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28 Cards in this Set

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  • Back
What are the four systemic mycoses and where are they endemic to?
1) Blastomycosis (US East of OK)
2) Coccidiodomycosis (C. America, Northern S. America)
3) Histoplasmosis (US East of OK)
4) Paraccidoiidomycosis (SW US and S. America)
What is the route of systemic infection for systemic mycoses?
dissemination from the lungs (inhalation), geophilic
Blastomycosis transmission/infection and demographic
inhalation of conidia or infectious particles from decaying matter from recreational or occupational exposure. dogs are 10x more susceptible.
Blastomycosis post infection presentation
50% asymptomatic. pulmonary infection, flu-like symptoms, resembles tuberculosis/lung cancer because pulmonary mass lesions on xray.
Blastomycosis rare presentation
cutaneous - diff squamous cell carcinoma. can also disseminate to skin, bone, prostate, liver, spleen, kidney, CNS
Blastomycosis causative agent
Blastomyces dermatitidis
Blastomycosis Dx
microscopy shows broad-based budding yeast, culture must be done to yeast to Dx
Blastomycosis Tx
Antifungal (Aphotericin B), surgical
Coccidioidomycosis transmission/infection and demographic
inhalation of arthroconidia, infectious particles, particles are converted to endospore producing spherules in lungs
Coccidioidomycosis post infection presentation
primary - 60% asymptomatic, hypersensitivity III immune complex formation. secondary - nodules on lungs, ulmonary disease. disseminated - lungs, meninges, bones, skin
Blastomycosis saprobic and parasitic phase quality
saprobic - mycilium form
parasitic - broad based buds
Coccidioidomycosis saprobic and parasitic phase quality
saprobic - mycilium form at cool temps, produce infectious arthroconidia here
parasitic - pherules are produced w/ endopores after infection
Coccidioidomycosis causative agent
Coccidioides immitis found in California
Coccidioides Posadasii outside of California
Coccidioidomycosis Dx
Microscropy - arthroconidia visible w/ endopores in sputum sample. Culture is dangerous because endospores are very contagious
Coccidioidomycosis Tx
primary - supportive. secondary and disseminated - antifungal (Amphotericin B)
Histoplasmosis saprobic and parasitic phase quality
saprobic - microconidia are inhaled from soil, bat and avian habitats
parasitic - yeast is phagocytized in alveola and suppresses cell-mediated immune response
Histoplasmosis transmission/infection and demographic
microconidia are inhaled from soil, bat and avian habitats
Histoplasmosis post infection presentation
depends on concentration of pathogen exposure. pulmonary infection - 90% asymptomatic. self-limited flu-like pulmonary histoplasmosis manifest as chronic symptoms w/ apical cavities and fibrosis. disseminated - oral ulcers, hepatosplenomegaly, fever, weight loss, septic shock-like symptoms
Histoplasmosis causative agent
Histoplasma capsulatum
Two variations, both thermal dimorphic
Variant capsulatum
Pulmonary and disseminated disease
Eastern US and Latin America
Variant duboisii
Skin and bone lesions
Tropical areas of Africa
Differentiate between Variant duboisii and Variant casulatum Histoplasmosis.
Duboisii (African) - less pulmonary involvement, more skin, bone involvement. larger, thick-walled yeast. GIANT cell formation in infected tissue.
Histoplasmosis Dx
Microscopy - sputum, tissue, marrow, CSF shows lots of clustered yeast in GIANT cells. Culture - unique mycilium
Histoplasmosis Tx
spontaneous, antifungal (amphotericin B)
Paracoccidioidomycosis transmission/infection and demographic
ONLY in men in high humid areas, acidic soil. infection by inhalation or traumatic innoculation and conidia
Paracoccidioidomycosis post infection presentation
latent form: asymptomatic, but opportunistic. symptomatic: chronic pulmonary, respiratory, cough, chest pain, nodular lung lesions
Paracoccidioidomycosis rare presentations
any dissemination is rare
Paracoccidioidomycosis causative agent
Paracoccidioides brasiliensis
Paracoccidioidomycosis Tx
anti-fungal (Amphotericin B)
Amphotericin B
intravenous anti-fungal therapy used more in systemic infectious agents.