Fungi

Question 1

Cutaneous Fungi?

Answer 1

dermatophytosis: Microsporum, Trichophyton, Epidermophyton

Question 2

subcutaneous Fungi?

Answer 2

Sporotichosis and Chromomycosis

Question 3

Systemic Fungi?

Answer 3

Histoplasma capsulatum, Blastomyces dermatidis, Coccidioides immititis

Question 4

superficial fungal infection that causes dark brown to black painless patches on the soles of the hands and feet. this infection is caused by? disease name?

Answer 4

Tina Niger is the disease

caused by: Exophiala wernechii

Question 5

(hypopigmented center with a hyperpigmention surrounding it. will look like hyphaw in KOH with spherical yeats.
disease name?
caused by?

Answer 5

pityriasis versicolor (multicolored)
caused by Malassezia furfur

Question 6

infections of the skin, hair, and nail. sereat keratinase to breat down keratin. infection names? caused by?

Answer 6

Dermatophytosis

common dermatophytes include microsporum, Trichophyton, and Epidermophyton.

Question 7

disease within the horny layer of the skin. form a ring with a red raised border. the border is the active inflammation. this is ring worm.

Answer 7

Tinea Corporis (body)

Question 8

Fungal disease red patches on the groin and scrotum

Answer 8

Tinea Cruris (groin)

Question 9

athletes foot. between the toes and causes cracking and peeling of the skin. infection requires warmth and moisture, so it only occurs in those wearing shows.

Answer 9

Tinea pedis (feet)

Question 10

mainly in children. appears like an expanding ring in the scalp. hair loss.

Answer 10

Infections of hair: tinea capitits (scalp)

Question 11

fungal disease causing nails to be thickened, discolored, and brittle.

Answer 11

Infections of nails: tinea unuium

Question 12

how to diagnose cutaneous fungi?

Answer 12

diagnosis: skin scrapings in KOH. it will digest the keratin and you can see the microscpoic hyphae. OR with a Woods light (UV at 365nm) certain microsporum sp will look bright green.

Question 13

gain entrance following trauma to the skin. will normally remain localized to the subcutaneous tissue or spread along lymph to loacl nodes. they are normal soil inhabitants of low varulence.

Answer 13

Subcutaneous fungi

Question 14

dimorphic fungi commonly found in soil and on plants (rose thorn splinters. this disease will occur in gardeners. following a prick from a thorn a subcutaneoud nodule gradually appears and becomes necrotic and ulcerates. will heal and new nodules pop up nearby along the lymph tracts of the arm. seens as a yeats at 37 degrees and 25 degrees reveals branching hyphae.

Answer 14

sporotichosis: (Sporothrix schenchii)

Question 15

These are soil saprophytes found in rotting wood. infectoin following a puncture wound. initially small, violet wartlike lesion develops. months to years later the violet colrd lesions arise nearby.they cluster together like cauliflower. KOH skin scrappings reveal copper-colored scleriotic bodies.

Answer 15

chromomycosis: (philalophora and cladosporium)

Question 16

all three are dimorphic fungi. they grow as mycel forms with spors at 25 degrees on sabouraud agar. at 7 degrees on blood agar they grow in the yeats form. this is DIMORPHISIM and it plays a part in causing infection. in their natural habatat (soil) they grow at mycelia and release spores into the air. spores are inhaled, and grow as yeats in the human at 37 degrees.

Answer 16

systemic: three main fungi cause systemic disease in humans: Histoplasma capsulatum, Blastomyces dermatidis, and Coccidioides immitis.

Question 17

endemic to the southwestern US (Arizona, New Mexico, southern California, and northern Mexico) causes mild pneumonia in a normal US person. common opportunistic infection in AIDS patients from that area. dimorphic fungi

Answer 17

coccidioidomycosis (Coccidioides immitis)

Question 18

all three systemic fungi are acquired from inhalation of spores. causing a local infection and then enters blood.
local infections that never spread person to person and NOT acid fast bacteria (unlike TB)
Coccidion and Histoplamin are like PPD and will be injected under the skin to know if ever exposed to the fungus.
Three possible clinical presentations:

Answer 18

1. asymptomatic: most are like this and left untreated
   2. Pneumonia: mile pneumonia with a fever, cough, and chest X-ray infiltrates. with TB like granulomas with calcifications that follow.
   small percentage get chronic pneumonie or chronic cavitary pneumonie
   3. Disseminated: rarely occurs, unless immunocompromised pt.

Question 19

endemic to areas that drain the Mississippi. NOT ENCAPSULATED. within most bird droppings, pneumonia from cleaning chicken coops or spelunking.

Answer 19

histoplasmosis (histoplasma capsulatum)

Question 20

endemic to areas that drain the Mississippi. isolated in soil and rotten wood. rarest are systematic fungal infections. rarely systematic when causing infections. most present as chronic disseminated disease with weight loss, night sweats, lung involvment, and skin ulcers. HARDEST TO GET AND HARDEST TO HAVE!

Answer 20

blastomycosis (blastomyces dermatitis)

Question 21

three possible infections for normal people and can be systemic in the immunocompromised.
1. oral thrus: creamy white excudate on the tongue with a reddish base cover the mucus membranes of the mouth.
2. vaginitis: “yeast infection” vaginal itching and discharge (thick copius secretions wetting the underwear) speculum reveals inflammed vaginal mucosa and patches of cottage cheese-appearing white clumps affixed to the vaginal wall.
3. diaper rash: warm moist areas like diaper folds or skin fold in adults can become ren and macerated secondary to canida invasion.
Immunocompromised pts:
1. Esophagitis: extension of thrush into the esophagus causing burning substernal pain worse with swallowing.
2. disseminated: retinal must be examined. in the blood is NEVER NORMAL.

Answer 21

Systemic canida (canida albicans):

Question 22

how to diagnose canidia?

Answer 22

Diagnosis: KOH preperation of scin scaping or with stains and cultures of biopsied tissue or blood. beta-D-glucan can be measured in blood. part of the fungal wall for invasive fungi.

Question 23

first in the US in 1999. C. neoforms in more widespread and more common species to cause infection in humans. these are polysaccaride encapsulated yeast that are inhaled into the lumgs but the major manifestation is meningoencephalitis (NOT pneumonia). found in pigeon droppings. inhaled and often asymptomatic, yeasts spread to blood, then the brian.
subacute chronic meningitis: headache, nausea, confusion, staggering, gait, and/or cranial nerve deficits. fever and meningismus can be mild. cryptococcal meningitis can be fatal due to brainstem compression.

Answer 23

cryptococcosis (Cryptococcu Neoformans and Cryptococcus gattii)

Question 24

Cryptococcus diagnosis?

Answer 24

Diagnosis: lumbar puncture. India ink stain shows yeasts cells with a surroudning halo (the polycacharide capsule). antigen test for polysaccaride antigens. culture to confirm diagnosis.

Question 25

Causes three major diseases:
Allergic Bronchopulmonary Aspergillosis (ABPA) - Asthma like allergic reaction in the airways.
IgG type one hypersensitivity with bronchospasm, inc in IgE, and blood eosinophilia
Cell mediated type one hypersensitivity with cell mediated inflaqmmtion and lung infiltrates.

Answer 25

Aspergilosis (Aspergillus fumigatus is the most common):

Question 26

an infection in preformed lung cavities (from TB), requires surgical removal.

Answer 26

Aspergilloma

Question 27

Invasive vs aspiration aspergillus

Answer 27

Invasive aspergillosis - invasive infection of the lung

Aspiration aspergillus = ASTHMA

Question 28

produce toxins that cauyse liver damage and liver cancer.
toxin = aflatoxin.
this is a world wide significance since it grows ubisuitously, contaminating peanuts, grains, rice.

Answer 28

aspergillus

Question 29

This is an opportunistic disease caused by several molds in the order Mucorales of the phylum Zygomycota.
People are risk of infection are those who develop acidosis, such as diabetics, the immunocompromised, burn patients, and person taking the iron chelator deferosamine.
mold aggressively invade the sinuses, cranial bones, and blood vessels.

Answer 29

Murcormycosis (Mucormycosis (zygomycocis)

primary pathogens are Rhizopus, Phizomucor, Mucor.

Question 30

Fungal like bacteria, they frequently grow in the form of mycelia and are water and soil saprophytes. the two that cause disease a G+ rods

Answer 30

Actinomycetes and Nocardia asteroides are bacteria that act like fungi.

Question 31

1. G+, beaded, filamentous anaerobic organism that groows as normal flora in the mouth and GI
2. causes an eroding abscesses following trauma to the mucus membranes of the mouth or GI tract.
   infection is named according to the area of the body through which the abscess erodes:
   cervicofacial actinomycosis
   abdominal actinomycosis
   thoracic actinomycosis
3. pus will reveal yellow granules = sulfer granules.
4. treatment of this G+ bacterium is with penicillin G an surgical drainage.

Answer 31

Actinomyces Israelii

Question 32

weakly G+ and Partially Acid Fast!
beaded branching this filiments. NOT NORMAL FLORA
mis diagnosed as TB ofen due to producing lung abscesses that erode into the plural cavity cauing abscesses in the bbbrain and other organs.

Answer 32

Nocardia asteroides

Question 33

Two superficial fungi?

Answer 33

pityriasis versicolor and Tina Niger