(1) Systemic Mycoses Flashcards
Refers to fungal infection that involves any internal organ of the body – can involve bone, lymph node, subcutaneous tissues, skin, meninges, etc.
- two or more organ systems involved, it is referred to as systemic (mycoses)
Systemic Mycoses
Enumerate the Systemic mycoses
- Blastomyces dermatitidis
- Paracoccidioides brasiliensis
- Histoplasma capsulatum
- Coccidioides immitis
match the systemic mycoses and its infection
- Blastomyces dermatitidis
- Paracoccidioides brasiliensis
- Histoplasma capsulatum
- Coccidioides immitis
a. Paracocidioidosis
b. Coccidioidosis
c. Histoplasmosis
d. Blastomycosis
- d
- a
- c
- b
Enumerate the characteristic of Systemic Mycoses
- Dimorphic
- Infectious = Inhalation of spore (mold form)
- Requires BSL 3 (BSC 2)
- Sputum (most common specimen)
- NO p-2-p contact
- Cottony white to brown colonies
- Exonatigen Test
General Characterisitc
They can exist both in the mold form (in their natural habitat) and in the yeast form (in the tissues)
Dimorphic
General Characterisitc
Infective stage or form of sysyemic mycoses
q
SPORE
through inhalation
General Characterisitc
What are the protection measure applied for labs to contain the microbes
BLS 3 with BSC 2
General Characterisitc
Most common specimen
Sputum
General Characterisitc
TOF
It DOES involve a person to person contact spread
F
General Characterisitc
Match the colony description
- Mycelial or Mold Form
- Yeast Form
a. Moist and creamy opaque to pasty colonie on the media
b. Cottony white to brown colonies
- b
- a
General Characterisitc
- Diagnosis is usually made through this
- antigen protein immunodiffusion method
EXOANTIGEN TEST
Causes
- North american blastomycosis
- Chicago disease
- Gilchrists disease
- PNEUMONIA and SKIN INFECTION
Blastomyces dermatitidis
Blastomyces dermatitidis
How pneumonia and skin infection are acquired
Pneumonia - inhalation of mold
Skin infection - Direct inoculation of the skin
Describe the tissue form of Blastomyces dermatitidis
SINGLE-BUDDING YEAST with BROAD based connection (double
contoured)
Describe the mold form of Blastomyces dermatitidis
Lollipop in appearance
Blastomyces dermatitidis should be culture in a medium with?
cycloheximide - an antifungal, to make the medium selective
Blastomyces dermatitidis uses what % of KOH for the tissue
10% KOH
Blastomyces dermatitidis uses and antifungal agent and is use as treatment
Amphotericin B
- Causes South American Blastomycosis
- Causes Lutz Splendore – Almeida Disease
- Organs attacked: Spleen, liver, lymph node, skin, lung
Paracoccidioides brasiliensis
Enumerate the route of spread of P. brasiliensis?
NONE
Describe the tissue form of Paracoccidioides brasiliensis
MULTIPLE BUDDING YEAST
“pinched-off” appearance or Mariners Wheel
Describe the mold form of Paracoccidioides brasiliensis
Lollipop in appearance (conidia)
Similar to B. dermatitidis
The conidia are usually found at the TIP of conidiophore
Paracoccidioides brasiliensis uses what % of KOH?
10% KOH: Yeast cell with multiple buds
Paracoccidioides brasiliensis uses what medication for treatment
- Itraconazole
- Ketoconazole
- Infection cause HISTOPLASMOSIS
- RES (RETICULOENDOTHELIAL SYSTEM) parasite
Histoplasma capsulatum
Histoplasma capsulatum is a RES parasite, what does this mean?
infects the
RETICULOENDOTHELIAL SYSTEM and it
refers to the MACROPHAGES
Histoplasma capsulatum can cause what disease
DARLING’S disease
Histoplasma capsulatum can be demonstrated in the blood by??
Blood smear stained with Giemsa
Describe the tisuse form of Histoplasma capsulatum
YEAST CELLS INTRACELLULAR IN MACROPHAGES
SINGLE BUDDING yeast with a
THIN BASE
Describe the mold form of Histoplasma capsulatum
TUBERCULATE MACROCONIDIA (rough external surface, rope like hyphae if they are together)
looks acanthocyte sa hema
it is the ENDEMIC DIMORPHIC fungus in the USA?
Histoplasma capsulatum
TOF
Histoplasma capsulatum is an extracellular mycoses of the RES
F
Intracellular
Histoplasma capsulatum uses what specimen
BONE MARROW, sputum, tissue
- Stain with Giemsa: bone marrow, sputum
- Stain with PAS and H&E: tissue
Histoplasma capsulatum use this test to know if it is and ACTIVE or EARLY infection
DOUBLE DIFFUSION TEST
DOUBLE DIFFUSION TEST
how many wells for the serum with antibody and antigen
- 2 well for serum w/ antibody
- 1 well contain antigen
DOUBLE DIFFUSION TEST
the wells will diffuse together and will form what?
PRECIPITATION LINE
DOUBLE DIFFUSION TEST
H or M line
- Closer to the serum wells
- Seen during ACTIVE INFECTION
- Disappears with the RESOLUTION of the disease but may persist up to 2 YEARS AFTER RECOVERY
H line
DOUBLE DIFFUSION TEST
H or M line
- Near the Ag-containing well
- Present during EARLY INFECTION (More Ag than Ab)
- Present in among those who have RECOVERED from the disease
- Signifies presence of EARLY INFECTION or CONVALESCENCE/RECOVERY
M line
Causes:
- COCCIDIOIDOMYCOSIS
- ## San Joaquin Valley Fever
Coccidioides immitis
Describe the tissue Coccidioides immitis
Spherule with endospores
Describe the mold Coccidioides immitis
- Barrel-Shaped Arhtroconidia (INFECTIOUS FORM)
- sac-like
Alternating barrel-shaped arthroconidia because they have a space
Enumerate the Diagnosis for systemic mycoses
- Direct Exam
- Cultures
- Immunological test
Stains used for HISTOPLASMA
to demonstrate yeast form
WRIGHT OR GIEMSA
Demonstrated using blood smear
what stains and reagents are used for Blastomyces, Paracoccidioides, Coccidioides
- 10 % KOH
- Periodic Acid-Schiff stain
- H&E (Hematoxylin and eosin) for tissue section
Cultures used for Diagnostic systemic mycoses
- Sabouraud Dextrose Agar (RT)
- Blood Heart Infusion Agar + BLOOD (37°C)
what Immunological Tests are used and which specific infection
SKIN TEST – coccidioidin, histoplasmin
Match the Tissue form to genus and SPP
- SINGLE-BUDDING YEAST with BROAD based connection (double contoured)
- MULTIPLE BUDDING YEAST
- YEAST CELLS INTRACELLULAR IN MACROPHAGES
- SPHERULE WITH ENDOSPORES
a. Paracoccidioides brasiliensis
b. Coccidioides immitis
c. Histoplasma capsulatum
d. Blastomyces dermatitidis
- d
- a
- c
- b
Match the MOLD form to genus and SPP
- Lollipop in appearance
- TUBERCULATE MACROCONIDIA
- BARREL-SHAPED ARTHROCONIDIA
a. Paracoccidioides brasiliensis
b. Coccidioides immitis
c. Histoplasma capsulatum
d. Blastomyces dermatitidis
- a & d
- c
- b