Deep Mycoses

Question 1

Lobomycosis
aka
fungus
associations
presentation
histo
txt

Answer 1

aka: keloidal blastomycosis
fungus: lacazia loboi
assoc: dolphins, amazon basin, gulf of mexico
presentation: painless smooth surfaced nodules
histo: kids pop bead necklace
txt: surgical excision

Question 2

eumycotic mycetoma
aka
location
presentation
histo
txt

Answer 2

aka: madura foot
location: soil and plants in mexico, s. america, india
presentation: penetrating foot wound –> tumefaction, draining sinuses, grains
histo: grains
txt: oral antifungal & debridement

Question 3

mycetoma organisms (3)

Answer 3

white grain: acremonium, aspergillus, fusarium
white-yellow grain: pseudallescheria boydii
black grain: exophiala jeansellmei, curvularia, madurella, leptosphaeria, pyrenochaeta romeroi

Question 4

chromoblastomycosis

1. most common organism
2. where is it found/who does it infect
3. presentation
4. histo
5. txt

Answer 4

1. fonsecaea (phialophora) pedrosoi
2. found in soil, vegetation - agricultural workers
3. slow growing papule –> verrucous plaque +/- annular central clearing +/- LAD +/- elephantiasis
4. Medlar bodies (copper pennies/sclerotic bodies)
5. surgery, itraconazole

Question 5

sporotrichosis

1. fungus
2. risk factors
3. 3 forms
4. path finding

Answer 5

1. sporothrix schenckii
2. florist, gardener
3. lymphocutaneous, fixed cutaneous, disseminated
4. asteroid body (splendore-hoeppli phenomenon)

Question 6

coccidioidomycosis

1. aka
2. fungus
3. location
4. types
5. histo
6. txt

Answer 6

1. san joaquin valley fever
2. coccidioides immitis
3. southwest US, arthroconidia inhaled in dust
4. pulmonary (erythema nodosum), disseminated (pink papules or deep nodules), cutaneous (indurated nodule)
   in HIV may look like molluscum
5. double refractile thick walls with endospores, barrel-shaped arthroconidia
6. azoles

Question 7

histoplasmosis

1. aka
2. fungus
3. associations
4. presentation
5. histo
6. txt

Answer 7

1. ohio valley disease
2. histoplasma capsulatum
3. bird/bat feces, southeaster US, caves
4. primary pulm infection with rare skin findings, HIV with umbilicated papules
5. intracellular yeast (sun)
6. amphotericin b

Question 8

blastomycosis

1. fungus
2. associations
3. presentation
4. histo
5. txt

Answer 8

1. blastomyces dermatitidis
2. great lakes, ohio river basin, mississippi
3. primary pulm infection (mimics TB), cutaneous infection (dissemination - papulopustules, verrucous plaques with ulceration)
4. broad based budding (snowmen)
5. azole or amphotericin b