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71 Cards in this Set
- Front
- Back
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What are most fungal spores?
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Asexual
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What are 2 fungal infections that are transmitted by INHALATION of ASEXUAL spores?
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-Histoplasmosis capsulatum
-Coccidioides immitis |
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What are the asexual spores called?
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Conidia
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What yeast causes systemic or superficial fungal infections?
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Candida albicans
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What does C. albicans grow as at 20'C?
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Budding YEAST and pseudohyphae
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What does C. albicans grow as at 37'C?
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Germ tubes
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What is Thrush esophagitis a sign of?
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Immunocompromised state!
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What does C. albicans cause in IV drug users?
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Endocarditis
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What can C. albicans cause post-antibiotic treatment?
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Vaginitis
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What does C. albicans typically cause in infants?
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Diaper rash
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What is the treatment for
-Superficial Candidiasis -Serious systemic infectino |
Superficial = Nystatin
Systemic = Amphotericin B |
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What are the 4 ENDEMIC mycoses?
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-Coccidioides immitis
-Histoplasma capsulatum -Paracoccidioides brasiliensis -Blastomyces dermatitidis |
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What are all of the endemic mycoses organisms?
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DIMORPHIC
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Where is Coccidioides immitis endemic?
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-Southwest US
-California |
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What is the hallmark appearance of Coccidioides at 37'C?
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Spherules filled with endospores in the lung tissue
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How is coccidioides transmitted?
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Through inhalation of airborne arthrospores
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What is available for more rapid testing for Coccidioides than culture on Sabdex?
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A skin test!
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What won't a skin test tell?
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Whether it is a past infection or currently active coccidioides
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Where is Histoplasmosis endemic?
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Mississippi valley
Ohio river valley |
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How is Histoplasmosis transmitted?
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By inhalation in bird/bat droppings
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What is the microscopic appearance of Histoplasmosis?
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Tiny yeast inside macrophages
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What does Histoplasma form at 25' C?
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Tuberculate chlamydospores
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What type of immune response forms against Histoplasmosis? Where?
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Granulomatous - in the lungs!
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Is there a skin test for Histoplasmosis?
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Yes!
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Where is Paracoccidioides endemic?
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Rural Latin America
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What does Paracoccidioides form at 37'C?
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Ship steering wheels - multiple buds off yeast cells
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Where is Blastomycosis endemic?
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East of the Mississippi river in northern America, and less in Central america
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What does Blastomyces form at 37?
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Broad based buds
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So what do all of the endemic opportunistic systemic mycoses form at 25'C? 37'?
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25 = MOLD
37 = Yeast |
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What is the one exception that does not form a yeast at 37?
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Coccidioides - it is a spherule filled with endospores at 37
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How are the systemic mycoses treated when localized to the lungs?
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-Fluconazole
-Ketoconazole |
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How are they treated if disseminated?
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Amphotericin B
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What organism causes Tinea versicolor?
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Malassezia furfur
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What is the hallmark finding of Tinea versicolor? When does this develop?
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-Hypopigmented skin lesions
-Hot humid weather |
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How is Tinea versicolor treated?
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Selsun or topical Miconazole
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What is Tinea nigra caused by?
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Cladosporium werneckii
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What is Tinea nigra?
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Infection of the keratinized layer of skin causing brown spots
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How is Tinea nigra treated?
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Topical salycylate
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What are the 4 opportunistic fungal infections?
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-Candidiasis
-Aspergillosis -Cryptococcus neoformans -Mucor/Rhizopus - Zygomycetes |
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What do immunocompromised patients get from Candida?
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Thrush
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What predisposes to Candida vulvovaginitis?
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High pH
Diabetes Antibiotic treatment |
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What does Candida form at 37?
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Germ tubes
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What causes fungus balls in the lungs within cavities caused by TB?
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Aspergillus
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What are 3 conditions that Aspergillus can cause?
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-Allergic bronchopulm aspergillosis
-Lung cavity aspergilloma -Invasive aspergillosis |
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What is the characteristic pattern of mold growth seen with Aspergillus? Type of hyphae? What is it NOT?
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-45' branching Hyphae
-Septate -Not dimorphic |
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Which opportunistic fungus causes meningitis?
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Cryptococcus neoformans
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What type of fungus is Cryptococcus neoformans? Hallmark feature?
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YEAST
Heavily encapsulated! |
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How is Cryptococcosis transmitted?
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In pigeon droppings and soil
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How is Cryptococcus cultured?
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On sabdex
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What stain shows cryptococcus and what is the hallmark morphology?
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INDIA INK shows the capsule with a wide halo around yeast cells
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What makes Cryptococcus distinct from Blastomyces at 37'?
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Crypto = narrow based buds
Blast = wide based buds |
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What do Mucor and Rhizopus cause?
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Mucormycosis
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What type of fungi are Mucor and Rhizopus?
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Zygomycetes - MOLDS
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What is the hallmark growth pattern seen with Zygomycetes? Type of hyphae?
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Irregular BROAD branches with wide angle branches >100'
-nonseptated hyphae |
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In what patients does Zygomycetes most often cause mucormycosis?
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-Ketoacidotic Diabetics
-Leukemia patients |
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What can the fungi from Mucor and Rhizopus do within the body?
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Proliferate in blood vessel walls and cause INFARCTS
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What are 2 hallmark conditions caused by Mucormycosis?
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-Rhinocerebral abscesses
-Frontal lobe abscesses |
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What fungus causes diffuse interstitial pneumonia?
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Pneumocystis carinii
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What type of a mold is PCP?
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YEAST
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How is PCP transmitted?
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By inhalation
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What are MOST infections with Pneumocystis?
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Asymptomatic
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What patients get disease from Pneumocystis?
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AIDS/immunocompromised
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What is required for Pneumocystis diagnosis?
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Lung biopsy or lavage
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What is used for diagnosing Pneumocystis?
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Methenamine Silver Stain of lung tissue
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What is PCP treated with?
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-Bactrim - TMP/SMX
-Pentamidine -Dapsone |
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When should prophylaxis in HIV patients start for PCP?
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When CD4 drops <200 cells/ul
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What is the dimorphic fungus that lives on vegetation?
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Sporothrix schenckii
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How do most Sporothrix infections occur?
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By traumatic introduction to the skin - rosethorn prick
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What happens after the initial inoculation of Sporothrix?
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Ascending lymphangitis - the local ulcer/pustule drains to lymph nodes
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What is the classic morphology of Sporothrix schenckii?
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Cigar-shaped budding yeast
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How is Sporotrichosis treated?
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-Itraconazole
or -Potassium iodide |
