Fungi Flashcards
What are the mycoses that are systemic infections?
Histoplasmosis
Blastomycosis
Coccidioidomycosis
Paracoccidioidomycosis
What fungi is common among farmers in the Ohio River Valley and causes granulomas in the lungs?
Histoplasmosis
- respiratory route from fucking caves, bat/bird droppings, and farmers
If an immunocompetent patient is infected with Histoplasmosis, what might be found on microscopy and x-ray?
- Chronic Cough, granuloma w/ fibrosis in the lung
- Yeast form
- Multiple ovul bodies within Macrophages, lungs/liver
What are symptoms a patient might expect from histoplasmosis?
- Resp Symptoms
- Hepatosplenomegaly
- Erythema Nodosum – from immune response
How do you differentiate a granuloma of histoplasmosis from TB?
Both have granulomas in the lungs and have similar respiratory symptoms
- TB would have night sweats
- Histo - hilar calcification, antigen in urine/serus
- *Need to biopsy**
If you are looking at a respiratory biopsy with KOH and notice broad budding yeast, what is the likely infection?
Blastomycosis
- blasto buds broadly
- yeast in heat, mold in cold
What are the typical manifestations of blastomyocosis?
Typically asymptomatic in competent hosts with a hazy infiltrate in the lungs
Immunocompromised = systemic spreading to bones (osteomyelitis) and skin
Where is Coccidioidomycosis usually located and why?
Southwest US
- spreads in the air from dust of soil
- earthquakes, dust storms, construction
What is the most concerning manifestiation of Coccidioidomycosis in immunocompromised individuals?
Can spread to the Meninges causing meningitis
How does coccidioidomycosis look under microscopy?
- Spherule filled with Endospores
What fungi would you be suspicious of if you saw a “Captain’s Wheel” formation on KOH stain?
Paracoccidiodomycosis
How do the symptoms of Coccidio compared to Paracoccidio?
Coccidio – pneumonia, meningitis, bone spread
Paracoccidio – granulomatous lungs, cervical LAD, Musosal ulcers in the mouth and upper resp
What has Spaghetti and Meatball appearance on KOH stain?
Malassezia furfur / Pityriasis Versicolor
Hot / Humid near the equator with scattered hyper and hypopigmentation on the torso?
Malassezia furfur / Pityriasis Versicolor
- only affects the top layer of skin without any itching or irritation, changes pigmentation
- Selenium Sulfate
Who are at risk for systemic Malassezia furfur?
Infants who are getting TPN and Lipid infusions, because M. Furfur love lipids and thrive in blood.
How can you diagnosis a tinea infection?
- KOH with hyphae present
- Woods Lamp will illuminate
What are common oral drugs to treat tinea infections, especially onychomycosis (of the nail)?
Terbinafine
- if needed Griseofuvum
What fungi can commonly infect gardeners and has a “cigar-like yeast” form in the infected wounds?
Sporothrix Schenckii – “Rose Gardeners Disease”
– getting cuts by thorn bush or other plants
What is a unique characteristic of Sporothrix Schenckii?
Ascending Lymphadenitis from the inoculation site
- Red raised bumps
If you find a person who has oral candida and candida esophagitis, what could that indicate?
They are immunocompromised and with the esophagitis must have CD4 count below 100. AIDS defining illness.