00e9ho organizmu sa myk\u00f3zy delia na: povrchov\u00e9 \u00a0a ko\u017en\u00e9 (kut\u00e1nne), subkut\u00e1nne a org\u00e1nov\u00e9 (syst\u00e9mov\u00e9). K povrchov\u00fdm \u00a0myk\u00f3zam patria superfici\u00e1lne koloniz\u00e1cie (bez tkanivovej odpovede) a superfici\u00e1lne myk\u00f3z y (napr\u00edklad <em>p<\/em><em>i<\/em><em>e<\/em><em>d<\/em><em>r<\/em><em>a <\/em>\u2013 mikromyc\u00e9ty kolonizuj\u00fa vlasy v podobe \u00a0uzl\u00edkov, <em>p<\/em><em>i<\/em><em>t<\/em><em>yri<\/em><em>as<\/em><em>i<\/em><em>s versicolor <\/em>\u2013 infekcia horn\u00fdch vrstiev epidermy <em>st<\/em><em>r<\/em><em>atum <\/em><em>c<\/em><em>o<\/em><em>rn<\/em><em>e<\/em><em>u<\/em><em>m<\/em>, spolup\u00f4vodcom s\u00fa lipofiln\u00e9 kvasinky rodu <em>M<\/em><em>al<\/em><em>a<\/em><em>ss<\/em><em>e<\/em><em>z<\/em><em>i<\/em><em>a<\/em>). Kut\u00e1nne a mukokut\u00e1nne infekcie s\u00fa charakteristick\u00e9 po\u0161koden\u00edm, ktor\u00e9 je sp\u00f4soben\u00e9\u00a0 prolifer\u00e1ciou h\u00fab v kerat\u00ednov\u00fdch tkaniv\u00e1ch \u2013 ko\u017ea, nechty, vlasy, ochlpenie \u00a0(dermatomyk\u00f3zy, onychomyk\u00f3zy, dermatof yt\u00f3zy). Patria sem aj infekcie \u00a0o\u010d\u00ed, s\u00ednusov, orofaryngu, vag\u00edny a vonkaj\u0161ieho \u00a0u\u0161n\u00e9ho \u00a0kan\u00e1la. Pri t\u00fdchto \u00a0infekci\u00e1ch je mo\u017en\u00e9 \u00a0sledova\u0165 imunitn\u00fa \u00a0odpove\u010f \u00a0(11). Subkut\u00e1nne \u00a0infekcie predstavuj\u00fa \u00a0heterog\u00e9nnu \u00a0skupinu ochoren\u00ed, ktor\u00e9 s\u00fa sp\u00f4soben\u00e9 \u0161irok\u00fdm spektrom taxonomicky rozdielnych h\u00fab. Intenzita tkanivov\u00e9ho po\u0161kodenia je r\u00f4zna a \u010dasto z\u00e1vis\u00ed od imunitn\u00e9ho stavu postihnut\u00e9ho organizmu.<br \/>\nSpektrum infekci\u00ed zah\u0155\u0148a: chromoblastomyk\u00f3zy, feoh\u00fdfomyk\u00f3zy, hyaloh\u00fdfomyk\u00f3zy, sporotrich\u00f3zy a mycet\u00f3my (11, 17). P\u00f4vodcom s\u00fa najm\u00e4 saprofytick\u00e9 vl\u00e1knit\u00e9 huby, vyskytuj\u00face sa be\u017ene v p\u00f4de, prachu, na rozkladaj\u00facich sa rastlinn\u00fdch zvy\u0161koch, dreve. Ochorenie vznik\u00e1 naj\u010dastej\u0161ie po traumatickej inokul\u00e1cii. Infek\u010dn\u00fd proces postihuje predov\u0161etk\u00fdm podko\u017eie a \u0161\u00edri sa len pomaly, \u010dasto ide o chronick\u00e9 infekcie. Org\u00e1nov\u00e9 (syst\u00e9mov\u00e9) mykotick\u00e9 infekcie s\u00fa \u017eivot ohrozuj\u00face \u00a0infek\u010dn\u00e9 komplik\u00e1cie, \u00a0ktor\u00e9 sa stali v posledn\u00fdch desa\u0165ro\u010diach v\u00fdznamnou pr\u00ed\u010dinou morbidity a mortality. Pri t\u00fdchto infekci\u00e1ch m\u00f4\u017ee patog\u00e9n diseminova\u0165 z jedn\u00e9ho org\u00e1nu do druh\u00e9ho. Najohrozenej\u0161ou \u00a0skupinou pacientov \u00a0s\u00fa imunosuprimovan\u00e9 osoby, u ktor\u00fdch \u00a0riziko vzniku, v\u00e1\u017eneho \u00a0priebehu \u00a0a pr\u00edpadnej \u00a0letality st\u00fapa s preh\u013aben\u00edm \u00a0deficitu ich imunitn\u00fdch \u00a0funkci\u00ed. V minulosti sa sp\u00e1jali takmer v\u00fdlu\u010dne s popul\u00e1ciou hematoonkologick\u00fdch pacientov (18). V s\u00fa\u010das- nosti je t\u00e1to problematika \u00a0aktu\u00e1lna \u00a0aj v in\u00fdch rizikov\u00fdch skupin\u00e1ch, v ktor\u00fdch sa pr\u00e1ve podmienene \u00a0patog\u00e9nne huby stali v\u00e1\u017enou hrozbou. S\u00fa to najm\u00e4 pacienti na jednotk\u00e1ch \u00a0intenz\u00edvnej starostlivosti, anest\u00e9ziologick\u00fdch, \u00a0chirurgick\u00fdch, intern\u00fdch, ale aj \u010fal\u0161\u00edch oddeleniach. Pod\u013ea Metodick\u00e9ho listu MZ SR 2005 (19) sa k syst\u00e9mov\u00fdm \u00a0myk\u00f3zam zara\u010fuj\u00fa: fung\u00e9mie (mykotick\u00e9 infekcie krvn\u00e9ho pr\u00fadu), fungi\u00farie (mykotick\u00e9 infekcie uropoetick\u00e9ho syst\u00e9mu), org\u00e1nov\u00e9 infekcie (hepatosplenick\u00e1 forma), pulmon\u00e1lne \u00a0infekcie (lok\u00e1lna invaz\u00edvna forma, mycet\u00f3m p\u013e\u00fac), infekcie centr\u00e1lneho nervov\u00e9ho syst\u00e9mu, invaz\u00edvna sinusit\u00edda (rinocerebr\u00e1lna forma) alebo chronick\u00e1 diseminovan\u00e1 forma. Poznanie rizikov\u00fdch, predisponuj\u00facich \u00a0faktorov umo\u017e\u0148uje \u00a0predpoklada\u0165 etiol\u00f3giu, a t\u00fdm lep\u0161ie cieli\u0165 diagnostick\u00e9 \u00a0a terapeutick\u00e9 \u00a0\u00fasilie (18). Diagnostika \u00a0myk\u00f3z a najm\u00e4 invaz\u00edvnych myk\u00f3z je interdisciplin\u00e1rny proces, ktor\u00fd vy\u017eaduje spolupr\u00e1cu viacer\u00fdch odbornost\u00ed. Opiera sa o dostupn\u00e9 mikrobiologick\u00e9, s\u00e9rologick\u00e9, histologick\u00e9, r\u00e1diologick\u00e9 a biochemick\u00e9 met\u00f3dy. Stru\u010dn\u00fd preh\u013ead diagnostick\u00fdch met\u00f3d je uveden\u00fd v tabu\u013eke 1.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Z<\/strong><strong>\u00e1<\/strong><strong>ver<\/strong><\/p>\n<p>Mikroskopick\u00e9 huby sa vyskytuj\u00fa vo v\u0161etk\u00fdch biotopoch (p\u00f4da, voda, vzduch). P\u00f4da, ktor\u00e1 vytv\u00e1ra mikromyc\u00e9tam \u00a0ve\u013emi dobr\u00e9 existen\u010dn\u00e9 podmienky (dostatok tepla, vlhkosti, organick\u00fdch \u00a0l\u00e1tok a chr\u00e1ni ich pred slne\u010dn\u00fdm \u017eiaren\u00edm), je pova\u017eovan\u00e1 za ich prirodzen\u00fd biotop. V porovnan\u00ed s p\u00f4dou sa v ove\u013ea men\u0161om mno\u017estve nach\u00e1dzaj\u00fa aj vo vode. Vo vzduchu s\u00fa pr\u00edtomn\u00e9 najm\u00e4 vo forme sp\u00f3r. Huby v\u010faka svojej metabolickej aktivite na\u0161li uplatnenie aj v mnoh\u00fdch v\u00fdrobn\u00fdch postupoch a odvetviach:<\/p>\n<ul>\n<li>potravin\u00e1rsky priemysel \u2013 v\u00fdroba syra, mlie\u010dnych produktov, chleba, alkoholick\u00fdch n\u00e1pojov,<\/li>\n<li>chemick\u00fd priemysel, biotechnol\u00f3gie \u2013 pri v\u00fdrobe organick\u00fdch kysel\u00edn, enz\u00fdmov, vitam\u00ednov, horm\u00f3nov, rastov\u00fdch l\u00e1tok,<\/li>\n<li>farmaceutick\u00fd priemysel \u2013 v\u00fdroba antibiot\u00edk, najm\u00e4 penicil\u00ednu (<em>P. <\/em><em>ch<\/em><em>r<\/em><em>ysogenum),<\/em><\/li>\n<li>po\u013enohospod\u00e1rstvo \u2013 v boji proti \u0161kodliv\u00e9mu hmyzu a parazitom<\/li>\n<li>kult\u00farnych rastl\u00edn,<\/li>\n<li>v environment\u00e1lnych biotechnol\u00f3gi\u00e1ch \u00a0\u2013 v biologickej degrad\u00e1cii odpadov (21).<\/li>\n<\/ul>\n<p>Okrem spom\u00ednan\u00e9ho \u00a0vyu\u017eitia s\u00fa mnoh\u00e9 p\u00f4vodcom \u00a0\u010dasto z\u00e1va\u017en\u00fdch ochoren\u00ed \u010dloveka, ale aj zvierat.<\/p>\n<p><em>C<\/em><em>enters <\/em><em>f<\/em><em>or Disease Control and Prevention \u2013 CDC\u2018s <\/em>vedie skupinu, <em>t<\/em><em>z<\/em><em>v. <\/em><em>My<\/em><em>c<\/em><em>ot<\/em><em>ic Disease Branch (MDB), <\/em>zameran\u00fa na prevenciu a kontrolu fung\u00e1lnych infekci\u00ed nielen v USA, ale aj na medzin\u00e1rodnej \u00farovni prostredn\u00edctvom epidemiologick\u00fdch a mikrobiologick\u00fdch \u0161t\u00fadi\u00ed umo\u017e\u0148uj\u00facich \u00a0zlep\u0161enie diagnostiky, lie\u010dby, prevencie a kontroly mykotick\u00fdch ochoren\u00ed.<\/p>\n<p>Hlavn\u00fdmi cie\u013emi s\u00fa:<\/p>\n<ul>\n<li>rozv\u00edjanie met\u00f3d umo\u017e\u0148uj\u00facich \u00a0v\u010dasn\u00fa diagnostiku,<\/li>\n<li>sledovanie geografickej distrib\u00facie environment\u00e1lnych mykotick\u00fdch ochoren\u00ed,<\/li>\n<li>ur\u010denie vplyvu klimatick\u00fdch podmienok a klimatick\u00fdch zmien na tieto ochorenia,<\/li>\n<li>identifikovanie os\u00f4b s vysok\u00fdm rizikom infekcie so zameran\u00edm sa na prevent\u00edvne strat\u00e9gie,<\/li>\n<li>zabezpe\u010dovanie\u00a0 vzdel\u00e1vania poskytovate\u013eov zdravotn\u00edckej starostlivosti, ako aj zvy\u0161ovanie povedomia \u00a0verejnosti o mo\u017enostiach prevencie a lie\u010dby t\u00fdchto ochoren\u00ed (22).<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><strong>Literat\u00fara<\/strong><br \/>\n1. Chen WCh, Kassi M, Saeed U, et al. A Rare Case of Amatoxin Poisoning in the State of Texas. Case Rep Gastroenterol. 2012;6(2)350\u2013357.<br \/>\n2. Gok F, Topal A, Hacibeyoglu G, et al. Fulminant Liver Failure Due to Amanita Phalloides Toxicity Treated with Emergent Liver Transplantation. Eur J Gen Med. 2015. 12(3):244\u2013248.<br \/>\n3. Roberts DM, Hall MJ, Falkland MM, et al. Amanita phalloides poisoning and treatment with silibinin in the Australian Capital Territory and New South Wales. Med J Aust. 2013;198(1):43\u201347.<br \/>\n4. Santi L, Maggioli C, Mastroroberto M, et al. Acute Liver Failure Caused by Amanita phalloides Poisoning. Int. J. of Hepatology. 2012;2012:1\u20136.<br \/>\n5. Pla\u010dkov\u00e1 S, Cag\u00e1\u0148ov\u00e1 B, Kres\u00e1nek J. Diferenci\u00e1lna diagnostika otr\u00e1v hubami na z\u00e1klade mykologickej anal\u00fdzy [online]. Bratislava: N\u00e1rodn\u00e9 toxikologick\u00e9 informa\u010dn\u00e9 centrum, KPLaT, FNsP Bratislava; 2009: 1. Available from: &lt;http:\/\/www.vzbb.sk\/sk\/aktuality\/spravy\/dokumenty\/32_plackova.pdf&gt;.<br \/>\n6. Mihinov\u00e1 D, Pieckov\u00e1 E. Sekund\u00e1rne metabolity mikromyciet mykotox\u00edny a ich biologick\u00e9 \u00fa\u010dinky. Lek Obz. 2011;60(1):40\u201345.<br \/>\n7. Bennett JW, Klich M. Mycotoxins. Clin Microbiol Rev. 2003;16(3):497\u2013516.<br \/>\n8. Mykotox\u00edny a mykoalergie [online]. Available from:&lt;http:\/\/uniba.sk\/fileadmin\/prif\/envi\/kpe\/environ_mikrobiologia\/04.pdf&gt;<\/p>\n<p>9. Williams JH, Phillips TD, Jolly PE, et al. Human aflatoxicosis in developing countries: a review of toxicology, exposure, potential health consequences, and interventions. Am J Clin Nutr. 2004;80(5):1106\u20131122<br \/>\n10. Rem\u017ea J, B\u00edre\u0161 J, Mat\u00fa\u0161ov\u00e1 M, et al. Official controls of foodstuffs \u2013 contamination of cereals<br \/>\nby mycotoxins of the genus Fusarium and ochratoxin A. Potravin\u00e1rstvo. 2011;5(2):63\u201366.<br \/>\n11. Anaissie EJ, McGinnis MR, Pfaller MA. Clinical Mycology. USA: Elsevier Science; 2003: 67\u201377. 12. Eadie MJ. Convulsive ergotism: epidemics of the serotonin syndrome? Lancet Neurol. 2003;2(7):429\u201334.<br \/>\n13. Lisalov\u00e1 M. Lexik\u00f3n lek\u00e1rskej mykol\u00f3gie. Bratislava: HPL SERVIS; 2014: 11.<br \/>\n14. Posp\u00ed\u0161ilov\u00e1 S. Toxiny a sekund\u00e1rni metabolity hub v potravin\u00e1ch. Krom\u011b\u0159\u00ed\u017e: Bakal\u00e1\u0159ska pr\u00e1ce, Univerzita T. Bati ve Zl\u00edne, Fakulta technologick\u00e1; 2011.<br \/>\n15. Bogacka E, Jahnz-R\u00f3zyk K. Allergy to fungal antigens. Pol Merkur Lekarski. 2003;14(83):381\u20134.<br \/>\n16. Vollekov\u00e1 A, Baro\u0148\u00e1kov\u00e1 A. Superfici\u00e1lne myk\u00f3zy. Via pract. 2005;2(3):129\u2013133.<br \/>\n17. Hoog de GS, Guarro J, Gene J, et al. Atlas of Clinical Fungi. 2nd ed. Spain, The Netherlands: 2000: 1126.<br \/>\n18. Drgo\u0148a \u013d. Infek\u010dn\u00e9 komplik\u00e1cie onkologick\u00fdch pacientov \u2013 vybran\u00e9 kapitoly. Bratislava: Univerzita<br \/>\nKomensk\u00e9ho; 2013: 24\u201334.<br \/>\n19. Diagnostika a lie\u010dba syst\u00e9mov\u00fdch myk\u00f3z. Metodick\u00fd list \u00dastrednej komisie racion\u00e1lnej farmakoterapie a liekovej politiky MZ SR 2005. 2005;9(3\u20134):1\u20138.<br \/>\n20. Alexander BD, Pfaller A. Contemporary Tools for the Diagnosis and Management of Invasive<br \/>\nMycoses. Clin Infect Dis. 2006;Suppl.1(43):15\u201327.<br \/>\n21. G\u00e1per J. Funkcie h\u00fab v ekosyst\u00e9moch a ich v\u00fdznam pre \u010dloveka [online]. Huby \u2013 Enviromagaz\u00edn. Available from: &lt;http:\/\/www.enviromagazin.sk\/enviro6_2\/funkcie22.html&gt;.<br \/>\n22. Centers for Disease Control and Prevention \u2013 CDC 24\/7 [online]. Fungal Diseases. 2016.<br \/>\nAvailable from: &lt;http:\/\/www.cdc.gov\/ncezid\/dfwed\/mycotics\/&gt;.<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>*V\u0161etky tabu\u013eky, grafy a obr\u00e1zky, ktor\u00e9 s\u00fa s\u00fa\u010das\u0165ou \u010dl\u00e1nku, n\u00e1jdete v prilo\u017eenom PDF s\u00fabore na konci \u0161t\u00fadie. &nbsp; \u00davod Huby ako jednobunkov\u00e9 a\u017e viacbunkov\u00e9 organizmy s\u00fa stabilnou zlo\u017ekou ka\u017edej biocen\u00f3zy. S\u00fa heterotrofn\u00e9, na svoju v\u00fd\u017eivu potrebuj\u00fa organick\u00e9 l\u00e1tky rastlinn\u00e9ho alebo \u017eivo\u010d\u00ed\u0161neho p\u00f4vodu. Pod\u013ea sp\u00f4sobu z\u00edskavania \u017eiv\u00edn je mo\u017en\u00e9 huby deli\u0165 na: saprofytick\u00e9, symbiotick\u00e9 a parazitick\u00e9<\/p>\n","protected":false},"author":7,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_mi_skip_tracking":false,"footnotes":""},"categories":[292],"tags":[772,770,771,774,773],"class_list":["post-1054","post","type-post","status-publish","format-standard","hentry","category-microbiology","tag-fungal-allergies","tag-microscopic-fungi","tag-mycetism","tag-mycosis","tag-mycotoxicosis","typ_clanku-review-article"],"acf":{"abstrakt":"<p>Microscopic fungi are eukaryotic, heterotrophic microorganisms occurring worldwide. Depending on the source of organic matter they can be divided into the saprophytes, symbionts and parasites.\u00a0 The mycotic diseases and morbid conditions caused by fungi including mycoses, mycotoxicoses, fungal allergies and mycetism. Mycetism (fungal poisoning) is caused by ingestion of certain mushrooms, e.g. Amanita phalloides and related species. Symptoms most often include dyspeptic problems. Fungal allergy is a hypersensitive immune system reaction to certain fungal antigens, so-called allergens. Allergic reaction in persons with predisposition can be caused by a whole range of micromycetes, namely the species Alternaria, Aspergillus, Cladosporium, Fusarium, Penicillium. Mycotoxicosis is a condition caused by toxins produced by moulds\u2019 metabolism released into the environment. These are usually chronic, repeated poisonings with smaller doses; however also lethal poisoning is possible as well as conditions with chronic consequences. Mycosis is a disease of humans or animals caused by microscopic fungi. Mycoses are classified according to the tissue depth levels affected by the disease process: superficial, subcutaneous and systemic\/organ mycoses.<\/p>\n<p><strong>Key words:<\/strong> microscopic fungi, mycetism, fungal allergies, mycotoxicosis, mycosis<\/p>\n<p>&nbsp;<\/p>\n","casopis":[{"ID":991,"post_author":"7","post_date":"2017-02-01 09:43:42","post_date_gmt":"2017-02-01 08:43:42","post_content":"<ul>\r\n \t<li>Pulmonary aspergillosis<\/li>\r\n \t<li>Infections caused by cytomegalovirus \u2013 diagnosis and therapy<\/li>\r\n \t<li>Long-term molecular remission as a precondition for successful pregnancy in patients with chronic myelocyte leukemia<\/li>\r\n \t<li>Chromosome 11 aberrations in a patient with acute myeloid leukemia \u2013 a case study<\/li>\r\n \t<li>New biomarkers in diagnosing IgA nephropathy<\/li>\r\n<\/ul>","post_title":"newslab","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"newslab-2016-02","to_ping":"","pinged":"","post_modified":"2017-08-16 21:36:48","post_modified_gmt":"2017-08-16 19:36:48","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.newslab.sk\/casopis\/newslab-2016-02\/","menu_order":0,"post_type":"casopis","post_mime_type":"","comment_count":"0","filter":"raw"}],"strana":"93","upload_clanok":{"ID":1055,"id":1055,"title":"Newslab_2_2016_Mykotick\u00e9 ochorenia a stavy podmienen\u00e9_Sl\u00e1dekova","filename":"Newslab_2_2016_Mykotick\u00e9-ochorenia-a-stavy-podmienen\u00e9_Sl\u00e1dekova.pdf","filesize":222027,"url":"https:\/\/www.newslab.sk\/wp-content\/uploads\/2017\/01\/Newslab_2_2016_Mykotick\u00e9-ochorenia-a-stavy-podmienen\u00e9_Sl\u00e1dekova.pdf","link":"https:\/\/www.newslab.sk\/en\/mycotic-diseases-and-morbid-conditions-caused-by-fungi-characteristics-and-classification\/newslab_2_2016_mykoticke-ochorenia-a-stavy-podmienene_sladekova\/","alt":"","author":"7","description":"","caption":"","name":"newslab_2_2016_mykoticke-ochorenia-a-stavy-podmienene_sladekova","status":"inherit","uploaded_to":1054,"date":"2017-02-01 19:40:40","modified":"2017-02-01 19:40:40","menu_order":0,"mime_type":"application\/pdf","type":"application","subtype":"pdf","icon":"https:\/\/www.newslab.sk\/wp-includes\/images\/media\/document.png"}},"_links":{"self":[{"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/posts\/1054","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/comments?post=1054"}],"version-history":[{"count":0,"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/posts\/1054\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/media?parent=1054"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/categories?post=1054"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newslab.sk\/en\/wp-json\/wp\/v2\/tags?post=1054"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}