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Pulmonary > Fungi > Flashcards

Fungi Flashcards

1
Q

Three common fungal causes of acute pneumonia?

A
  • Histoplasma capsulatum
  • Coccidioides immitis
  • Mucormycosis (rhizopus)
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2
Q

Five common fungal causes of chronic pneumonia syndrome?

A
  • aspergillus
  • blasto derm
  • coccidioides
  • histo
  • cryptococcus neoformans
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3
Q

Which 3 fungi are associated with infections in patients with granulocyte dysfunction (neutropenia)?

A
  • aspergillosis
  • zygomycosis
  • candidiasis
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4
Q

Which 5 fungi are associated with infections in patients with depressed CMI?

A
  • candida (mucosal)
  • coccidioidomycosis
  • cryptococcus
  • histoplasmosis
  • pneumocytosis
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5
Q

Most prevalent and most virulent aspergillus species?

A
  • fumigatus

- flavus

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6
Q

Mycology of aspergillus?

A
  • MOLD

- narrow, branching, septate hyphae

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7
Q

Most widely used test for aspergillus detection?

A
  • galactomannan antigen test (immunofluoresence)
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8
Q

Three allergic classifications of aspergillosis?

A
  • extrinsic allergic alveolitis
  • extrinsic asthma and allergic bronchopulmonary aspergillosis (ABPA)
  • allergic sinusitis
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9
Q

What kind of patient does extrinsic allergic alveolitis with aspergillus occur in?

A
  • farmer or malt work

- non-atopic workers to antigen in moldy hay/grain

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10
Q

What kind of patients does ABPA occur in?

A
  • children, adolescents and young adults with asthma

- allergic response to hyphae without direct tissue invasion

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11
Q

What kind of patient does allergic sinusitis with aspergillus occur in?

A
  • immunocompetent atopic patient with history of repeated bouts of sinus congestion
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12
Q

What kind of patient does saprophytic aspergillosis occur in?

A
  • patients with cavities due to TB, sarcoid, bronchiectasis, pneumoconiosis, CF
  • fungal balls –> local hemorrhage
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13
Q

Three major predisposing factors to invasive aspergillosis?

A
  • granulocytopenia
  • high dose corticosteroids
  • HIV
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14
Q

What is the airborne form of mucormycosis?

A

sporangiospores (contains lots of individual spores)

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15
Q

Unique, common predisposing factor to mucormycosis?

A
  • DM
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16
Q

Structure of mucomycosis? Diagnosis?

A
  • broad, irregularly wide, non-septate hyphae

- NO serology available

17
Q

Presentation of pulmonary mucormycosis?

A
  • persistent fever and pulmonary infiltrates refractory to AB Tx
  • consolidation involving one or multiple lobes
  • endobronchial masses, erosion of bronchi, bronchopleural, and broncocutaneous fistulae and granulomatous mediastinitis
18
Q

Two AIDS-defining pulmonary illnesses?

A
  • Cryptococcus neoformans

- Pneumocystis jirovecii

19
Q

What is the morphology of cryptococcus?

A
  • encapsulated yeast (polysaccharide capsule with India Ink)
20
Q

How does cryptococcus manifest in COPD patients? IC?

A
  • pneumonia with nodular lesions/cavitary disease/pleural effusions
  • disseminated disease – meningoencephalitis, cutaneous lesions
21
Q

Primary predisposing factor to PCP?

A
  • CD4 T cell defect caused by HIV infection
22
Q

How does PCP usually present? (pneumocystis jirovecii)

A
  • pneumonia
  • history of dry cough, fever, dyspnea, difficulty with deep inspiration
  • bilateral diffuse infiltrates with ground-glass appearance
  • extra-pulmonary infections rare
23
Q

Histopathology of PCP?

A

characteristic eosinophilic honeycombed material in alveolar space with H&E

24
Q

Geographic distribution and morphology of Histoplasma capsulatum?

A
  • Mississippi-Ohio River valleys
  • dimorphic
  • mold in environment = septate hyphae, large tuberculated conidia and small smooth conidia
  • yeast in tissue = small, single bud with narrow septum
25
Q

Three pulmonary disease manifestations of histo?

A
  • acute primary pulmonary: immunocompetent with heavy inoculum; influenza-like illness, self-limiting (diffuse alveolar infiltration or military pattern that resolves with calcifications)
  • chronic cavitary pulmonary: COPD; indolent but progressive respiratory infection (low grade fever, productive cough, dyspnea, night sweats)
  • asymptomatic infection: fungemia and dissemination that could reactivate later
26
Q

How does histo present in the immunocompromised?

A

dissemination

27
Q

Diagnosis of histo?

A

serology, agglutination, complement fixation, immunofluorescence

28
Q

Morphology of blastomyces dermatiditis? Specific environmental association?

A
  • dimorphic
  • mold in environment = septate hyphae, conidia on slender conidiophores
  • yeast in tissue = thick walled, budding, WIDE septum
  • bodies of water – Mississippi-Missouri River valleys
29
Q

Four pulmonary manifestations of blastomycosis?

A
  • 70% asymptomatic
  • acute or subacute with influenza-like symptoms in immunocompetent patients
  • chronic that may progress to dissemination particularly in IC patients
30
Q

What fungal disease is fulminant with ARDS?

A

Blastomycosis

31
Q

What cross-reaction can complicate blastomycosis serology?

A
  • H. capsulatum
32
Q

What other animal is highly susceptible to blastomycosis?

A
  • canines

- not contagious to humans from dogs

33
Q

Geographical distribution and morphology of coccidioidomycosis?

A
  • desert southwest and deserts of Central and South America
  • dimorphic
  • mold in soil = septate hyphae with arthroconidia
  • spherules containing endospores in tissues
34
Q

What fungal disease is associated with erythema nodosum? Implications?

A
  • Coccidioidomycosis

- associated with good prognosis

35
Q

How does cocci present as a pulmonary disease?

A
  • initial infection = self-limiting
  • complications occur in IC – nodules, cavities, progressive pneumonia, pyopneumothorax, bronchopleural fistula
  • extra pulmonary disease: skin, soft tissue, osteomyelitis, arthritis, meningitis
36
Q

Which fungus exists as spherules instead of yeast in tissue?

A

Cocci

Pulmonary (7 decks)

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