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Fungal infx of the respiratory tract Flashcards

1
Q

What is the main factor that dictates whether a host will be infected with a fungus?

A

Immune status

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2
Q

What is zygomycosis?

A

a term used to describe a group of relatively uncommon, but potentially fatal infection caused by fungi belonging to the class Zygomycetes

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3
Q

What are the three predisposing factors to zygomycosis?

A

Immuno suppression
DM
burns

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4
Q

Where are zygomycetes usually found in the environment?

A

soil, vegetation, fruit,

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5
Q

What are the three fungi genera that are implicated in causing zygomycosis/are zygomycetes?

A

Rizopus
Absidia
Mucor

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6
Q

What is the organism and disease caused by fungi in the sinuses?

A

Zygomycetes

Mucormycosis

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7
Q

What is the organism and disease caused by fungi in oral cavity?

A

Candida

Thrush/ esophagitis

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8
Q

What are the 7 organisms and disease caused by fungi in the lungs?

A 
Histoplasma
Blastomyces
Paracoccidiodies
Coccidioides
Crytpococcus
Pneumocystis
Aspergillus
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9
Q

True or false: infection with zygomycoses are rare in healthy individuals

A

True

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10
Q

What is the black mold that is found on bread?

A

Zygomycetes

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11
Q

Zygomycetes (like rhizopus, absidia and mucor) are septate or not? What is their morphology?

A

Wide, broad, Non-septate

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12
Q

What is the most common clinical presentation of zygomycoses? Who are they usually found in?

A

Rhinocerebral zygomycosis

DM pts

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13
Q

What are the initial symptoms of rhinocerebral zygomycosis?

A

Sinusitis / epistaxis,

fevers

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14
Q

Progression of rhinocerebral zygomycosis can lead to what?

A

AMS, brain death

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15
Q

What is the major predisposing factor to zygomycotic infections?

A

Immunosuppression / burn pts

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16
Q

How are zygomycoses diagnosed? What are the visual features?

A

Observation in culture, with broad aseptate hyphae, frequently have right angle

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17
Q

What is the treatment for zygomycoses?

A

Amphotericin B

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18
Q

What is the most common form of candida that cause infections in humans?

A

Candida albicans

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19
Q

What is the diagnostic test for candida albicans?

A

Spoon shaped germ tube

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20
Q

True or false: candida albicans are normal flora on the skin

A

True

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21
Q

Where is candida albicans usually found in the environment?

A

Food and fomites

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22
Q

What is the form that candida albicans takes in infections? In the environment?

A

Pseudohyphal form infection

Environment = yeast

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23
Q

Who gets thrush?

A

Immunosuppressed

Abx use

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24
Q

What is the clinical manifestation of thrush?

A

White, cheesy material in the mouth. With diffuse erythema beneath.

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25
Q

What is the treatment for thrush?

A

Mouth washes of nystatin and azole compounds

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26
Q

How do you diagnose thrush?

A

Direct observation in mouth and looking at them microscopically

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27
Q

How do all systemic mycoses initially present?

A

Respiratory infections through spores

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28
Q

Are the fungi that cause systemic mycoses opportunistic?

A

No, they can cause disease in previously healthy individuals

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29
Q

What is characteristic of the fungi that cause systemic mycoses?

A

Dimorphic

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30
Q

Where is histoplasmosis most commonly found?

A

Mississippi and ohio river

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31
Q

What is darling’s disease, cave dwellers disease, or spelunker’s disease?

A

Histoplasmosis infx

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32
Q

What is the cause of histoplasmosis?

A

Histoplasma capsultaum

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33
Q

Where is histoplasma found in the environment?

A

Soil containing bird/bat droppings

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34
Q

How is histoplasmosis inoculated?

A

inhalation of micro or macoconidia

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35
Q

What do histoplasma look like?

A

Round bumps around a central circle (turburculate)

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36
Q

True or false: histoplamsa are intracellular agents

A

True

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37
Q

Where do histoplasma replicate?

A

Macrophages

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38
Q

How many individuals who are infected with histoplasma shows symptoms?

A

~5%

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39
Q

What are the symptoms of pulmonary histoplasmosis? Duration?

A

Mild, flu like symptoms with a dry cough

Self limiting in 2-3 weeks

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40
Q

What causes the smalle, coin-like calcifications in the lungs that are usually incidental findings?

A

past infections with histoplamosis

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41
Q

What are the signs/symptoms of chronic pulmonary and disseminated histoplasmosis? Who does this occur in?

A

Fever, night sweats, weight loss. Hepatosplenomegaly, lymphadenopahty

this occurs in immunocompromised people

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42
Q

How do you diagnose histoplasmosis? What are the visual features?

A

Direct observation of the fungi in macrophages or antibody detection

Lack of distinctive morphology

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43
Q

What is the treatment for histoplasmosis?

A

Amphotericin B

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44
Q

Where are blastomycosis common?

A

Ohio river and mississippi

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45
Q

How many hospitalization happen each year d/t balstomycosis?

A

~1000 / year

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46
Q

Where in the environment can blastomyces be found/

A

Moist soil, vegetation

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47
Q

What is the visual characteristic blastomyces dermatitidis?

A

Large yeast, with thick cell walls

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48
Q

What are the symptoms of blastomycosis?

A

pulmonary symptoms (like flu),

can also cause ulcerative lesions of the skin, bone, and UG tract

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49
Q

How can blastomycosis be acquired?

A

Inhalation

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50
Q

What is the cough like in blastomycoses? Histomycoses?

A

Blasto = wet cough

Histo - dry

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51
Q

What are the symptoms of systemic blastomycoses? (3)

A

Painless skin lesions
Prostate infection
Bone infection

52
Q

How do you diagnose blastomycosis?

A

Visual inspection in sputum

53
Q

What is the treatment for blastomycosis?

A

Amphotericin B or

Azole compounds

54
Q

Where are paracoccidioidoides brasiliensis founds geographically?

A

South america

55
Q

Why are men more often affected with paracoccidioidomycosis?

A

Estrogen may inhibit their growth

56
Q

What are the symptoms of paracoccidioidomycosis?

A

Pulmonary similar to histoplasmosis abd blastomycosis

57
Q

How do you diagnose paracoccidioidomycosis? Visual features?

A

Ships wheel or mickey mouse ears

58
Q

What is the biggest fungal infection in the US?

A

Coccidioidomycosis

59
Q

Where, geographically, is coccidioidomycosis found?

60
Q

What is the one type of fungal infection that have a mandatory reporting requirement?

A

Coccidioidomycosis

61
Q

What is the epidemic pattern of Coccidioidomycosis?

A

Drough-rain-drought pattern d/t dust blowing around

62
Q

What are the visual features of Coccidioidomycosis?

A

arthrohyphae in “a bag of yeast” forming spherules

63
Q

What is the infectious form of Coccidioidomycosis?

A

Small hyphae

64
Q

What is the species of Coccidioidomycosis found in AZ?

A

Coccidioidomycosis poseadasii

65
Q

What is the species of Coccidioidomycosis found in cali?

A

Coccidioidomycosis immitis

66
Q

Which fungi cause symptoms more often that others?

A

Coccidioidomycosis

67
Q

What are the symptoms of Coccidioidomycosis?

A

Pulmonary infections (fever, cough, night sweats, malaise, CP)

68
Q

Members of the Zygomtcetes class (e.g. Rhizopus, absidia, and mucor), produce what type of hyphae?

A

Non septate

69
Q

What are the two forms that candida albicans can take? When/where do they take these forms?

A

Yeast = in environment

Pseudohyphae/Hyphal forms = in infx

70
Q

What is the india ink test positive for?

A

Crytococcus neoformans

71
Q

What fungi forms a germ tube?

A

Candida albicans

72
Q

Infections with what two forms of fungi are much more common in immunosuppressed individuals?

A

Pneumocystis

Aspergillus

73
Q

What are the five fungi that cause systemic mycosis?

A
  1. Histoplasma capsulatum
  2. Blastomyces dermatitidis
  3. Paracoccidioides brasiliensis
  4. Coccidioides immitis
  5. Cryptococcus neoformans
74
Q

Which of the five fungi that cause systemic mycosis are not dimorphic? What is its form?

A

Cryptococcus neoformans–capsulated yeast

75
Q

What is the form that dimorphic fungi take when infecting our tissues? What about in the environment?

A

Yeasts in tissues

Molds in environment

76
Q

Which of the five systemic mycoses have a worldwide distribution, as opposed to specific location?

A

Cryptococcus neoformans

77
Q

Which fungal infections are intracellular pathogen, and can be diagnosed by observing that the organism lives inside macrophages?

A

Histoplasmosis

Blastomycosis (larger)

78
Q

What is the pathogen that causes Chicago’s disease or Gilchrist’s disease?

A

Blastomycosis

79
Q

What are the two ways of diagnosing histoplasmosis?

A

Culture (long time)

Serological ab testing

80
Q

Which of the systemic mycoses have the potential to disseminate, and cause ulcerative lesions of the skin, bone, and urogenital tract?

A

Blastomycosis

81
Q

How can one differentiate Blastomyces dermatitidis from other fungi?

A

Larger, with very thick cell walls

82
Q

What are the symptoms of an acute infection of blastomycosis?

A

Dry cough, other cold like symptoms

83
Q

What are the symptoms of a chronic infection of blastomycosis?

A

cough, fever, chills, night sweats

84
Q

What are the symptoms of a systemic infection of blastomycosis?

A

Skin lesions
Bone infections
Prostatitis

85
Q

How do you diagnose Blastomycosis?

A

Sputum analysis

86
Q

What is the treatment for blastomycosis?

A

Amphotericine B if it does not resolve on its own

87
Q

How does disseminated paracoccidioidomycosis present?

A

Chronic, cutaneous and mucocutaneous ulcers

88
Q

How do you diagnose paracoccidioidomycosis?

A

Direct observation, cultivation, and serology

89
Q

How does the disseminated form of coccidioidomycosis present?

A

Infection of bones, joints, skin, and CNS

90
Q

How does coccidial meningitis differ from bacterial meningitis?

A

Much more gradual onset

91
Q

How do you diagnose coccidoidomycosis?

A

Direct observation (spherules)
Cultivation
Serology

92
Q

What is the treatment for coccidoidomycosis?

A

Azole and amphotericin B

93
Q

What is the leading cause of fungal meningitis?

A

Cryptococcal neoformans

94
Q

What is the shape of cyrtpococcal neoformans? Is it dimorphic?

A

Encapsulated yeast that is NOT dimorphic

95
Q

Where does cryptococcus neoformans live in the environment?

A

Bird droppings and soil

96
Q

What are the pulmonary symptoms of cryptococcal neoformans? What is the sputum like?

A

Asymptomatic to flu like.

Little sputum production

97
Q

What are the symptoms of the disseminated disease of cryptococcos neoformans?

A

Skine and bone lesions

98
Q

What is the treatment for cryptococcosis?

A

Long term treatment with amphotericin B and 5-flurocytosine

99
Q

What does pneumocystis jiroveci (carinii) cause? Who is notorious for developing this disease?

A

Pneumonia (PCP).

AIDs pts get this

100
Q

What is the fungus that acts like a parasite?

A

Pneumocystis carinii

101
Q

What is the clinical syndrome of PCP? (3 symptoms)

A

dyspnea, nonproductive cough, fever

102
Q

How does pneumocystis jiroveci (carinii) spread?

A

Through the inhalation of cysts

103
Q

How do you diagnose pneumocystis jiroveci (carinii PCP?

104
Q

What is the treatment for pneumocystis jiroveci (carinii)?

A

trimethoprim-sulfamethooxazole

105
Q

True or false: aspergillious always causes disease

A

Very false– found everywhere, only in immunocompromised pts

106
Q

What are the two forms of fungi that commonly cause aspergillosis?

A

A. Fumigatus and A. Flavus

107
Q

What is significant about how aspergillus grows in our tissues?

A

Its a mold, not a yeast.

108
Q

Is aspergillus septate or non-septate?

109
Q

Which fungi can form “fungus balls’ in preexisiting cavities in the lungs?

A

Aspergillus

110
Q

True or false: aspergillosis in the lungs is usually bilateral?

A

False–unilateral

111
Q

Which type of fungus causes space-occupying lesions in the lungs that move as the pt changes position?

A

ASpergillomas

112
Q

How does aspergillus cause hemoptysis?

A

Hyphae infiltrate the blood vessels in the lungs

113
Q

Who gets aspergillosis?

A

pts with leukemia, … ANY immunocomprosmied people

114
Q

True or false: aspergillosis can disseminatie into organs and CNS

115
Q

How do you diagnose aspergillosis?

A

Obseveation of hyphal elements in sputum or biopsy materal, culture

116
Q

What is visually characteristic of aspergillosis?

A

Septate hyphae with 45 degree angles

117
Q

Which fungi grows Septate hyphae with 45 degree angles?

A

Aspergillosis

118
Q

What is the treatment for aspergillosis?

A

Azole
Echinocandin
Amphtericin B

119
Q

Which fungi grows as a broad-base, budding yeast in tissue?

A

Blastomycosis

120
Q

Which fungi grows as sphereules in tissue?

A

Coccidoidomycosis

121
Q

Which fungi grows as an intracellular budding yeast in tissue?

A

Histoplasmosis

122
Q

Which fungi grows as a large and multiple, budding yeast in tissue? (mickey-mouse ears)

A

Paracoccidoidomycosis

123
Q

Which fungi do not have Hyphae? Which do?

A

Do = asperillus

Do not = Zygomycosis

124
Q

You see branched, septate hyphae at 45 degree angles. Diagnosis?

A

Aspergillosis

125
Q

You see broad, non-septate hyphae at 90 degree angles. Diagnosis?

A

Zygomycosis

Microbio (50 decks)

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