24 - 162 - DEEP FUNGAL INFECTIONS

Question 1

asteroid body may be seen in what condition?

Answer 1

Sprotrichosis

Question 2

this nontuberculous mycobacterial infection closely resembles lymphangitic sporotrichosis.

Answer 2

Mycobacterium marinum (fish-tank granuloma)

Question 3

treatment options for sporotrichosis

Answer 3

• traconazole 200 mg once daily
• Terbinafine 200 mg once daily
  *treatment continued until 1 week after clinical resolution
• Saturated solution of potassium iodide (SSKI), 4 to 6 mL thrice daily × 3 to 4 weeks

Question 4

mycetomas caused by fungi are known as

Answer 4

Eumycetoma

Question 5

mycetomas caused by bacteria are known as

Answer 5

actinomycetoma

Question 6

in mycetoma grains,** Black or dark grains** are always produced by what?

Answer 6

fungi

Question 7

in mycetoma grains, Red grains are always produced by what?

Answer 7

actinomycetes (bacteria)

Question 8

in mycetoma grains, pale (white) grains may be produced by what?

Answer 8

either fungi or actinomycetes

Question 9

causative agents of Mycetoma (maduromycosis, Madura foot)

Answer 9

Question 10

Treatment options for eumycetoma

Answer 10

• Ketoconazole 200 mg
• Itraconazole 200 mg
• Voriconazole 200 to 400 mg daily × several months

Question 11

treatment options for Actinomycetoma:

Answer 11

• Dapsone + streptomycin
• Sulfamethoxazole-trimethoprim + rifampin or streptomycin

Question 12

chronic fungal infection of the skin and subcutaneous tissues caused by pigmented (dematiaceous) fungi that are implanted into the dermis from the environment

Answer 12

Chromoblastomycosis

Question 13

most common causative agents of Chromoblastomycosis

Answer 13

• Fonsecaea pedrosoi
• Cladophialophora carrionii

Question 14

• The initial site of the infection is usually on the feet, legs, arms, or upper trunk. The clinical features vary.
• The initial lesion is often a warty papule that expands slowly over months or years

Answer 14

Chromoblastomycosis

Question 15

• The typical **sclerotic or muriform fungal cells ** can be seen in skin scrapings taken from the surface of lesions where there is a small, dark spot on the skin surface, using KOH mounts
• In culture, these fungi are very similar in gross macroscopic appearance, producing ** black colonies with a downy surface.**

Answer 15

Chromoblastomycosis

Question 16

• rare infection characterized by the formation of subcutaneous inflammatory cysts or plaques.
• caused by dematiaceous fungi, the most common of which are Exophiala jeanselmei and** W. dermatitidis,**
• these organisms form short, irregular, pigmented hyphae in tissue
• cyst wall consists of palisades of macrophages and other inflammatory cells surrounded by a** fibrous capsule,** and the fungal hyphae are found in the macrophage zone.

Answer 16

PHAEOHYPHOMYCOSIS/ PHAEOMYCOTIC CYST/ CYSTIC CHROMOMYCOSIS

Question 17

causative agent of lobomycosis

Answer 17

Lacazia loboi

Question 18

chief opportunistic systemic mycoses seen in humans

Answer 18

systemic or deep candidiasis, aspergillosis, and systemic zygomycosis

Question 19

Question 20

patient with diabetes mellitus are predisposed to what systemic mycoses?

Answer 20

Mucormycosis

Question 21

patient who underwent abdominal sugery are predisposed to what systemic mycoses?

Answer 21

Candidiasis

Question 22

patient who underwent heart valve sugery are predisposed to what systemic mycoses?

Answer 22

Various but mainly Candida albicans and non-albicans Candida sp.

Question 23

• The fungus can be found in KOH mounts of pus, skin scrapings, or sputum as thick-walled, rounded, refractile, spherical cells with broad-based buds
• In culture, the fungus grows as a mycelial fungus at room temperature.
• It produces small, rounded, or pear-shaped conidia.

Answer 23

Blastomycosis

Question 24

most common clinical type of coccidioidomycosis

Answer 24

primary pulmonary form

Question 25

antigen obtained from spherules of C. immitis and may be better than coccidioidin for detecting sensitization

Answer 25

Spherulin

Question 26

* Sputum, exudates, and scrapings can be screened using KOH. * They show numbers of round yeasts with a **characteristic form of multiple budding in which a parent cell is surrounded by large numbers of smaller buds.**

Answer 26

PARACOCCIDIOIDOMYCOSIS

Question 27

Patients with AIDS, as well as those receiving what biologic therapy, appear to be particularly susceptible penicilliosis?

Answer 27

rituximab

Question 28

In culture, this presents with a **green or grayish mold **that produces typical **conidiophores** and a diffusible red pigment

Answer 28

Talaromyces marneffei

Question 29

most common clinical manifestation of cryptococcosis

Answer 29

meningoencephalitis

Question 30

Cryptococci are large (5 to 15 µm in diameter), budding cells with capsules that are best observed by what examination?

Answer 30

direct microscopy of India ink or Nigrosin mounts

Question 31

What fungal infection has cigar-shaped or oval yeasts may, be surrounded by a thick, radiating eosinophilic fringe forming an asteroid body

Answer 31

Sporotichosis

Question 32

2.A cheaper alternative, effective treatment for cutaneous Sporotrichosis with hyper salivation and nausea as side effects

Answer 32

Potassium iodide (saturated solution)

Question 33

Complications such as elephantiasis and Squamous cell Ca can occur in this infection

Answer 33

Chromoblastomycosis (Chromomycosis)

Question 34

Characterized by keloid-like skin lesions on exposed sites with surgical removal as the only main treatment

Answer 34

Lobomycosis (Keloidal Blastomycosis, Lobo Disease)

Question 35

Its early infection starts in the inferior turbinates of the nose then spreads to the central part of the face causing deformities of the nose lips and cheeks

Answer 35

Conidiobolomycosis

Question 36

Characterized by polyps studded with white flecks affecting mucous membranes

Answer 36

Rhinosporidiosis

Question 37

What pathogen produces small, rounded, or pear-shaped conidia

Answer 37

Blastomyces dermatitidis

Question 38

This infection is predominant in males due to the presence of a cytoplasmic estrogen receptor on the fungus, and, in vitro, estradiol suppresses the conversion of mycelium to yeast

Answer 38

Paracoccidioidomycosis (South American Blastomycosis, Paracoccidioidal Granuloma)

Question 39

AIDS pxs with this infection have multiple skin lesions, which are umbilicated papules that may enlarge and ulcerate w/c are scattered on the face and trunk

Answer 39

Infections caused by Talaromyces Marneffei (Penicilliosis, Penicilliosis Marneffei)

Question 40

**Acneiform papules **or pustules progressing to warty or vegetating, crusted plaques, ulcers, and hard infiltrated plaques or nodules are characteristic of widespread systemic infection

Answer 40

Cryptococcosis

Question 41

Mucicarmine or Alcian blue can stain capsules of its cells

Answer 41

C. neoformans

Question 42

Presents as large necrotic lesions such as ecthyma gangrenosum, but smaller papules and cold abscesses can occur and laboratory detection of Galactomannan can confirm its diagnosis

Answer 42

Aspergillosis

Question 43

Caused by filamentous bacteria that form large granules (sulfur granules) in abscess cavities and draining sinuses

Answer 43

Actinomycosis