Fungi Flashcards
4 Systemic Mycoses
Histo
Blasto
Coccidio
Paracoccidio
Systemic Mycoses Presentation
All can cause pneumonia and all can disseminate
Can mimic TB (granuloma formation), but without person-person transmission
Morphology of Systemic Mycoses
Mold in cold (20) and yeast in heat (37).
Exception: coccidio is a spherule (not yeast) in heat
Treatment of Systemic Mycoses
Fluconazole or itraconazole for local infection
Amphotericin B for systemic infection
Histoplasmosis Epidemiology, Microscopic Finding, and Transmission
Systemic mycosis found in Mississippi and Ohio river valley “Histo hides” within macrophages
Found in bird or bat droppings
Blastomycosis Epidemiology, Microscopic Binding, and Complication
Systemic mycosis in states east of Mississippi River
“Blasto buds broadly”
Can disseminate to skin and bone
Coccidioidomycosis Epidemiology, Microscopic Findings, and Presentation
Systemic mycosis found in southwestern US
Has spherules that are filled with endospores
Causes pneumonia and meningitis that can disseminate to bone and skin
Can also form erythema nodosum and arthralgias
Paracoccidioidomycosis Epidemiology and Microscopic Finding
Systemic mycosis found in Latin America
“Captain’s wheel” formation
Tinea versicolor Presentation, Treatment, and Microscopic Appearance
Caused by Malassezia spp which is on your normal skin flora
Degradation of lipids produces acids that damage melanocytes and causes hypopigmented and/or hyperpigmented patches
Occurs in hot, humid weather
Treatment: topical miconazole and selenium sulfide
“Spaghetti and meatball appearance”
3 Dermatophytes
Microsporum, Trichophyton, Epidermophyton
Dermatophytic Diseases (5) and Treatment
Tinea pedis (foot) Tinea cruris (groin) Tinea corporis (ringworm: on body) Tinea capitis (head/scalp) Tinea unguium (onychomycosis, on fingernails) Treat with terbinafine (topical or oral?)
Dermatophyte Morphology
Mold hyphae in KOH prep (not dimorphic)
Candida albicans Presentation
Systemic or superficial fungal infection
Usually in immunocompromised
Can cause thrush, vulvovaginitis, diaper rash, endocardiditis (IV drug users), disseminated to any organ, or chronic mucocutaneous candidiasis
Candida albicans Treatment
Topical azole for vaginal
Fluconazole or caspofungin for oral/esophageal
Fluconazole, amphotericin B, or caspofungin for systemic.
Aspergillus fumigatus Presentation
Invasive aspergillosis (especially in immunocrompromised). Allergic bronchopulmonary aspergillosis (associated with asthma and CF) Aspergillomas in lung cavities (especially after TB infection)
Aspergillus fumigatus Morphology and Toxins
Mold only
Some produce aflatoxins which are associated with HCC
Cryptococcus neoformans Presentation
Cryptococcal meningitis
Pulmonary infection
Crytococcus neoformans Morphology, Transmission, and Microscopic Finding
Heavily encapsulated yeast (not dimorphic)
Found in soil and pigeon droppings
Acquired through inhalation
“Soap bubble” lesions in brain
Mucor and Rhizopus Presentation, Morphology, and Treatment
Mucormycosis (disease mostly in ketoacidotic diabetic and leukemic patients): fungi proliferate in blood vessel walls when there is excess ketones and glucose, penetrates cribiform plate, and enter sbrain causing frontal lobe abscesses
Mold (not dimorphic)
Treat with amphotericin B.
Pneumocystic jirovecii Presentation, Morphology, Transmission, and Treatment
Pneumocystic pneumonia (most are asymptomatic, but immunosuppression predisposes to disease)
Yeast (not dimorphic)
Inhaled
Treatment: TMP-SMX (and other random drugs).
Sporothrix schenckii Presentation, Morphology, and Transmission
Sporotrichosis (local pustule or ulcers)
Dimorphic, cigar shaped budding yeast
Spores traumatically introduced into the skin by a thorn (lives on vegetation)
Candida albicans morphology
Dimorphic (opposite from systemic mycoses)
Budding yeast form “germ tubes”
Candida albicans morphology
Dimorphic (opposite from systemic mycoses)
Candida albicans presentation
Systemic or superficial fungal infection. Usually in immunocrompromised. Can cause thrush, vulvovaginitis, diaper rash, endocardiditis (IV drug users), disseminated to any organ, or chronic mucocutaneous candidiasis
Candida albicans treatment
Topical azole for vaginal; fluconazole or caspofungin for oral/esophageal; fluconazole, amphotericin B, or caspofungin for systemic.
Aspergillus fumigatus presentation
Invasive aspergillosis (especially in immunocrompromised). Can also cause allergic bronchopulmonary aspergillosis (associated with asthma and CF). Can also get aspergillomas in lung cavities, especially after TB infection.
Aspergillus fumigatus miscellaneous
Mold only. Some produce aflatoxins which are associated with HCC.
Cryptococcus neoformans presentation
Cryptococcal meningitis. Also pulmonary infection.
Crytococcus neoformans other information
Heavily encapsulated yeast (not dimorphic). Found in soil and pigeon droppings. Acquired through inhalation. “Soap bubble” lesions in brain.
Mucor and Rhizopus
Mucormycosis. Disease mostly in ketoacidotic diabetic and leukemic patients. Fungi proliferate in blodo vessel walls when there is excess ketones and glucose, penetrate cribiform plate, and enter brain. Frontal lobe abscesses. Just mold (says they’re hyphae)? Treat with amphotericin B.
Pneumocystic jirovecii
Pneumocystic pneumonia. Yeast. Inhaled. Most are asymptomatic, but immunosuppression predisposes to disease. Treatment: TMP-SMX (and other random drugs).
Sporothrix schenckii
Sporotrichosis. Dimorphic, cigar shaped budding yeast that lives on vegetation. Spores traumatically introduced into the skin by a thorn and cause local pustule or ulcers.
Candida albicans morphology
Dimorphic (opposite)
Candida albicans morphology
Dimorphic (opposite). Budding yeast form “germ tubes” in C. albicans
