Deep Fungal Infections

Question 1

What temperature does yeast exist at? Mold?

Answer 1

37 degrees C, 25 degrees C

Question 2

Name the subcutateous mycoses? How are the inoculated?

Answer 2

Basidiobolomycosis
Sporotrichosis
Mycetoma
Chromoblastomycosis
Phaeohyphomycosis
Lobomycosis
Inoculated by break/stab in skin

Question 3

Name the three forms of sporotrichosis?

Answer 3

Lymphocutaneous (naive), fixed cutaenous (prior exposure), disseminated/pulmonary (immunocompromised)

Question 4

What findings would you have in sporotrichosis on biopsy?

Answer 4

asteroid bodies (also seen in sarcoid), “cigar bodies” on PAS stain

Question 5

Name the effect when increasing doses of exogenous iodide inhibit thyroid hormone production leading to hypothyroidism?

Answer 5

Wolff-Chaikoff effect

Question 6

What is the sporotrichoid lesion ddx?

Answer 6

SLANT
Sporotrichosis, S. aureus, S. pyogenes, S. boydii
Leishmaniasis
Atypical mycobacteria (m. marinum)
Nocardiosis
Tularemia, Toxoplasmosis, Tuberculosis

Question 7

What is the mycetoma triad?

Answer 7

Tumefaction
Sinus tracts
Granules

Question 8

What is the important histologic finding in chromoblastomycosis?

Answer 8

Pigmented fungal sclerotic bodies (Medlar bodies “copper pennies”),

Question 9

What causes Lobomycosis (Keloidal Blastomycosis)?

Answer 9

Locazia Loboi-can be from dolphin

Question 10

What do you seen on histology in lobomycosis?

Answer 10

Chains of spheres connected by narrow tubes (child’s pop beads

Question 11

What causes rhinosporidiosis?

Answer 11

Rhinosporidium seeberi

Question 12

Name the systemic mycoses?

Answer 12

Coccidioidomycosis
Histoplasmosis
Blastomycosis
Paracoccidiodomycosis

Question 13

What is the most virulent fungal pathogen?

Answer 13

Coccidioides immitus

Question 14

What is the histopath finding in coccidioidomycosis?

Answer 14

Septate hyphae with 90° branching and thick-walled barrel shaped rectangular arthroconidia alternating with empty cells

Question 15

What is another name for histoplasmosis?

Answer 15

Darling’s disease

Question 16

What is the DDX for parasitized macrophages?

Answer 16

HIS  - Histoplasmosis
PEN - Penicilliosis
G – Granuloma Inguinale
R – Rhinoscleroma (Wat!)
L - Leishmaniasis

Question 17

What is the histopath for South American Blastomycosis (Paracoccidioidomycosis)?

Answer 17

Large thick–walled round cell 10-60μm with thin delicate wall and single to multiple surrounding buds with thin points of attachment {“mariner’s (captain’s) wheel” appearance}

Question 18

What is the most common cause of primary cutaneous apergillosis?

Answer 18

Aspergillus Flavus

Question 19

What is the differential for molluscum-like lesions?

Answer 19

“CCHIP”
Cryptococcosis
Coccidioidiomycosis
Histoplasmosis
Penicillium

Question 20

What is the most common cause of disseminated candidiasis in a patient with leukemia?

Answer 20

C. tropicalis

Question 21

What is the most common cause of eumycotic mycetoma in the US and what color are the grains?

Answer 21

Pseudallecheria boydii (white to yellow grains)

Question 22

What is the most common cause of chromoblastomycosis?

Answer 22

Fonsecaea pedrosi
Others Fun with PCR all dematiaceous fungi
F. Compacta
F. Monophora
Phialophora Verrucosa
Cladophialophora carrionii
Rhinocladiella aquaspera

Question 23

What dermatologic sign can you see in coccidiodomycosis that is portends a favorable prognosis?

Answer 23

Erythema nodosum