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65 Cards in this Set
- Front
- Back
- 3rd side (hint)
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SYSTEMIC FUNGI
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Require 3-6 wks until colonies are mature (except coccidiodes)
Are dipmorphic: mold at room temp, yeast at body temp 37 MOLD phase is HIGHLY infective |
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BOARD QUESTION
BLASTOMYCES DERMATIDITIS with nicknames |
BLASTOMYCES DERMATITIDIS
aka GILCHRIST Dz aka BLASTOMYCOSIS aka NORTH AMERICAN BLASTOMYCOSIS Starts in in resp system with spore (conidia) inhalation If not resolved, severe URI Is endemic East of Mississippi River & south of Ohio River, & in Boundary Waters |
Blast out the Bible camp
Says its derm but its resp |
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TB:
secondary miliary extrapulmonary |
SECONDARY: reactivation, usually in upper lobe
MILIARY: shot-gun lesions, wide hematological spread in kidneys, lungs, CNS, GI tract, etc EXTRAPULMONARY aka POTT'S Dz (skeletal), chronic MENINGITIS, SCROFULODERMA (skin) |
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ANTIFUNGAL AGENTS
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1. BIG GUN with side effects = AMPHOTERCIN B
2. NYSTATIN = POLYENE MACROLYDES 3. PYRIMIDINE analogs (5-FC) 4. AZOLE antifungals 5. GRISEOFULVIN 6. ALLYLAMINE |
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TB DRUGS
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STRIPE:
STreptomycin Rifampicin Isoniazid Pyruzinamine Ethambutol |
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COCCIDIOIDES IMMITIS
& nickname |
aka SAN JOAQUIN VALLEY FEVER
1. Inhalation of spores 2. Respiratory infection Tissue phase = thick-walled spherules with endospores. 20% AIDS pt will develop due to poor cell-mediated immunity Seen in DESERT, SW US & S.America |
Syd Cox's imminent move to the SW US
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ZYGOMYCETE
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**MOST ACUTE & FULMANENT INFECTION OF AIDS pts
Death unless rapidly dx & tx |
GO! (acts fast/fulminant)
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What can ASPERGILLUS do that most mold & yeast cannot?
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Can grow at body temp (unlike most yeast & mold, per lecture)
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BOARD QUESTION
ASPERGILLUS FUMATICUS |
Farmer's lung
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ASPERGILLUS FLAVUS
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ASPERGILLUS FLAVUS
aflaxotoxins cause liver dz & in feed, animal abortions |
a-fla
Flavus Flavors animal feed. |
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ASPERGILLUS NIGER
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ASPERGILLUS NIGER
Fungus causing black/gray growth on eardrum |
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PIEDRA HORTAI
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"Black Piedra"
African-American, black hard nodules around scalp hair @ scalp level. Tx: shave affected hair |
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TRICHOSPORON BEIGII
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"White Piedra"
Light brown nodules around genital hair, mustache, beard |
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HOW TO DX
CRYPTOCOCCUS NEOFORMANS |
1. Is a bad yeast,
2. Can cause meningitis without bacteria, also cutaneous, sub-q, hepatosplenic, osteomyelitis, skin nodules. DX: 1. Cryptococcal polysaccharide (from cell membrane) antigens in CSF 2. INDIA INK STAIN: yeast cells with large zone of clearing around them (capsule) |
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ANAEROBIC ACTINOMYCETES
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LUMPY JAW from dental work, mucus membrane injury, can abscess to outside of cheek & rupture.
IUD infection "SULPHUR GRANULES" yellow or orange in color Tx: good response to PCN |
Anaerobic in the mouth
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PITIRIASIS VERSICOLOR
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aka MALASSEZIA FURFUR
Scaly patches of red, brown, white Fluoresce under a WOODS LAMP "Spaghetti & Meatball" appearance under microscope. |
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3 MAIN SUB-Q FUNGAL INFECTIONS
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1. MYSETOMA
2. CHROMOMYCOBLASTOSIS 3. PHAEHYPHOMYCOSIS |
MY
CHROME PHAROH |
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HISTOPLASMOSIS CAPSULATUM
with nickname |
HISTOPLASMOSIS CAPSULATUM
DARLINGS DISEASE Bat guano, bird & chicken droppings Can be reactivated years later & disseminate |
THINK SPELUNKERS
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BOARD QUESTION
MOST COMMON CUTANEOUS FUNGI |
DERMATOPHYTES
Some cause hair/nail epidemics |
derm = cutaneous
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MYCETOMA
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MYCETOMA = FUNGAL TUMOR
Tropics & subtropics, skin infxn often follows lymph canal |
OMA
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ACTINOMYCOTIC MYCETOMA
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A fungus-like bacteria
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ACTIN' LIKE A BACTERIA
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EUMYCOTIC MYCETOMA
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Mycetoma due to a fungi
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YOU (eu) are a FUN - GUY
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DERMATOPHYTE Rx (topical)
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Use topical whenever possible!
WHITFIELD'S, AZOLE |
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DERMATOPHYTE Rx (oral)
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GRISEOFULVIN - liver toxin
KETOCONAZOLE - hepatitis risk |
Grizelda & Kegan need dermatophyte Rx
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HOW LONG TO Tx DERMATOPHYTES
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SCALP: 6 - 12 wks
FINGERNAILS: 6 months TOENAILS: up to 1 year RELAPSE IS COMMON |
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DERMATOPHYTES:
3 Genusus |
1. MICROSPORUM (skin & hair)
2. EPIDERMOPHYTON (skin & nails) 3. TRICHOPHYTON (skin, hair, nails) |
I MET a DERM
M E Tri Derm = not too serious, only skin |
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MICROSPORUM species
& what they can cause |
1. MICROSPORUM CANIS: ringworm, form dogs, cats. will FLUORESCE. Spores look like little canoes.
2. MICROSPORUM GYPSEUM can cause INFLAMMATORY: Tinea corporis Tinea capitas |
Micro = relatively small problem (skin)
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TRICHOPHYTON MENTAGROPHYTES
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** MOST VIRULENT OF THE DERMATOPHYTES***
(Photo of badly affected girl) Most common cause of ATHLETE'S FOOT. |
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PARACCIDOIDES BRASILIENSIS
& nickname |
SOUTH AMERICAN BLASTOMYCOSIS
1. Chewing on contaminated vegetables 2. Disseminates to ulcerative lesions on nasal & GI mucosa, bad mouth ulcers 3. Intestines 4. Death in 2-3 yrs w/o Tx |
Close to Paraguay
Photo of Bazilian man with mustache & diseased lip. Cox family has a vegetable garden. |
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TRICHOPHYTON TONSURANS
& nickname |
BLACK DOT TINNEA CAPITAS
Causes 90% of tinea capitas Endemic in BLACK SCHOOL KIDS |
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TRICHOPHYTON SCHOENLEINII
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SEVERE Tinea capitas = FLAVUS
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Photo of sad boy with cauliflower-looking lesions all over his scalp
Does Papa Len have a favorite? |
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TRICHOPHYTON VERRUCOSUM
"Try go fight on" playground fight because of appearance. |
Usually acquired from cattle
1. Endothrix 2. Tinea capitas 3. Tinea barbae 4. Tinea corporis |
Photo of man with sparse beard
"where you go, son?' to feed the cattle |
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EPIDERMOPHTON FLOCCUSUM
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Jock itch
Tinea unguium (nails) EPIDEMIC Tinea PEDIS |
Does Flo have thick, brittle, discolored nails?
Epiderm |
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TINEA UNGUIUM
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Fungus infxn of nails
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CHROMOMYCOBLASTOSIS
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CHROMOMYCOBLASTOSIS
Black dots on tissue surface, or copper penny appearance Can take up to 15+ yrs to involve entire limb |
Copper-colored penny
Black as a crow Black as a cow Photo of raised lesions - practically need a lawn mower to blast them off |
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PSEUDOALLESCHERIA BOYDII
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#1 CAUSE OF MYSETOMA IN US
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Photo of boy's (pseudo-boyd's) entire heel affected.
Heel matches fungus on my theater chair. #1 show at the theater. |
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#1 CAUSE OF MYOSETOMA IN US
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PSEUDOALLESCHERIA BOYDII
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Photo of boy's (pseudo-boyd's) badly affected heel
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BOARD QUESTION
SPOROTHRIX SCHENKII & nickname |
Spore does tricks (DIMORPHIC)
YEAST at body temp MOLD at room temp ROSE THORN DISEASE |
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SPOROTHRIX SCHENKII
causes: |
Nonhealing lesion on extremity (nodular, expands into tissue around it)
Lesions develop ALONG LYMPH channels "chain of lesions" aka ROSE THORN DISEASE |
"Chain of lesions"
Think "flower chain" |
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3 GENUS (species?) of FUNGUS-LIKE BACTERIA
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FUNGUS-LIKE BACTERIA:
1. NOCARDIA = PARTLY acid fast 2. STREPTOMYCES: NON acid fast White to yellow granules 3. ACTINOMADURA |
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What FUNGUS LIKE BACTERIA do
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1. Mimic TB
2. Can be sub-q & also systemic |
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BOARD QUESTION
Is NOCARDIA acid fast? |
NOCARDIA is PARTLY acid-fast.
Nocardia - No granules - No hope 40% of Nocardia is dx on autopsy (a fungus-like bacteria) |
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Is STREPTOMYCES acid-fast?
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STREPTOMYCES is NOT acid-fast
(a fungus-like bacteria) |
There is neither an A or an F in streptomyces.
A fungus-like bacteria. |
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TB TESTING
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INTRADERMAL PPD
> 15 mm indurantion "normals" > 5 mm induration AIDS, etc PCR for TB nucleic acid CXR |
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ATYPICAL MYCOBACTERIUM
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Same species as TB
Common in AIDS pt with CD4 ct < 100 30% are M Avian complex Same sx as TB |
Same species as TB
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TB Sx
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TB Sx
night sweats fever weight loss generalized lymphedema |
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MYCOBACTERIUM LEPRAE
Causes 3 kinds of: |
LEPROSY
1. TUBERCULOID: granuloma limited to a few peripheral nerves or adjacent skin areas 2. LEPROMATOUS: all tissues are affected 3. BORDERLINE: between the other two |
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FUNGI divided according to BODY SITE
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SAPROPHYTIC FUNGI = OPPORTUNISTIC
1. SUPERFICIAL: COSMETIC 2. CUTANEOUS: dermatophytes (skin, hair, nails) 3. MUCUS MEMBRANES: yeasty type 4. SUBCUTANEOUS: tumors, ulcers 5. SYSTEMIC |
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PYRIMIDINE ANALOGS
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PYRIMIDE ANALOGS = ANTIFUNGALS
ex: 5FC (5-fluorocysteine) cause RNA to make nonsense protein SYNERGYSTIC with AMPHTOTERCIN B Quickly develop resistance |
Pyramid (triangle shape) = change
ANalog - ANtifungal 5-Fc = anti-Fungal |
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AZOLE ANTIFUNGALS
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oral, topical, IV
faster than Nystatin (1-3 days) FUNGISTATIC Monitor LIVER function |
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GRISEOFULVIN
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GRISEOFULVIN: antifungal
Disrupts mitotic spindle Rx for DERMATOPHYTES |
Griselda, sitting at spinning wheel, has skin problems
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ALLYLAMINE
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Rx for DERMATOPHYTES
(antifungal agent) |
Allyn has skin problems, too, just like Griselda
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Rx for serious DISSEMINATED FUNGAL infections
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AMPHOTERCIN B
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AMPHOTERCIN B side effects
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Magnesium, low
Anemia Renal failure K, low (potassium) |
M
A R K |
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POLYENE MACROLIDE
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NYSTATIN
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Polly N's Swish & Swallow
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ACINOMYCETE is:
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An Anaerobic fungus
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My theater seat is covered with fungus.
I can't breathe in here! |
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CRYPTOCOCCUS NEOFORMANS
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CRYPTOCOCCUS NEOFORMANS
found in pigeon droppings 1. Starts as asymptomatic resp infxn 2. Granulomas (inflammatory lesions) in lung 3. AIDS: meningitis |
Think Lisa's grandpa
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CRYTOPCOCCUS NEOFORMANS
MENINGITS Dx |
CRYPTOCOCCUS NEOFORMANS
CSF is clear, low pro, low glucose, + lymphocytes |
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TORULOPSIS GLABRATA
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TORULOPSIS GLABRATA
lungs kidneys disseminates - mimics histoplasma mold phase -mimics candida - toxic shock, fungemia, UTIs |
bad things - tore you lopsided
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GEOTRICHUM CANDIDUM
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Opportunistic pathogen
Mimics: thrush & TB Bronchial infxn Chronic cough Bloody sputusm |
Gretchen has a bad cough & her mouth hurts.
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BOARD QUESTION
YEAST SPECIES with GERM TUBES in human serum |
YEAST with GERM TUBES
CANDIDA ALBICANS |
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The only FAST-GROWING
SYSTEMIC FUNGI |
COCCIDIOIDES
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Syd Cox
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TEST QUESTION
To test for CELL-MEDIATED IMMUNITY |
1. Injection of fungal antigen into skin (candida & other environmentals. Response is always delayed 24-48 hrs.
2. No response = inadequate immune response (ie, AIDS) 3. Sera drawn 2-3 wks apart. Look for 4-FOLD OR 2-TUBE titer increase. |
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CANDIDA ALBICANS causes:
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Bronchopulmonary
Onychromycosis (nail infxn) Intestinal candidosis Endocarditis Meningitis Brain abscess |
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ONYCHOMYCOSIS
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Nail yeast infection
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lots of Os
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