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12 Cards in this Set

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Histoplasmosis
3-5um, endemic to Mississippi and Ohio river valleys. Causes pneumonia. Hides w/in macrophages. Found in bird or bat droppings. Lab finding- macrophage filled w/ Histoplasma, smaller than RBC. Dimorphic. Tx-local fluconazole or ketoconazole, systemic- amphotericin B
Blastomycosis
5-15um, endemic to east of Mississippi and central America, Causes inflammatory lung dz, can disseminate to skin and bone. Forms granulomatous nodules. Lab findings-broad-base budding, same size as RBC. Dimorphic. Tx-local fluconazole or ketoconazole, systemic- amphotericin B
Coccidioidomycosis
20-60um, endemic to Southwestern US, California. Causes pneumonia and meningitis. Can disseminate to bone and skin. Case rate increases after earthquakes bc spherules throwen up to air, Lab Findings- Spherule filled w/ endospores, much larger than RBC. Dimorphic. Tx-local fluconazole or ketoconazole, systemic- amphotericin B
Paracoccioiodomycosis
40-50um, endemic to Latin America. Causes pneumonia can disseminate. Lab finding-Budding yeast with "captain's wheel" formation, much larger than RBC. Dimorphic. Tx-local fluconazole or ketoconazole, systemic- amphotericin B
Tinea versicolor
caused by Malassezia furfur. Degradation of lipids produces acids that damage melanocytes and cause hypopigmented patches. Occurs in hot, humid, weather. Tx- topical miconazole, selenium sulfide (Selsun). "Spaghetti and meatballs" on KOH prep.
Tinea pedis, cruris, corporis, capitis
Pruritic lesions with central clearing resembling a ring. Caused by dermatophytes (Microsporum, Trichophyton, and Epidermophyton. Mold hyphae on KOH prep, not dimorphic. Pets are reservoir. Tx- topical azoles
Candida albicans
Systemic or opportunistic fungal infections. Dimorphic: Yeast w/ pseudoohyphae at 20C, germ tube at 37C. Causes oral and esophageal thrush in immunocompromised, vulvovaginitis (high pH, diabetes, use of antibiotics), diaper rash, endocarditis in IV drug users, disseminated candidiasis, chronic mucocutaneous candidiasis. Tx- superficial-nystatin, systemic- amphotericin B
Aspergillus fumigatus
Causes allergic bronchpulmonary aspergillosis, lung cavity aspergilloma-fungu ball, invasive aspergillosis esp in immunocomp and chronic granulomatous dz. Lab- mold w/ septate hyphae that branch at ²45 degrees. Not dimorphic
Cryptococcus neoformans
Causes cryptococcal meningitis, crytococcosis. Heavily encapsulated yeast, narrow-based unequal budding. Not dimorphic. Found in soil, pigeon droppings. Culture on Sabouraud's agar. Stain w/ India ink. Latex agglutination test detect polysaccharide capsular antigen. Soap bubble lesions in brain
Mucor and Rhizopus species
Mucormycosis. Mold w/ irregular nonseptate hyphae branching at ³90 degrees. Disease mostly in ketoacidotic diabetic and leukemic pts. Fungi proliferate in walls of blood vessels and cause infarction and necrosis of distal tissue. Rhinocerebral, frontal lobe abscesses.
Pneumocystis jiroveci (formerly carinii)
Causes diffuse interstitial pneumonia. Yeast. Inhaled. Most infection asymptomatic. Immunosuppression at risk. CXR- Diffuse bilateral. Dx- bx or lavage. Identified by methenamine silver stain of lung tissue. Tx- TMP-SMX, pentamidine, dapsome. Start prophylaxis in HIV pts when CD4²200
Sporothrix schenckii
Sporotrichosis. Dimorphic fungus that lives on vegetation. Traumatically introduced into skin- by rose thorn. Causes local pustule or ulcer w/ nodules along draining lymphatics= ascending lymphangitis. Lab- cigar shaped budding yeast visible in pus. Tx- itraconazole or potassium iodide.