Fungal Infections

Question 1

Dx of Aspergillous

Answer 1

• Radiology: CT: ground glass attenuation surround a pulmonary nodule = “Halo” sign
• Histology: dichotomous acute-angled branching septated hyphae

Question 2

Manifestations of Cryptococcus

Answer 2

Pigeon poop

CNS invasion in immunocompromised

Question 3

Dx and therapy of Cryptococcus

Answer 3

Dx: No hyphae, urease positive

Tx:-Asymptomatic: observe Immunocompromised/Symptomatic: Fluconazole, Itraconazole

Question 4

Histoplasmosis epidemiology

Answer 4

Mississippi & Ohio river valleys; Indianapolis

Question 5

Dx of Histoplasmosis

Answer 5

Elevated Alk Phos

-Culture (definitive): small thin/round budding yeast; intracellular macrophage parasite; positive silver stain (PAS)

Question 6

Tx of Histoplasmosis

Answer 6

Ampotericin B and Azoles; NOT Echocanadins

Question 7

Epidemiology of Blastomycosis

Answer 7

-South Central & North Central USA

beaver ponds

Question 8

Clinical manifestation of Blastomycosis

Answer 8

Atypical pneumonia presentation with no response to Abx

Question 9

Dx of Blastomycosis

Answer 9

• CXR: multiple mass-like lesions

- Culture (definitive): large thick-walled yeast w/ single broad based buds;

Question 10

Epidemiology of Coccidiomycosis

Answer 10

SW US, San Joaquin Valley,

Question 11

Dx and Tx of Coccidiomycosis

Answer 11

Tx: CNS involvement requires life-long suppressive therapy
Dx: Culture (definitive): small spherules w/ multiple endospore