Fungal Respiratory Infections

Question 1

What are the 3 systemic mycoses?

Answer 1

Histoplasma Capsulatum, Bastomycetes Dermatidis, Coccidiodes Immitis

Question 2

What are the 3 opportunistic mycoses?

Answer 2

Aspergillus spp., Zygomycetes (Mycormycosis), Pneumocystis Jerovici

Question 3

Are the systemic mycoses dimorphic?

Answer 3

Yes

Question 4

What is the reason that dimorphic fungi are resistant to phagocytic killing?

Answer 4

The tissue form, not the environmental form (mold) is invasive and resistant

Question 5

What is the distinct form of conida that Histoplasma form?

Answer 5

Tuberculate (bumpy)

Question 6

Where is Histoplasma found and in what form?

Answer 6

It is found as mold in soul with bird/bat excrement; OH + MS River Valley and Central America

Question 7

What does the Histoplasma yeast target in the human body?

Answer 7

The RES System (Lymph nodes, bone marrow, spleen)

Question 8

What disease does H. Capsulatum cause?

Answer 8

Histoplasmosis

Question 9

What is the damage from fungal infections caused by?

Answer 9

Our immune system response to phago-resistant fungi

Question 10

What are the symptoms of Histoplasmosis?

Answer 10

None > mild flu > pneumonia

Question 11

What patients have an increased risk of contracting Histoplasmosis?

Answer 11

ICP’s

Question 12

What is the difference between B. Dermatitis and H. Capsulatum in terms of where they can survive?

Answer 12

B. Dermatitis cannot survive in macrophages when in the yeast form

Question 13

Where is B. Dermatitis found?

Answer 13

In the soil of the Mid-South, SE, and Mid-West

Question 14

Who is most commonly infected with B. Dermatitis?

Answer 14

Middle aged to older men

Question 15

What disease does B. Dermatitis cause?

Answer 15

Blastomycosis

Question 16

What symptoms does Blastomycosis cause?

Answer 16

Acute Pneumo (Brown, purulent/bloody sputum) and wart-like skin lesions > meningitis

Question 17

What does Blastomycosis look like? Hint: Lung masses develop

Answer 17

TB/Cancer

Question 18

What form does Coccidiodes Immitis take in its tissue form?

Answer 18

Spherules

Question 19

Because it is highly infective, C. immitis is considered a what?

Answer 19

Bioweapon

Question 20

Where is C. Immitis found?

Answer 20

The semi-arid climates of SW US

Question 21

What disease does C. Immitis cause?

Answer 21

Coccidiodomycosis (Valley fever - San Joaquin, CA)

Question 22

What symptoms does C. Immitis cause?

Answer 22

None > flu > Skin lesions > mengitis

Question 23

Who is most likely to get Coccidiodomycosis?

Answer 23

Men, dark skinned, ICP’s (increased for dissemination)

Question 24

What are the treatments for Systemic Mycoses?

Answer 24

If healthy: Observe for 1 mo., if infection after 1 mo = 6-12 wks azole
If chronic/systemic = Amp B for wks > Azole for 1-2 yrs
If ICP = Abp b for wks > Azole for rest of life

Question 25

What form does Aspergillus spp. form and where is it found?

Answer 25

45 degree branching septate hyphae; It is a nosocomial infection so it is found in hospital air ducts (ICP's)

Question 26

What disease does A. spp. cause?

Answer 26

Aspergillosis

Question 27

What symptoms will a patient with Aspergillosis exhibit?

Answer 27

Previous respiratory disorders; an aspergilloma @ pre-existing lesion

Question 28

What form does Zygomycetes (Mucormycoses) take?

Answer 28

90 degree broad nonseptate hyphae

Question 29

Under what conditions are Zygomycetes found?

Answer 29

After an increase in soil disturbance; think tornadoes

Question 30

What disease does Zygomycetes cause?

Answer 30

Mucormycosis/zygomycosis

Question 31

What are the symptoms of Mucormycosis?

Answer 31

Acidosis (diabetes pts) or corticosteroid pts; presents as pneumonia or rhinocerebral form (rapid death)

Question 32

What form does P. Jerovici take?

Answer 32

Thin walled cysts that contain sporozoites; NO hyphae

Question 33

What is special about the way P. Jerovici is cultured?

Answer 33

It cannot be cultured - both fungal and protozoal characteristics

Question 34

What is the P. Jerovici membrane made of?

Answer 34

Cholesterol

Question 35

What disease does P. Jerovici cause?

Answer 35

Pneumocystis pneumonia (PcP)

Question 36

What does pneumocystis pneumonia look like? What causes death?

Answer 36

Like diffuse interstitial pneumonia; asphyxiation

Question 37

What is the treatment for the Opportunistic fungi?

Answer 37

``` Asp./Zyg: = Amp B + Excision Pneumo = O2 + Trimethorpim-sulfa-methoxazole ```

Question 38

What does KOH stain for fungals?

Answer 38

Ergesterol

Question 39

AIDS is the most common predisposing condition to PcP, what therapy has reduced the incidence of PcP in the AIDS population?

Answer 39

HAART therapy

Question 40

Cultures must be grown from what for Aspergillosis?

Answer 40

Brochoalveolar Lavage (BAL)