Systemic Mycoses

Front 1

1. What 3 fungus cause systemic mycoses?
2. pathogenesis of these 3 is similar to what?
3. How do you become infected?
4. Where are initial lesions and how are they disseminated?
5. What type of inflammation do they cause?

Back 1

1. Coccidiomycosis, Histoplasmosis, Blastomycosis
2. TB
3. Inhale spores
4. Lungs, Lymphatic and hematogenous dissemination
5. Granulomatous

Front 2

1. What is a dimorphic fungus, produces arthospores, forms multinucleated spherules in the host, and is found in desert SW and mexico?
2. How do you get it?
3. How does the inhaled product survive in macrophages?

Back 2

1. Coccidiomycoses (aka valley fever
2. Inhale arthrospore
3. block fusion of phagosomes with lysosome; causes high infectivity.

Spreads from MO -> Hilar nodes -> contained by DTH resposne (CD4+ cells)

Front 3

1. What ethnic group is more likely to get Coccidiomycoses?
2. What % of patients have symptomatic primary infection?
3. What do the sx look like?

Back 3

1. Filipinos, and Japanese
2. 40%
3. Fever, cough, chest pain, fatigue, night sweats, wt loss up to 30% present as community acquired pneumonia

usu. resolves but can progress to lung disease w/ cavitation

Front 4

1. Where does Coccidiomycoses disseminate to?
2. What can it present as?
3. What stain to diff. from TB?
Histo: Granuloma, high MO, often necrotic center, w/ diminished resistance purulent inflammatory rxn

Back 4

1. Skin, muscle, meninges, spleen, liver, bone and joints
2. Solitary pulmonary nodule masquerading as a carcinoma
3. GMS (TB use acid fast)

Front 5

1. A narrow necked budding yeast in tissue, mold in soil, high incidence in Ohio and Mississippi valleys, in bird/bat poop?
2. How do you catch it?

Back 5

1. Histoplasmosis
2. Spores or hyphae then germinate to yeast, infect MO, spread to Hilar nodes, contained by DTH CD4+ response

Front 6

1. What % of HIsto infection is subclinical
2. What does it look like in immunocompetent hosts?
3. What can develop if greater exposure?

Back 6

1. 95
2. Mild flu-like
3. Pulmonary consolidation

Front 7

Histoplasmosis in immunocompromised:
1. Sx?

Disseminate to an organ, liver spleen bone marrow; org. not always cleared so can relapse later

Back 7

1. Night sweats, fever, wt loss, mucosal lesions

Front 8

1. Dimorphic fungus, high incidence in Ohio and Mississippi river valleys & East coast, least common of big 3
2. Presents with broad based budding?

Back 8

1. Blastomycosis
2. Blasto

Spreads the same way as Histo and cocci, get from inhalation

Front 9

1. Where does blasto preferentially migrate to?

If Sx can range from pneumonia to nodular or cavitary disease similar to TB

Back 9

1. Skin, may or may not cause sx

Histo: from suppurative inflamamtion (from PMNs) to granulomas, mixed patter is common, heals by fibrosis