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54 Cards in this Set

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4 systemic mycoses
Histoplasmosis
Blastomycosis
Coccidioidomycosis
Paracoccidioidomycosis
Two forms of dimorphic fungi?
Cold = mold (20C)

Heat = yeast (37C)
Which of the systemic mycoses is not a dimorphic fungus?
Coccidioidomycosis: is a spherule, not yeast, in tissue
Treatment of systemic mycoses (local infection)
Fluconazole or ketoconazole
Treatment of systemic mycoses (systemic infection)
Amphotericin B
Mycosis that hides in macrophages?
Histoplasmosis
Mycosis transmitted by bird or bat droppings?
Histoplasma
Clinical sequela of histo?
Pneumoina
Broad-based budding?
Blastomycosis
Clinical features of blasto?
Inflammatory lung disease

Forms granulomatous nodules
Which 2 mycoses can disseminate to skin and bone?
Blastomycosis
Coccidioidomycosis
Mycosis associated with earthquakes?
Coccidioido

Spherules in dust thrown up in the air
Clinical features of coccidioido
Pneumonia and meningitis
Spherule filled with endospores
Coccidioidomycosis
Budding yeast w/ captain's wheel formation?
Paracoccidioidomycosis
Malassezia furfur -->
Tinea versicolor
Pathogenesis of tinea versicolor
Degradation of lipids produces acids that damage melanocytes --> hypo and/or hyperpigmented patches
Treatment of M. furfur
Topical miconazole, selenium sulfide
Spaghetti and meatball appearance on KOH prep
Tinea versicolor
Pruritic lesions w/ central clearing resembling a ring
Tinea pedis, cruris, corporis, capitis
Mold hyphae in KOH prep
Dermatophytes

NOT dimorphic
Treatment for Tinea pedis, cruris, corporis, capitis
Topical azoles (tinea capitis needs oral) or terbinafine
Reservoir for Microsporum (a dermatophyte)?
Pets
Dimorphic forms of Candida albicans
Yeast w/ branched budding and pseudohyphae (20C)

Germ tube formation (37C): diagnostic
C. albicans in i/c pts
Oral and esophageal thrush
C. albicans in IV drug users
Endocarditis
C. albicans in diabetics or post-antibiotics
vulvovaginitis
C. albicans treatment: superficial infection
Nystatin
C. albicans treatment: serious systemic infection
Amphotericin B
Fungus ball
Aspergillus

Presents w/ cough and hemoptysis
Aspergillosis is most common in these two groups of pts
I/C

Chronic granulomatous disease
Pathology of Aspergillus fumigatus
Mold with septate hyphae that branch at acute angles
Heavily encapsulated yeast
Cryptococcus neoformans
Narrow-based budding
Cryptococcus neoformans
"Soap bubble" lesions in brain
Cryptococcus
Diagnosis of Cryptococcus
Culture on Sabouraud's agar
Stains w/ India ink
Latex agglutination test detects polysaccharide capsular antigen (more specific)
Clinical sequelae of cyrptococcus
Cryptococcal meningitis
Cryptococcosis (non-specific symptoms)
Treatment of acute meningitis caused by cryptococcus
Amphotericin B and flucytosine

Fluconazole is used for pts for lifelong prophylaxis
Mycosis disease associated w/ diabetic ketoacidosis
Mucormycosis
Mold with irregular nonseptate hyphae branching at wide angles
Mucor and Rhizopus
Wide angle branching (90degrees +) vs. acute angle branching (<45 degrees)
Mucormycosis

Aspergillus
Two types of pts most commonly infected with Mucor/ Rhizopus
Ketoacidotic diabetic
Leukemic

Fungi proliferate in vessel walls when there is excess ketone and glucose, penetrate cribriform plate, and enter brain
Infection of paranasal sinuses
Mucormycosis
Clinical sequelae of mucormycosis
Rhinocerebral, frontal lobe abscesses
Headache, facial pain, CN involvement
Black necrotic eschar on face
Can lead to confusion/ death
Treatment of Mucor/ Rhizopus
Surgical debridement + amphotericin B
Clinical sequela of pneumocystis jiroveci
Diffuse interstitial pneumonia (diffuse, bilateral CXR appearance)
Diagnosis of p. jiroveci
Lung biopsy or lavage
Identified by methenamine silver stain of lung tissue
Saucer-shaped yesast forms
Pneumocystis jiroveci
Treatment of p. jiroveci
TMP-SMX
Pentamidine
Dapsone
Thorn transmission
Sporothrix schenckii
Dimorphic fungus that lives on vegetation
sporothrix schenckii (rose gardener's disease)
Clinical sequela of sporothrichosis
Local pustule or ulcer w/ nodules along draining lymphatics (ascending lymphangitis)
Treatment of sporothrix schenckii
Itraconazole or potassium iodide
Narrow vs. broad-based budding
Cryptococcus is narrow
Blastomycosis is broad