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208 Cards in this Set
- Front
- Back
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Are fungi prokaryotic or eukaryotic?
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Eurkaryotic
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What is the chemical nature of the cell wall of fungi?
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peptidomannan, hitin, glucans
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What is a blastoconidium?
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a yeast cell
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What type of general structure do molds have?
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they are comprised of long filaments call hyphae
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What is the name of a mass of hyphae?
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mycelium
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In relation to fungi, what does dimorphic mean?
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a fungal organism that can grow in two different forms depending upon the culture conditions. Often seen by growth at 37 and 25 C
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What is the name for the reproductive cell of a filamentous fungus?
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spore - it is now usually called a conidium
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What is the term for hyphae that has no cross wall or septa?
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aseptate or coenocytic
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What is the term for hyphae that have cross walls?
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setate hyphae
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What type of spore is formed by fragmentation of thick walled hyphal elements that are barrel shaped?
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arthroconidia
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What are the asexual spores that are produced when yeast cells bud?
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blastoconidia
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What is the name of the fungal element composed of several elongated blastoconidia that are arranged in a straight line and that appear to be hyphae?
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pseudophyae
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Name the thick walled conidium that develops within a hyphal element by modification of an existing cell
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chlamydospore
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What is the name given to a very small spore (or conidium)?
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microconidium
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What is the name given to a large spore (conidium)?
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macroconidium
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What is the specialized hyphal element upon which conidia are produced?
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conidiophore
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What is the name of a sac-like structure that contains asexual spores?
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sporangium
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What is the name of the conidia (spores) that are contained within a sporangium?
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sporangiospores (or sporangioconidia)
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Which class of fungi is characterized by having aseptate hyphae and sporangiospores?
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zygomycetes
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Which class of fungi is characterized by having ascospores and septate fungi?
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ascomycetes
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Which class of fungi is characterized by having basidiospores and septate hyphae?
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basidiomycetes
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Which class of fungi does not have a sexual stage?
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deuteromycetes
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What does antropophilic mean?
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a fungus that preferentially grows on man rather than on animals or in the soil
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What does zoophilic mean?
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a fungus that preferentially infects an animal rather than man
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What does geophilic mean?
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a fungus that has a coil reservoir
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What is the difference between mycotoxicoses and a mycoses?
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a mycotoxicosis is caused by a toxin that is ingested by man, a mycosis is an infection due to a fungus
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Name four different types of mycoses
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1. superficial, 2. cutaneous, 3. subcutaneous, 4. systemic
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Are most fungal infections from an endogenous or exogenous source?
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most are from an exogenous source
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Which fungus is obtained from an endogenous source and where does it reside in the body?
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candida albicans. Normally found in the gut, mouth and vagina
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What is the target of attack for most of antifungal agents?
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they interfere with ergosterol synthesis
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What is the etiologic agent of Tinea versicolor?
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malassezia furfur
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What does the agent of Tinae vesicolor look like when skin scrapings are digested with 10% KOH and examined microscopically?
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yeast cells and hyphae that look like spaghetti and meat balls
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Where does the infection known as Tinae nigra usually occur on the body?
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the palms and soles
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What is the etiological agent of tinea nigra?
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phaeoannellomyces werneckii
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What does the agent of tinae nigra look like in KOH preparations of skin scrapings?
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brown/olive/black branched, septate twisted hyphae. Can see chlamydospores
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What is the etiologic agent of black piedra?
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pledraia hortal
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What clinical manifestations are associated with black piedra?
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firm nodules of the hair shaft that have a gritty feeling when the hair is combed
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What do the crushed nodules of black piedra look like?
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brown septate hyphae, may see banana shaped ascospores
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What is the etiological agent of white piedra?
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Trichosporon beigelii
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What clinical manifestation is associated with white piedra?
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light colored nodules along the hair shaft, may infect hair, beard, mustache and genital area hair
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What do the crushed nodules of white piedra look like microscopically?
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hyphae with oval arthrospores. Mycelial elements held together with cement like matrix
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Which group of fungi is responsible for the ringworm infections?
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the dermatophytes
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What is different about infection with dermatophytes as compared to the superficial mycoses?
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they parasitize all layers of the skin, hair and nails and produce significant lesions
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Which 3 genera are involved in ringworm infections?
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trichophyton, micorsporum, epidermophyton
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What is characteristic about spores and hyphae of the Trichophytons?
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thin walled, smooth, cigar shaped macroconidia; numerous microconidia in engrappe (grape like clusters) or en thyrse (along hyphae); spiral hyphae seen
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What tissues are infected by Trichophyton species?
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hair, skin, nails
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What do the spores of Microsporum species look like?
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thick walled, rough, spindle shaped, macroconidiae; microcondidia
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What tissues are infected by Microsporum species?
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skin and hair
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What do the spores of Epidermophyton look like?
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club-shaped, smooth, thin walled macroconidia in clusters of 2-3; no microcondidia
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What tissues are infected by Epidermophyton?
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skin and nails
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What is the id reaction?
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the production of dermatophytosis-like symptoms at uninfected sites on an infected person. It is an allergic response
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What types of fungi cause chromomycosis (also called chromoblastomycosis)?
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the dematiaceous (black) fungi
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What is the natural habitat of the dematiaceous fungi?
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soil and plant debris
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What type of lesion occurs in chromomycosis?
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warty, ulcerated and crusted lesions that may be raised above the skin surface. Cauliflower- like in appearance
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What lab findings are found in chromomycosis?
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direct mouth of tissue from lesion shows thick walled chestnut brown bodies referred to as "copper pennies"
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What is the prognosis for chromomycosis?
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usually remains localized. Occasionally dissemination to the brain with a grave prognosis
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What species of microorganisms cause actinomycotic mycetoma?
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actinomyces, nocardia, actinomadura, stretomyces
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What species of fungi are responsible for infections known as Eumycotic mycetomas?
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1. pseudoaliescheria, 2. madurella, 3. exophiala
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What is characteristic about the granules of the Actinomycotic mycetomas?
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granules are composed of gram-positive filaments that are thin
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What is characteristic about the granules from the eumycotic mycetomas?
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the granules are composed of fungal hyphae that are large in diameter with many intercalary swollen cells
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Which type of mycetoma has a better prognosis and why?
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the actinomycotic mycetomas has the better prognosis. The eumycotic mycetoma is usually resistant to chemotherapy
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What are the staining and morphological characteristics of the actinomyces species?
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fine gram positive filaments (may be short and branching). They are not acid fast
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Name the two henera that contain agents that cause actinomycosis
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actinomyces species and propionibacterium species
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In which anatomic locations is Actinomyosis most often found?
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cervicofacial
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What is the source of infection for Actinomycosis?
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the organism is found among the normal flora of the mouth. It is introduced into tissues by dental procedures
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What predisposes an individual to development of Actinomycosis?
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1. malnutrition, 2. alcoholism, 3. systemic disease, 4. disruption of mucosal surfaces, 5. depressed immunity
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What can be seen direct examination of pus from Actinomycosis?
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sulfur granules, fine Gram positive filaments
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How is Nocardiosis transmitted to humans?
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via the pulmonary route or after trauma with a contaminated object
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What is the normal habitat of Nocardia species?
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the soil
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Name 3 different infections that can be caused by nocardia
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1. thoracic, 2. cutaneous, 3. meningitis
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What is seen when pus from Nocardia infection is examined?
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delicate multiple branching or fragmented filaments
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What are the staining and morphological characteristics of Nocardia species?
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gram positive, partially acid fast, delicate filaments
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What type of lesions occur in Sporotrichosis?
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chronic cutaneous and lymphcutaneous nodular lesions with adjacent lymphatics that suppurate, ulcerate and drain
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How does man obtain sporotrichosis?
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the fungus is inoculated by trauma to the skin. Inhalation causes pulmonary disease which is rare
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What is the etiological agent of sporotricholsis?
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Sporothrix schenckii
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What is the natural habitat of Sporothrix schenckii?
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soil, bark, rose bushes, straw
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What does sporothrix schenckii look like in tissues?
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elongated, irregular yeast cells (cigar shaped). Not always seen in direct preparations
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What does Sporothrix schenckii look like after growth in 30C?
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septate hyphae with tapered conidiophores that bear clusters of conidia (spores ) at the tips in floweret arrangements (some say they look like daisies)
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What is the treatment for sporotrichosis?
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oral potassium iodide
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What is the treatment if lymphocutaneous sporotrichosis relapses or if the disease is disseminated or pulmonary?
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Amphotericin B
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What species of fungi cause Phaeohyphomycosis?
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exophialia and wagiella
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What is characteristic of the disease Phaeohyphomycosis?
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subcutaneous infection with a dematiaceous fungus. Pigmented hyphae in tissues without copper pennies
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What type of infection is usually caused by Coccidioides immitis?
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respiratory infection that resolves rapidly
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What happens when coccidioidomycosis goes systemic?
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it spreads to meninges, bones, joints, subcutaneous and cutaneous tissues in 0.5-1% of individuals
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What does Coccidioides immitis look like in tissues?
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spherules with a thick wall containing endospores
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What does Coccidioides immitis look like when grown at 30C?
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mycelial growth that produces barrel-shaped anthroconidia with a disjunctor cell between each arthroconidium
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What is the infectious agent of Coccidioides immitis?
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arthroconidia that are aerosolized and inhaled
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What is the natural habitat and endemic area of Coccidioides immitis?
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soil of the lower Sonoran life zone in North, central and south America. In the USA it is found in southern Texas, southern new Mexico, southern Arizona and in southern and central California
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What types of clinical infection are caused by histoplasma capsulatum?
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inapparent, subclinical or benign lung infections (95% of cases). Chronic progressive lung disease which can go systemic - may mimic TB
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What does Histoplasma capsulatum look like in tissues?
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small yeast cells are seen inside of macrophages
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What does Histoplasma capsulatum look like when grown at 30C?
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beige to light brown mold characterized by septate hyphae that bear microconidia and large tuberculated macroconidia. The tuberculated macroconidia are the key identifying feature
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What does histoplasma capsulatum look like when grown at 37C on Brain heart infusion agar?
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small single budding yeast (blastoconidia) with a thin neck between mother and daughter cells
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What is the natural habitat and endemic area of histoplasmosis?
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soil with a high nitrogen content. Endemic area is the Mississippi and Ohio River Valleys. Oklahoma is in that area
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What types of infections are caused by Blastomyces dermatitidis?
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benign self-limiting pulmonary infection. Disseminated infection from lungs to other sites of the body especially skin and bone
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What does Blastomyces dermatitidis look like in tissues?
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Blastoconidia (yeast) that are thick walled with a large isthmus between mother and daughter cells (some call this a broad based bud)
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What does Bastomyces dermatitidis look like when grown on Brain Heart infusion agar at 37C?
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The yeast phase grows. Thick walled yeast cells with a broad-based bud (isthmus) between mother and daughter cell
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What does Bastomyces dermatitidis look like when grown at 30C?
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Mycelial growth with septate hyphae and microconidia
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What is the natural habitat and endemic area for blastomycosis?
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soil is the natural habitat. Endemic area: mississippi and Ohio River Valley, the area extends further over to the east coast than for Histoplasmosis and does NOT include Oklahoma
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How is man infected with Blastomycosis and Histoplasmosis and what is the infectious particle?
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Inhalation. The microconidia are the infectious particle for both
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Where does the disease paracoccidioidomycosis occur?
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In South America. Also called South American Blastomycosis
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What is the etiologic agent of paracoccidioidomycosis?
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Paracoccidioides brasiliensis
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What types of infections occur as a result of infection with Paracoccidioides brasiliensis?
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pulmonary. Dissemination results in ulcerative granulomata in the nasal, buccal and occasionally GI mucosa
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What does Paracoccidioides brasiliensis look like in tissues?
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As multiple budding yeasts. May look like a 'mariner's wheel' or 'Mickey mouse' form
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What does Paracoccidioides brasiliensis look like when grown at 30C?
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a mycelial form with no special Identifying features
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What does Paracoccidioides brasiliensis look like when grown on a Heart Brain infusion agar at 37C?
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grows as the multiple budding yeast form
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What is the natural habitat of Paracoccidioides brasiliensis?
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soil and wood
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What is the treatment of choice for the systemic mycoses?
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Amphotericin B
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Infection with Candida albicans can occur at what sites in the body?
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vagina, oral cavity, esophagus, perianal, superficial skin, systemic
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What is the primary predisposing factor for development of mucocutaneous candidiasis?
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T cell deficiency
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What is the primary predisposing factor for the development of systemic candidiasis?
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neutropenia
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Besides T cell deficiency and neutropenia, what other factors can predispose the patient for the development of candidiasis?
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1. antibiotic use (due to effects on natural flora), 2. pregnancy, 3. endocrine abnormalities, 4. local tissue damage, 5. malnutrition, 6. severe burns, 7. drug abuse, 8. IV catheters
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What does Candida albicans look like in tissues?
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budding yeast cells, hyphae and pseudohyphae
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How can Candida albicans be differentiated from other Candida infections?
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C. albicans makes germ tubes when incubated at 37C in serum. C. albicans will make chlamydoconidia when grown on special medias
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What is used to treat superficial skin infections due to Candida?
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Nystatin
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What treatment is used for mucocutaneous Candida infection?
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Ketoconazole
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What treatment is used for systemic candidiasis?
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Amphotericin B
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What is the natural habitat of Candida albicans?
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Normal flora of the gut, vagina and oral cavity
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What is the primary site of infection with Cryptococcus neoformans?
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the lungs
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Upon dissemination systemically, C. neoformans has a predilection for what tissue?
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the CNS
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What form of disease due to C. neoformans infection is most frequently diagnosed?
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meningitis
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What predisposes patients to development of infection with Cryptococcus neoformans?
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T cell deficiency. Especially important in AIDS populations
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What does Cryptococcus neoformans look like in spinal fluid or other tissues?
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an encapsulated yeast cell. Capsule is visualized in India ink preparations
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What does Cryptococcus neoformans look like when grown in the lab at 30C?
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an encapsulated yeast cell
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What does Cryptococcus neoformans look like when grown in the lab at 37C?
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an encapsulated yeast cell
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What test is commonly done on serum or spinal fluid to detect infection with Cryptococcus neoformans?
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a test for the presence of cryptococcal antigen. Latex beads coasted with antibody to cryptococcal antigen will agglutinate in the presence of serum or CSF that contains the antigen
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What is the prognosis of non-compromised patients with localized pulmonary lesions due to C. neoformans?
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good
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What is the prognosis of compromised patients with systemic infections due to C. neoformans?
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very poor
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What is the recommended treatement for cryptococcal meningitis?
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a combination of 5 FC and amphotericin B
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After treatment of AIDS patients with cryptococcosis, they must be placed on maintenance therapy for life with what drug?
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Fluconazole
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What is the natural habitat and endemic area for Cryptococcus neoformans?
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found in soil, especially in areas containing large amounts of pigeon feces. The organism is found world wide
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How is man infected with C. neoformans?
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believed to be by inhalation of small desiccated forms of the yeast found in the soil
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What types of patients are at risk of developing pneumocystis pneumonia?
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Immunocompromised patients such as: AIDS, bone marrow transplant, chronic corticosteroid treatment
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When do people become infected with Pneumocystis and how are they infected?
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by 4 years of age, via the respiratory route
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What immune response is primarily responsible for protection against pneumocystis pneumonia?
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CD4 mediated
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What two names are given to the etiological agent of pneumocystis pneumonia?
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1. pneumocystis jiroveci (new name), 2. pneumocystis carinii (old name)
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What are the symptoms of pneumocystis pneumonia?
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dry cough, fever, progressive shortness of breath, rapid breathing (only immunocompromised patients develop the disease)
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What is used for prophylaxis of AIDS patients to prevent pneumocystis pneumonia?
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pentamidine
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What range of infections can be caused by Aspergillus species?
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a spectrum from allergic to invasive infection
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What is the most common species of Aspergillus that causes human infections?
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Aspergillus fumigatus
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Where are Aspergillus organisms found?
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throughout the world
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What type of hypersensitivity reaction can be induced after inhalation of Aspergillus conidia?
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immediate hypersensitivity (IgE mediated)
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What clinical features are characteristic of allergic bronchopulmonary aspergillosis?
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fungal growth in the bronchi. Asthma. Immediate hypersensitivity to aspergillus. Skin test antigen. Positive culture for Aspergillus from sputum
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What clinical features are commonly associated with aspergilloma?
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fungus ball in the lungs, can be asymptomatic or result in productive cough and hemoptysis
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What are the common sites of infection in non-invasive aspergillosis?
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pulmonary cavity, external ear canals, nasal cavity, eye, nail plate, paranasal sinuses
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What individuals are most susceptible to non-invasive aspergillosis?
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immunosuppressed
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What type of immunosuppression leads to invasive aspergillosis?
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granulocytopenia (neutropenia)
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What can be a potential consequence of exposure to some of the metabolites of Aspergillus?
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they are toxic and carcinogenic
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What does Aspergillus look like in tissues?
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branching, septate hyphae
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What does Aspergillus look like when grown in the lab?
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mycelium bearing conidiophores on which are found phialides. Conidia are found at the tips of phialides
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Why is it difficult to prove that Asperigillus was cultured from a clinical specimen?
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the organism is a common contaminant in the air and therefore a contaminant of media used to grow fungi in the lab
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What additional information helps establish that Aspergillus is the cause of an infection other than a culture grown in the lab?
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direct observation of septate hyphae in the clinical specimen
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What other types of tests can be used to aid in the diagnosis of Aspergillosis?
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detection of antigens by double diffusion or other immunologic assays
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What is the treatment for aspergilloma?
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may range from non to surgical resection and treatment with antifungals (Amphotericin B and flucytosine)
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What is the treatment for invasive aspergillosis?
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Amphotericin B and itraconazole
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What is the name for the disease caused by an opportunistic mycotic infection caused by a mold in the class Zygomycetes?
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mucormycosis (also zygomycosis)
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What patient groups are susceptible to the development of mucormycosis?
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Ketoacidosis resulting from diabetes mellitus, drugs or uremia. Burn patients, leukemia and lymphoma, steroid therapy, immunosuppressed
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Several different fungal species can cause mucormycosis but which two are most prevalent?
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mucor and rhizopus
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What types of infection can be caused by mucormycosis?
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rhinocerebral infection. Thoracic infection causing destruction of lung parenchyma, localized infection after tissue trauma, kidney infection, cutaneous infection
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What do the fungi that cause mucormycosis look like in tissues?
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broad, irregular, branching, nonspetate hyphae. Key identifying feature: the branching nonspetate hyphae
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What do the organisms that cause mucormycosis look like when grown in the lab?
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aseptate hyphae (also called coenocytic hyphae) with sproangiophores bearing sporangia which are filled with spores (sporangioconidia). If the species is Rhizopus, rhizoids will be seen. If it is Mucor, rhizoids will not be present
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What is the treatment for mucormycosis?
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Surgical debridement and Amphotericin B
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how do polyene antifungals work?
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forms complexes with ergosterol and increases permeability
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what type of antifungal is amphotericin B?
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polyene
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how do fulcytosine antifungals work?
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metabolic activation of the drug disrupts DNA synthesis
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how do azole antifungals work?
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interfere with synthesis of ergosterol by blocking P450 dependent 14alpha-demethylation of ianosterol
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what is griseofulvin given for?
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keratinophili fungi - toe and fingernail infections
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how do tervinafine antifungals work?
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allylamine that inhibits squalene epoxidase = interferes with syntehsis of membrane ergosterol (at an earlier stage than zoles)
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what is tervinafine given for?
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orally for nail infections or for infections with some species of candida
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what does endothrix mean?
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fungi invade hair shaft and internalize into hair - trichophyton
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what does ectothrix mean?
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fungi are confimed to hair surface - microsporum
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fluorescent under wood's lamp
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microsporum
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tissue morphology: yeast cells and hyphae (like spagetti and meat balls)
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malessezia furfur
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thin walled cigar shpaed macrocondia. lots of microcondida en grappe and en thrice
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trichophyton
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thick walled rough spindle shaped single macroconidia
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microsporum
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club shaped smooth thin walled macroconidia in clusters of 2-3. no microconidium
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epidermophyton flocosum
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cutaneous infections of the skin, nails and hair
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trichophyton
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cutaneous infections of the skin and hair
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microsporum
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cutaneous infections of the skin and nails
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epidermophyton
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gram positive anaerobic rods. not acid fast
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actinomyces
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gram positive aerobic rods, slightly acid fast
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nocardia
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in tissue: small elongated irregular cigar shaped yeast
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sporothrix schenckii
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nodular lesions of subcutaneous tissues and adjacent lymphatics that suppurate, ulcerate and drain
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sporotrichosis
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30 degrees: branched septate hyphae with slender tapered conidiophores that bear clusters of conidia at the tips
37 degrees: small blastoconidia with irregular cigar shaped buds |
sporothrix schenckii
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30 degrees: barrel shapred arthroconidia with disjunctor cell between each arthroconidium
37 degree: spherules with endospores |
coccidiodies immitis
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in tissue: spherules with a thick wall and endospore
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coccidiodies immitis
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infectious agent: arthroconidia that are barrel shaped
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coccidiodies immitis
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in tissue: intracellular pathogen that appears in macrophages
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histoplasma capsulatum
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stained by PAS, Giemsa or GMS
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histoplasma capsulatum
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30 degrees: hyline septate hyphae that bear microconidia and large thick walled tuberculated macroconidia
37 degrees: yeast |
histoplasma capsulatum
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infectious particle: microconidia and fragments of hyphae
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histoplasma capsulatum
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associated with bird and bat poop and chickens and pigeons
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histoplasma capsulatum
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tissue: thick walled globose yeast, the blastoconidium is attached to the parent cell by broad base
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blastomyoces dermatitidis
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infectious particle: microconidium
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blastomyces dermatitidis
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ovoid budding yeast, pseudohyphae or true hyphae
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candida
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culture: hyphae, chlamydoconidia and blastoconidia
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candida albicans
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neutropenia, severe burns, drug abuse, intravenous catheters are predisposing factors to what infection?
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candidiasis
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globose yeast with capsule
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cryptococcus neoformans
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culture: sensitive to cycloheximide
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cryptococcus neoformans
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cysts without intracystic bodies in pulmonary material
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pneumocystis
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stained with Gomori's methenamine silver of Diff-Quik
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pneumocystis
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infected by respiratory route at early age but protected in healthy people by CD4 cells
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pneumocystis
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branching septate mycelium in tissue
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aspergillus
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metabolites are carcinogenic
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aspergillus
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culture: aerial mycelium that are often pigmented
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aspergillus
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mycelium bear conidiophores with vesicles with phialides or metulae topped with phialides; conidia are in chains at the tips fo the phialides
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aspergillus
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nonseptate hyphae
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zygomycetes
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broad irregular branching nonseptate hyphae
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zygomycetes: rhinopus and mucor
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ketoacidosis, burns, leukemia, lymphoma, steroid use, immunosuppression are predisposing factors to what disease?
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mucormycosis: caused by zygomycetes - rhinpus and mucor
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