export_respiratory tract fungal infections

Question 1

Common infection by zygomycetes

Answer 1

Mucomycosis (sinus infection)

Question 2

Common infection caused by Candida

Answer 2

Thrush, esophagitis

Question 3

Common fungal infections (and cause) of the lungs

Answer 3

Histoplasmosis (Histoplasma)
Blastomycosis (Blastomyces)

Paracoccidioidomycosis) Paracoccidioides)

Coccidioidomycosis (Coccidioides)

Cryptococcosis (Cryptococcus)

PCP (Pneumocystis)

Aspergillosis (Aspergillus)

Question 4

Zygomycete organisms

Answer 4

Rhizopus
Absidia

Mucor

Question 5

Zygomycete characteristics

Answer 5

Non-septate hyphae

Sporangia bearing sporangiospores

Question 6

Most common zygomycete infection, and symptoms

Answer 6

Rhinocerebral zygomycosis

Congestion, blood-tinged rhinorrhea, headache, facial edema, coma, death

Question 7

What comorbidity is common with rhinocerebral zygomycosis?

Answer 7

Diabetes

Question 8

Diagnose zygomycoses

Answer 8

Hyphal elements
Culture confirmation

Broad, aseptate hyphae, frequently branching at 90 degree angles

Question 9

Treatment for zygomycoses

Answer 9

Amphotericin B

Question 10

Candidiasis

Answer 10

Most common cause is C. albicans

Yeast is normal flora, hyphal form is tissue

Question 11

Oral candidiasis presentation

Answer 11

Diffuse erythema

White lesions composed of yeast and pseudohyphal C. albicans

Question 12

Diagnose oral candidiasis

Answer 12

Observation in clinical material

Cultures generally NOT necessary

Question 13

Treatment for oral candidiasis

Answer 13

Mouth washes or lozenges of nystatin and azole compounds

Question 14

Systemic mycoses features

Answer 14

Not opportunistic, can cause disease in healthy individual

Inhalation leads to pulmonary infection, which results in all these systemic infections

Question 15

Special feature of coccidioides immitis

Answer 15

Dimorphic - mold in environment, yeast in tissues

You will NOT see hyphae in the infection, but would in the environment

Question 16

Special feature about Cryptococcus neoformans

Answer 16

Encapsulated yeast in both environment and in infection

Question 17

Cause of histoplasmosis

Answer 17

Histoplasma capsulatum

Question 18

Where does histoplasma grow?

Answer 18

In soil with bird/bat droppings

Chicken coops, caves, etc.

Question 19

How is histoplasmosis contracted?

Answer 19

Inhalation of micro- or macroconidia

Question 20

Characteristics of the macroconidia of histoplasma

Answer 20

Tuberculate (round bump) appearance

Question 21

Progression of histoplasmosis

Answer 21

Inhalation of spores results in phagocytosis and convert into yeast form
Organism replicates and spreads through lymphatics/reticuloendothelial systems

Question 22

Disseminated histoplasmosis

Answer 22

Typically in immuno-compromised
Can be acute/life-threatening, or chronic and debilitating

Fever, night sweats, anorexia, weight loss, fatigue

Hepatomegaly, splenomegaly, lymphadenopathy

Question 23

Diagnose histoplasmosis

Answer 23

Observation
Culturing organism - requires time (weeks) for yeast to grow out to mold, confirming dimorphism

Serology

Question 24

Treat histoplasmosis

Answer 24

Amphotericin B

Azoles

Question 25

Blastomycosis cause

Answer 25

Blastomyces dermatitidis | Dimorphic fungi

Question 26

Differentiate blastomyces dermatitidis from histoplasma capsulatum

Answer 26

B. dermatitidis is larger and has very thick cell walls

Question 27

Consequences of disseminated blastomycosis

Answer 27

Ulcerative lesions of skin, bone, and UG tract

Question 28

Symptoms of blastomycosis

Answer 28

Sputum production in cough, unlike H. capsulatum | Can mimic bacterial pneumonia

Question 29

Diagnose blastomycosis

Answer 29

Observation in sputum, thick cell walls

Question 30

Treatment for blastomycosis

Answer 30

Amphotericin B | Azole

Question 31

Paracoccidioidomycosis prevalence

Answer 31

Mostly occurs in men

Question 32

Paracoccidioidomycosis cause

Answer 32

Paracoccidioides brasiliensis | Dimorphic fungi

Question 33

Disseminated paracoccidioidomycosis presentation

Answer 33

Chronic cutaneous and mucocutaneous ulcers

Question 34

Diagnose p aracoccidioidomycosis

Answer 34

Observation, cultivation, serology

Question 35

Coccidioidomycosis causes

Answer 35

Coccidioides immitis and posadasii

Question 36

Coccidioidomycosis progression

Answer 36

Fungus converts into a spherule upon inhalation, which is multinucleated and produces hundreds of single nucleated spores

Question 37

Coccidioidomycosis symptoms

Answer 37

Mild to moderate influenza like syndrome

Question 38

Disseminated c occidioidomycosis

Answer 38

``` Desert rheumatism Coccidial meningitis (slow development) ```

Question 39

Diagnose c occidioidomycosis

Answer 39

Observation | Spherule in sputum

Question 40

Treatment for c occidioidomycosis

Answer 40

Azole | Amphotericin B

Question 41

Cryptococcosis cause and characteristics

Answer 41

Cryptococcus neoformans NOT dimorphic Encapsulated yeast

Question 42

Cryptococcal meningitis

Answer 42

Leading cause of fungal meningitis infections

Question 43

Cryptococcal meningitis progression

Answer 43

Develops slowly | Headaches, irritability, etc.

Question 44

Diagnose cryptococcosis

Answer 44

India ink stain Cultivation Serology

Question 45

Treatment of cryptococcosis

Answer 45

Long-term combo of Amphotericin B and fluconazole

Question 46

Pneumocystis jiroveci (carinii) pneumonia (PCP) cause and characteristics

Answer 46

``` Pneumocystis jiroveci (carinii) Phylogenetically related to fungi ``` Similar to protozoa

Question 47

PCP symptoms

Answer 47

Dyspnea, nonproductive cough, fever

Question 48

Diagnose PCP

Answer 48

ID organisms, requires specific staining

Question 49

Treatment of PCP

Answer 49

Trimethoprim-sulfamethoxazole

Question 50

Aspergillosis cause and characteristics

Answer 50

Asperigillus fumigatus and Aspergillus flavus NOT dimorphic SEPTATE HYPHAE "Fungus balls"

Question 51

Treat aspergillosis

Answer 51

Azole Echinocandin Amphotericin B