Dimorphic Fungi Flashcards

1
Q

What makes a fungi “dimorphic”

A

Grow as a mold at 25-30C and in nature and grow as a yeast (or yeast-like or spherule) at 37C or in tissue

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2
Q

Who can be infected from dimorphic fungi?

A

“Normal” people

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3
Q

What is the infective stage of the fungi, mold or yeast?

A

mold stage

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4
Q

What tests can you run on a direct smear?

A

Giemsa, GMS, H&E, Gram stain, ect.

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5
Q

What temperature and plates do you use for molds?

A

25-30C usually on SAB, PDA, PFA

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6
Q

What temperature and plates do you use for yeasts?

A

37C usually on enriched media (BHI with blood)

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7
Q

Name the 6 Dimorphic Fungi

A
Sporothrix Schenckii 
Histoplasma capsulatum 
Blastomyces dermatitidis 
Paracoccidioides brasiliensis 
Penicillium marneffei
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8
Q

Sporotrichosis:

- Primary Clinical presentation

A

non-healing ulcer at inoculation site; finger, hand, arm, leg

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9
Q

Sporotrichosis:

- Secondary Clinical Presentation

A

linear series of nodules and draining ulcers along lymphatics
(pulmonary form is RARE)

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10
Q

Sporotrichosis:

- At Risk Occupations

A

Gardeners
Farmers
Florists
Horticulturists

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11
Q

Sporotrichosis:

- what plants cause infections

A

rose thorns and sphagnum moss

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12
Q

Sporotrichosis:

- Morphology of yeast

A

small, round or show the “cigar shape”

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13
Q

Sporotrichosis:

- Morphology of mold

A

septate hyphae with floweriness or rosettes of conidia

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14
Q

Histoplasmosis:

- At risk population and symptoms

A

Otherwise “healthy” people

  • most habe asymptomatic infection
  • may have calcification in lungs, liver, spleen
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15
Q

Histoplasmosis:

- clinical presentation in immune suppressed people

A

disseminated disease

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16
Q

Histoplasmosis:

- endemic area

A

Mississippi River Valley (Ohio River, Missouri River)

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17
Q

Histoplasmosis:

- What is it associated with?

A

soil enriched by droppings of blackbirds, chickens and bats (nitrogen content)
“Spelunker’s disease”, “Cave disease”, “Darlings Disease”

18
Q

Histoplasmosis:

- Should we skin test people from the midwest? Why or why not?

A

80-85% of people living in the midwest test positive for histoplasma skin test and show antibodies in their serum (so skin test is worthless)

19
Q

Histoplasmosis:

- Yeast appearance

A

SMALL yeast inside monocytes or macrophages; usually in clumps; often gives a hint of “halo” but there is NO CAPSULE

20
Q

Histoplasmosis:

- Mold appearance

A

shows spiked or “tuberculate” macroconidia

21
Q

Histoplasmosis:

  • Three available tests for diagnosis
  • Which one is diagnostic in disseminated disease?
A
  • Skin test
  • Serum antibodies
  • URINE ANTIGEN TEST (diagnostic)
22
Q

Blastomycosis:

- Primary clinical presentation

A

Most asymptomatic; may progress to chronic pulmonary disease, cutaneous ulcers or pustules may mimic cancer!

23
Q

Blastomycosis:

- Endemic area

A

States adjacent to Mississippi and Ohio rivers

24
Q

Blastomycosis:

- Yeast appearance

A

BIG, thick cell wall, single bud with a BROAD BASE,

25
Blastomycosis: | - Mold appearance
Show microconidia on short conidiophores (lollipops)
26
Blastomycosis: | - Identification
Urine Antigen (EIA)
27
Paracoccidioidomycosis: | - Clinical presentation
Respiratory infection; ulcerative lesions of mouth, nose and GI; Dissemination in immunocompromised host
28
Paracoccidioidomycosis: | - Endemic area
Brazil and other countries in South America (high rainfall areas)
29
Paracoccidioidomycosis: | - Yeast appearance
large, with multiple daughter buds (Mariner's Wheel)
30
Paracoccidioidomycosis: | - Mold appearance
Small lollipops and septet hyphae; conidia are a smaller version of those seen in Blasomyces
31
Coccidioidomycosis: - Seen in what type of people - associated with what?
- Black and Filipino males | - Associated with dust storms; inhalation of arthroconidia from desert soil
32
Coccidioidomycosis: | - Endemic area
Desert southwest U.S. (California, Arizona, SW texas)
33
Coccidioidomycosis: | - What does a tissue biopsy show for this organism?
Spherules (contain bodies called endospores); can be empty, endospores can produce new spherules; TISSUE PHASE IS NOT A YEAST
34
Coccidioidomycosis: | - temperature mold will grow
25C and 37C
35
Coccidioidomycosis: | - mold appearance
alternately staining, barrel-shaped ARTHROCONIDIA
36
In Coccidioides immitis mold phase is highly ________
infectious
37
Coccidioidomycosis: | - Why are labs not allowed to keep cultures without special permission?
It is a bioterrorism alert!
38
Penicillium marneffei: | - pathogen or nonpathogen?
only real pathogen in penicillium family
39
Penicillium marneffei: | - Endemic area
SE Asia (AIDS patients)
40
Penicillium marneffei: | - Yeast appearance
may resemble Histoplasma
41
Penicillium marneffei: | - mold appearance
Green to reddish-green aerial hyphae
42
Penicillium marneffei: | - Colony morphology
RED DIFFUSIBLE PIGMENT