FUNgi Flashcards
WHat niche does FUngi fill
Principle decomposers (Saprophytic)
how does Fungi decompose
Secrete digestive enzymes
What kingdom are fungi
Their own kingdom
what type of cell are Fungi
Eukaryotes
where does Fungi live
Most are free living in nature
how does one get fungi
acquired from the environment, and some are part of the normal human flora
are fungi anaerobes or aerobes
Most are strict aerobes ( few are facultative anearobes)
how does Fungi cause disease
Induce an inflammatory response
through direct invasion
Destruction of tissues (some produce toxins)
Nucleus of Fungus as eukaryotic organisms
defined nucleus
chromosomes of Fungus as eukaryotic organisms
Linear Chromosomes
ploidy of Fungus as eukaryotic organisms
Diploid (mostly
can Fungus reproduce sexually as eukaryotic organisms
possibly
sexual reproduction of fungi leads to
Polyploidy leads to creating genetic diversity
What separates Fungi from plants
No chloroplasts or photosynthetic energy-producing mechanisms
Obtain nutrients from exogenous sources ( In nature, decaying organic matter)
what does Fungus cell membrane consist of that is different from mammalian cells
Contains Ergosterol (mammalian cells contain cholesterol)
how are Fungus cell walls diff from plants and bacteria
No peptidoglycan, LPS, glycerol or teichoic acid
Fungal walls contain chitin, mannan, and Glucan
The 3 categories of Fungi
Yeast
Molds
Dimorphic Fungi
Unicellular fungi
Yeast
Multicellular fungi
Molds
fungi that can exist as both mold and yeast
Dimorphic fungi
how does yeast reproduce
Asexual reproduction by budding
What kind of fungi is Candida albicans
Yeast
Types of Molds
Mycelium (Vegatative)
Hyphae (filamentous, tube-like)
how does Mold reproduce
sexual and asexual reproduction
How does Mold reproduce asexually
By conidia that form on the tips of growing Hyphae
how does mold reproduce by sexual reproduction
Through the development of spores
Septated Fungus
Hyphae that are separated protoplasm by cell walls
diagnostic factors for modlds
Are Hyphae present, and are they septated
What type of mold reproduction involved rearrangement
Asexual
are all hyphae the same for molds
Vary depending on species
what may be contained on the septa of molds
Pores and incomplete walls
why would septa of molds be incomplete or contain pores
Allow movement of Nutrients, organelles, and nuclei between adjacent cells
where does Mycelium Conidia form on mold
On hyphae
where does Arthroconidia develop
within the hyphae and eventually break off
Size of chlamydoconidia compared to hyphae
Chlamydoconidia are larger
how does Chlamydoconidia develop
with the cell or terminally
where are sporangioconidia borne
Terminally in sporangium sac
Where does Simple Conidia arise
Directly from a conidiophore
Types of Mycelium conidia
Arthroconidia
Chlamydoconidia
Sporangioconidia
Simple Conidia
asexual form of Fungus
Anamorph
what does an anamorph form to do asexual reproduction
Conidia
how does Asexual reproduction of fungus occure
Mitotic division of haploid nucleus with not genetic recombination
sexual form of fungus
Teleomorph
what is formed in sexual reproduction by fungus
spores (also called ascospores, sygospores, basidiospores, depending on strucutre)
how is a diploid nucleus created in sexual fungal reproduction
Haploid nuclei of donor and recipient cells fuse (Allowing for genetic recombination) then devides by classic meiosis
When temperature determines whether a fungi is mold or yeast
Thermally dimorphic
what does the temperature shift from soil to host in Histoplasma Capsulatum lead to
over 500 differently expressed genes
Is Dimporphism perminant
No it is reversable
what pathogenic part of fungi dimorphism linked to
Linked to virulence (if Dimorphic removed, loses it Pathogenicity)
How are Fungi encountered
Incidental contact In envirnoment
Normal Human Flora
Contact with infected individual
what does incidental contact with fungi do to healthy people
Develop no symptoms
what is needed to create an infection due to incidental contact with fungi
High inoculum exposure
Immunosuppression
what types of fungi are the normal human flora
Yeasts
What kind of infection can the normal human flora of yeast create
Disseminated infection in immunocompromised hosts
what are Dermatophytes
Fungi from contact with infected individuals
how good is the immune system at fighting fungi
Provides great protections (most infections are mild and self-limiting)
what is the primary barrier for fungal entry
Intact skin and mucosal surfaces
what all in the skin and mucosa provides a barrier to fungus
Desiccation
Epithelial Cell turnover
Fatty acids and low pH of skin
what on the skin prevents fungi growth
Bacterial normal flora
what may allow Fungus to enter the body
Alterations in normal flora (antibiotics)
Compromised Skin/mucosal surfaces (trama..) allow for entry and infections
what is needed to Eliminate fungal infections
T Cell-mediated immunity
what is the immune repsonse to fungal infections
CD4+ TH1/TH17
what patients are susceptible to fungal infections
AIDS patients
How are Fungal infections controlled and killed
Phagocytosis and killing by Neutrophils
What does the immune sytem do if fungal infectiosn are too large to be phagocytized
Phagocytic cells secrete enzymes and reactive oxygen species that can digest or kill large fungi
antibodies effect on fungi
can kill some fungi, as a minor component to protection (but may also be detrimental)
what cells are used to meidate immunity to fungal infections
T cells
How does the body respond to infection by fungus
CD4+ cells recognize presented antigens in MHC complex on APC (dendritic Cell) through interaction with their TCR
Stimulates release of Cytokines, which activate neutrophils and macrophages
Problem with Anti-fungals
unstable, toxic to humans, have undesirable side-effects
what type of therapy is preferred if possible to treat fungal infections
Topical Therapy
Types of antifungals
Azoles
Polyenes
Types of Azoles
Itraconazole
Ketoconazole
Clotrimazole
Micronazole
action of azoles
Interfere with ergosterol synthesis
What type of antifungal is an azoles
Fungistatic
Action of Polyenes
Lipophilic - bind to cell envelope ergosterols and form channels
Types of Polyenes
Amphotericin B
Nystatin
Hamycin
Amphotericin B action
Forms a pore in the membrane allowing for stuff to leak out
Itraconazole action
target enzyme for synthesis of Ergosterol
what do other anti-fungals target
DNA synthesis
PAthways downstream of ergosterol
Cell wall synthesis
What drug targets ergosterol in fungal cell membranes by forming channeling leading to the leakage of essential small molecules and cell death
Polyenes (amphotericin B)
Effectiveness of Polyenes (Amphotericin B)
Effective against most fungus ( can cross react with mammalian sterols too )
Problems with Polyenes (Amphotericin B)
Can cross reaction with mammalian sterols
Not Abosbed in GI tract
Not soluble at physiologic pH, must be administered intravenously at coloidal suspension
Side Effects: Chills, fever, headache, dyspnea
Can cause renal dysfunction leading to nephrotoxicity
when would you use Polyenes (Amphotericin B)
Life threatening Fungal infections
Resistance to Polyenes (Amphotericin B)
Rare as the fungi much change sterol composition of membrane
what can Systemic Azoles target
Either Yeast or mold forms of fungi
Body tolerance to azoles over Amphotericin B
Better Tolerated
Action of Azoles
Target enzymes that convert lanosterol to ergosterol resulting in defective membranes
Problems with Azoles
Toxic to liver
Cause cardiac myocyte repolarization increasing risk of cardiac arrhythmias
Resistance to Azoles
Can occure due to efflux pumps that transport drug out of cell
Types of Medically important fungi
Superficial cutaneous mycoses
Subcutaneous Mycoses
Opportunistic mycoses
Endemic (aka systemic) mycoses
the common fungal infection limited to the skin and skin strucutres
Superficial cutaneous mycoses
the fungal disease of the skin, subcutaneous tissue and lymphatics
Subcutaneous mycoses
Cause life-threatening system disease in immunosuppressed patients
Opportunistic mycoses
Infections caused by geographically restricted fungi (true pathogens) - cause serieous systemic infections in healthy individuals
Endemic (a.k.a systemic) mycoses
who usually gets cutaneous and superficial Mycoses
humans
Types of Cutaneous and Superficial Mycoses
Dermatophytes (tinea)
Malassezia (yeast or normal flora)
The most common fungal infection in humans
Dermatophyte
what is the source of Dermatophytes
Soil, animals, or humans
What do Dermatophytes infect
Keratinized Tissues (nails, hair, and skin) - the keratinase enzyme
what type of skin are dermatophytes restricted to
Non-viable skin (can’t grow at body temps of 37 degrees)
what type of Dermatophyte infections are hard to treat
Nail infections
Clincal diseases by Dermatophytes
Tineas (ringworm, athletes foot , Jock itch
Types of Dermatophyte skin infections
acute or chronic
What etiological genera are Dermatophytes
Molds :
Microsporum
Trichophyton
Epidermophyton
How to name Dermatophyte infections
Based on latin word Capitis: head Corporis: body Pedis: foot Unguium: toenail
Niches for Dermatophytes
GEophilic: soil
Zoophili: domestic and wild aniamls
Anthropophilic: live in humans
how does Anthropophilic Dermatophytes establish infection in humans
Chronic
Dermatophytes as part of Normal flora
NO
how does Dermatophytes tend to spread with humans
Crowding facilitates spread, due to contagious nature
Survives on locker room floors
what does the most body do to fight pathogenic immunity of Dermatophytes
Innate immunity high for most people
how does Innate immunity stop dermatophytes
Skin and mucosa a good barrier (dry, cell sloughing, fatty acid, low pH)
Bacterial Flora hostile to fungus
what is required for Dermatophytes to infect
Skin trama
what helps Dermatophytes to establish and maintain infection
Moisture
skin occluded with nonporous materials (shoes)
how does Hydration and temp effect Dermatophytes
Increase due to interference with stratum corneum function
how can chronic infection with Dermatophytes occure
When fungal growth rate and skin dequamation are balanced
Poor Inflammatory response
why do dermatophytes grow in a circle
Hyphae grow outward in centrifugal pattern
what is found at the Inflammed margin of the Dermatophyte damage
Viable fungal elements
what is found at the center of the Dermatophytes
few/no viable fungi
What does healing tissue do to the Dermatophyte infection
Healing tissue is refactory (resistant to infection)
Commonality of systemic infection of Dermatophytes
extremely rare
why are systemic infections of Dermatophytes so rare
Inability to grow at human body temp
Hard to get iron
what binds to iron, harming the Dermatophytes ability to grow
Transferrin
were can Dermatophytes spread
From skin to other keratinized strucutres
when Hyphae invade the ahir shaft, causing the hair to break
Tinea Capitis
what Can Tinea Capitis do if hair breaks at the root
Fungus can plug hair follicle, cuasing bald pathces
Nail plate fungal invasion
Tinea Unguium
nail plate invasion by fungus leads to
Hyperkeratosis and discoloration
Dislodges and distorts nail (onychomycosis)
What is Dermatophytes often diagnosed incorrectly as
Non-infectious disorder that cause similar skin inflammation
What disease may have similar feats and are treated with steroids (bad for fungi) incorrectly instead of Dermatophytes
Psoriasis and contact dermatitis
how to diagnose Dermatophytes
FLuoresce in UV (somtimes)
Microscopic examination of material from lessions
How Can septate Hyphae be visualized
Using potassium hydroxide or cacofluor white preparations of scales scraped from advancing edge of lesions
Superficial Mycoses causing Patches with greasy Scales in facial hiar and scalp
Dandruff
Superficial Mycoses that causes Hypopigmented or Hyperpigmented pathces on chest or neck with Scaling
Tinea Versicolor
what can cause Tinea Versicolor
Malassezia Furfur
where does Malassezia Furfur grow
On skin lipids - common to normal flora
How can Malassezia( cause superficial mycoses
Part of normal flora, but may colonize the stratum corneum
what kind of fungus is Malassezia
Yeast
how does Dermatophytosis and Superficial mycoses usually resolve
spontaneously
how to treat Dermatophytosis and superficial mycoses
Topical anti-fungal (terbinafine or azoles)
time it tkaes for topical antifungals to work
Takes several weeks
when would systemic antifungals be indicated
In some wide-spread infections (miconazole or ketoconazole)
why are nail infections hard to treat
Slow turnover of infected nail and poor penetration of antifungals
Mycoses of Implantation
Subcutaneous Mycoses
how does Subcutaneous Mycoses organisms enter skin
Via thorns or splinters
how do subcutaneous mycoses infections evolve
over several weeks
Spread of Subcutaneous Mycoses
Generally localized
who does Subcutaneous Mycoses effect the worst
Immunocompromised patients (lesions usually heal following antifungal treatment)
What happens when Subcutaneous Mycoses infects Immunocompromised patients
Widespread cutaneous and visceral infections
Types of Subcutaneous Mycoses
Sporothrix Schenckii
Chromoblastomycosis
mycetoma (madura foot)
what type of Fungus is Sporothrix Schenckii
Thermally dimorphic fungus (environment - mold, tissue - yeast)
where is Sporothrix schenckii found
soil, moss, decaying wood, and veggies
what does Sporothrix schenckii cuase
Sporotrichosis
Disseminated disease
Other name for Sporotrichosis
Rose picker’s disease
how is fungus introduced for sporotrichosis
By trauma (thorn prick)
What does sportrichosis once infection begins and spreads
Starts as a small lesions (ulceration and/or erythema)
spreads through lymphatic vessels
when Sporothrix schenckii gets in to the lymph
Lymphocutaneous sporotrichosis
who gets disseminated disease
only in immunocompromised patients
what does Disseminated disease affect
Afflicts joings, brain, spine (serious)
How is Disseminated disease treated
Antifungals (itraconazole for 3-6 months)
Infection progression by Sporothrix Schenckii
Painless papules developing a few weeks to a few months after inoculation
Papules enlarge and eventually ulcerate, leaving open sores
Infection follows lymphatic’s
Why is Microscopic examination of Sporothrix Schenckii not very helpful in diagnosis
Very few organisms can be detected with KOH preparations
How definitively diagnose Sporothrix Schenckii
depends on Culture of infected pus or tissue, grow 205 days on standard medical mycology media
treating Cutaneous Sporotrichosis
Oral anti-fungals (itraconazole)
treating Pulmonary systemic infections
Itraconazole, but may require additional drugs like amphotericin B
What does CHromoblastomycosis cause
Dematiaceous Fungi (pigmented black fungus)
What does Chromoblastomycosis result in
Scaly, wart like lesions on feet or leg
what causes Chromoblastomycosis
Soil mold (working barefoot in endemic areas is a risk factors
How to treat chromoblastomycosis
Surgery or amputation
what can Chromoblastomycosis infect
Also infect bone and muscle
where in the world does Chromoblastomycosis occur
In rural tropical areas of the world (Madagascar and brazil)
what causes Mycetoma
Different species of environmental fungi) also actionomycetes (Nocardia)
what does cronic infection by mycetoma lead to
sinus tract nodule
discharge of visible grains (colonies of fungus)
what happens to the draining sinuses in Mycetoma
Massive induration (loss of elasticity and pliability) with draining sinuses
what is a risk factor for Mycetoma
Walking barefoot in tropical environments
Opportunistic Fungal Pathogens
Candida (albicans, glabrata, Parapsilosis)
Aspergillus (fumigatus, Flavus)
Mucormycetes (Rhizopus, Mucor)
Pneumocystis jiroveci
What causes Candidiasis
Candida
What causes Aspergillosis
Aspergillus
what causes Mucomycosis
Mucormycetes
what causes Pneumocytosis
Penumocystis jiroveci
source of Candida
Normal flora - yeast
Source of Aspergillus
Common environmental mold
Source of Mucomycetes
Environmental mold
source of Pneumocystis jiroveci
Fungus
why are opportunistic fungal pathogens not considered true pathogens
only cause disease when host defenses are decreased
What type of patients would be immunocompromised
Immunosuppressive therapy - organ and stem cell transplant
Hematologic malignancies
HIV infection
Corticosteroid and other immunosuppressive drugs (Humara)
Risk factors aside from immunocompromised for opportunistic fungal pathogens
Major burns wounds or trauma Central Venous Catheters Broad-spectrum antibiotics Intensive care unit Real failure requiring dialysis Premature babies
Most frewuent oppotrunistic fungal pathogen
Candida Albicans
where do candida albicans grow
Rapid growth on standard rich media
what does Candida albicans look like on standard rich media
Staphlococci
how does Candida albicans reproduce
Form buds or blastoconidia
formation of Hyphae by candida albicans
some form hyphae or pseudohyphae in vivo
what type of Fungus is Candidia Albicans
Polymeorphic (not true dimorphism)
what typ eof hyphae are associated with invasive candidiasis
Mycelial (hyphae)
What does Candida Shift from and to with pathogenesis
Shift from yeast to hyphae
what does hyphae of Candida do with Epithelial cells
Form strong attachment
what does the Hyphae of Candida secrete
Proteinases and phospholipases that digest epithelial cells
what is the roll of the proteinases and phospholipases secreted by Hyphae of Candida do
Facilitate invasion by digesting keratin and collagen
Problem with Candida and Prosthetics
Biofilm
what type of infection is most Candidiasis
Endogenous
where is Candidiasis found as a colony
GI tract
Vagina
Skin
who all is colonized by Candidiasis
30-50% of people
when does Candidiasis infect
Only when normal flora is disrupted or patient is immunocompromised
what is the biggest Culprit of normal flora disruption leading to Candidiasis
Bread spectrum antibiotics ( then skin macerations, moist hot conditions)
what increses mucosal infections of CAndidiasis
Decreased T-cell function (aids patients)
What Candidiasis yeast infection is in the Mucosa
Trush
Appeaenceof thrush
Thick, white plaques on oropharyngeal and vaginal mucosa
when Candidiasis yeast infections is Cutaneous
Intertriginous Candidiasis
where does one find Intertriginous candidiasis
warm and moist areas of skin (groin, under boobs, Diaper rash)
what does Candidiasis yeast infections do to the Urinary tract
Produce Cystis, pyelonephritis, renal abscenss
what would casue of UTI by Cndidiasis yest infections
Urinary catheters, Kidnery transplants
a systemic Candidiasis infection
Disseminated candidiasis
hoe does a systemic infection of Candidiasis occur
Follows superficial infections when candida gains access to the bloodstream
When Candida gains access to bloodstream
Disseminated Candidiasis
Seriousness of Disseminated Candidiasis
Life threatening
How does CAndida enter the blood stream
Through Skin lesions Disruption of GI tract Prosthetic Devices colonized by Candida biofilms Intravenous catheters Urinary tract
Where does Candida form Micro-abscesses once in the blood stream
Kidneys Meningitis Eyes liver and spleen Spine Heart on prosthetic valves
What are the symptoms of Disseminated CAndidiasis
Similar to bacterial infections
often involve eyes though to lead to blindness (endopthalmitis)
Diagnosis of Mucosal or cutaneous candidiasis
Microscopic examination of scrapping - budding yeast and pseudohyphae
Culture on blood agar plates to grow within 24 hours
Diagnosis of Invasive (Disseminated) Candidiasis
Hard to document:
culture from blood (not sesnitive) requires biopsy of involved tissue
Germ-test tube - elongated buds from yeast when exposed to calf serum
treatment of Mucosal Candidiasis
Topical antifungal creams
Systemic therapy for severe cases
TReatment for Systemic Candidiasis infection
systemic antifungal (min of 2 weeks)
- Fluconazole and Echinocandin most common
- AMphotericin B - used in some cases
Immunity to Candidiasis
Humoral and cell mediated immunity are involved in defence
activity of Antibodies against CAndidiasis
Oposonizing IgG antibodies fight against yeast carbs mannan
- this activates the classical complement pathway
What keeps CAndidiasis in check on mucosal surfaces
T cell mediated Immunity via Neutrophils
The main host defence against invasion through mucosa
Neutrophils (T-cell mediated immunity)
What immuno-deficiency leads to high spread of candida
Neutropenia (low neutrophils)
What balance is needed to clear Candidiasis infection
Balance between Th1 and Th2 mediated Cytokine response
what cytokine is correlated with enhance resistance to Candida Infection
Th1 - mediated immunity (IL-2, IFN-gamma, TNF-alpha)
what Cytokine response is associated with Chronic disease of Candida
Th2 response (IL-4, IL_6, and IL-10)
What does Aspergillosis look like?
Filamentous fungi
how does Aspergillosis reproduce
Forming conidia and aerial conidiophores (sexual reproduction)
where is Aspergillosis found
Uniquitous in soil, manuure, decomposing vegitation
how would someone get pneumonia from apsergillosis
Inhalation of spores by immunocompromised people
How does Aspergillosis enter
Conidia are inhaled into the upper and lower respiratory tracts where they can germinate into hyphae
What happens to inhaled Aspergillosis (Conidia) in healthy individuals
Macrophages kill conidia that reach aveoli (but can’t kill hyphal form)
Neutrophils line up along hyphae and secrete reactive oxygen intermediates that kill the fungus
Where does Conidia aspergilosis infection occur
in immunocompromised host
WHere hyphae invade through blood vessel walls causing tissue infarction, hemorrhages, and necrosis)
Agioinvasiv fungus
Aspergillosis infection manifestations
Aspergillus pneumonia
Disseminated aspergillosis
Allergic respiratory disease
Aspergilloma (fungus Balls)
most common ASpergillosis infection
Aspergillus pneumonia
who is at increased risk of aspergillus pneumonia
Patients with emphysema and bronchiectasis
how does Disseminated aspergillosis occure
Through the bloodstream and affects any organ system
what type of disseminated aspergillosis is the worst
CNS
How does Allergic respiratory diease from aspergillosis occure
People with allergies build up mucus allowing fungus to grow, cuasing more allergies and more mucas in inflammation
how gets Aspergilloma
REsults in patients with prior lung infections with scarring and cavities (TB) and fungal spores germinate in cavities and fungal hyphae grow into balls
where do people with emphysema and bronchiectasis get more aspergillus pneumonia
Walls of airways thicken from chronic inflammation and resident macrophages and neutrophils are less effective at clearing infections from areas
result of ASpergillus pneumonia in people with severe defects in immunity
fungal hyphae penetrate intact lung tissue leading to necrosis
when does DIsseminated aspergillosis occure
Follows primary aspergillosis when fungus enters blood stream and then spreads to organs
CNS involvement of DIsseminated aspergillosis leads to
Mental status changes
how to increase survival rate of disseminated aspergillosis patients
Surgical debridement
Diagnosis of ASpergillosis
Grow on Sabouraud
Tissue biopsy to confirm hyphae in tissue, but not specific for Aspergillus
why is it hard to grow Aspergillosis
Contamination
Treating Aspergillosis
Voriconazole - choice
Amphotericin B or echinocandin also used
Why was there an outbreak of fungal meningitis
Steroids contaminated with aspergillus
Most common species of Zygomycosis
Absidia, Rhizopus and Mucor
where are Zygomycetes found
Ubiquitous saprophytes in soil, food, bread
Where can Zygomycetes colonize
Oral mucosa, Paranasal sinuses, and pharyngeal mucosa
Who does Zygonmcetes cause disease in
People with diabetes(Diabetic Ketoacidosis) and immunosuppressed people
How my Zygomycetes manifest
Pulmonary disease (fungal pneumonia) or rhinocerebral disease (invasive necrotic lesions)
where does Pneumocystis colonize
Ubiquitous colonizer of human airway
who gets a disease from Pneumocystis
Immunovompromised persons with aids
Virulence of Pneumocystis
Low Virulences
How does Pneumocystis Pneumonia present itself
Diffuse Pneumonitis (lung inflammation) leading to diffiult labored and rapid breathing , mild fever
Progressive Dyspnea and Tachypnea
Difficult labored and rapid breathing
what type of fungus is Crytococcosis
Environmental yeast
what does Cryptococcosis express in the host
Huge Polysaccharide Capsule
Where is Crytococcosis found
Soil and brid exceta
can Crytococcosis infect normal people
Yes, about 20%
VIrulence factors of Cryptococcus neoformans
Capsule
Laccase enzyme
Phospholipases
Urease
What is Cryptococcus Neoformans Capsule made of
Glucuronoxylomannan and glucuronoxylomannogalactan
roll of Capsule
Immunosuppresssive function (repressed under environmental conditions)
what does the LAccase enzyme do
Produces antioxidant melanin pigments
does Fungi have virulence factors like bacteria
Yes
How does Cryptococcois infect
yeast are inhaled into alveoli producing an asymptomatic lung infections
what controls the Cryptococcosis infections
T cell mediated immunity
where does Cryptococcosis spread
HematogenousSpread from the lung to meningitis
Severity of Meningitis from Cryptococcis
Acute to Chronic
If you have aids and Cryptococcosis, what happens
Diffuse pulmonary infiltrates
Skin lesions
Widespread visceral infection in internal organs
Culturing Cryptococcosis
Easily cultured on agar for identification
How to Diagnose Cryptoccosis
Culture, oberseve Encapsulated uding yeast in CSF using latex agglutination
Treating Meningitis via Cryptococcosis
Amphotericin B and Flucytosin followed by fluconazole
Treating Pulmonary infection from Cryptococcosis
Fluconazole
Endemic Mycoses
Geographically restricted
Dimorphic
infect healthy
where is Histoplasmosis found
Bird and bat poop in the Mississippi and Ohio river valleys
where is Blastomycosis found
Soil mold in the Mississippi river valley and southereastern and North central steates
where is Coccidioidomycosis found
Desert soils in Southwestern U.S.
Symptoms of Endemic Mycoses
Mostly asymptomatic and mild self- limiting
Clearing Endemic Mycosis
Cell mediated (CD4- T cells)
Primary site of entry for Endemic Mycoses
Lung
What type of Fungus is Histoplasmosis
Dimorphic soil fungus
where is Histoplasmosis a mold and yeast
Environment with macroconidia and microcondidia ( mold)
yeast in body
The infectious form of Histoplasmosis
Microcondidia
Who all has been infected by Histoplasmosis
90% of people in endemic areas
Where is Histoplasmosis found
Soil with High nitrogen (poop)
Why would there be an outbreak of Histoplasmosis
Disrupt soil due to demolition of old buildings
where does Histoplasma tun into yeast
in the lungs
What does Histoplasma infect
inside Macrophages and neutrophils by modulating phagolsomsomal pH
why does Histoplasmosis disease manifestation change
Based on number of Conidia inhaled and host response
most Infected people with Histoplasmosis symptoms
None or mild
If large amounts of Histoplasmosis is inhaled
Even healthy people get bad pneumonia
How to get rid of Histoplasmosis in healthy people
Will clear on its own without antifungals
Who has difficulty clearing Histoplasmosis
Patients with COPD- eventually becomes fatal
How common is Hisseminated Histoplasmosis
Nearly everyone that is infected
Symtpotms of Disseminated Histoplasmosis
usually asymptomatic
Symptoms in people with AIDs ro Immunosuppressive therapy
Symptoms of Acute Disseminated Histoplasmosis
Fever, chils, fatigue, mucous membrane ulcer, Hepatosplenomegaly, pancytopenia, sepsis syndrome
who gets chronic progressive disseminated histoplasmosis
Old people
What happens if Chronic Progressive Disseinated Histoplasmosis is untreated
Patients dies
Diagnoisi if Histoplasmosis
Grow from sputum, blood, tissues, or body fluids
Histopathological analysis of intracellular yeast in bone marrow, liver, lungs, lymph nodes- faster
treating Histoplasmosis for healthy, moderate and sever infrections
healthy- none
moderate: itraconzaole
Severe> amphotericin B to contain than itraconzole
Whereis Blastomycosis a fungus and yeast
Fungus in envirnoment and yeast in body
Cell wel of Blastomycosis
Thicccc with broad based budding
Commonness oF blastomycosis outbreaks
Mostly sporadic cases with maybe a small outbreak
Who does Blastomycosis disease occure
INhaled into lungs leading to pneumonia
What does Blastomycosis do when out of lungs
Disseminated
Skin lesions occur
GRanulomas develop
Who to clear Blastomycosis
Cell-mediated immunity to clear yeast by phagocytosis by macrophages and neutrophils
Why does Coccidioidomycosis/ valley fever form blooms
Proper envirnomental conditions
How many people are infected by Coccidioidomycosis/ valley fever in endemic areas
80% of the pop
How is Coccidioidomycosis spread preson to person
It is not
What causes the Dimoprhic change in Coccidioidomycosis.valley fever
Not temp
Treatment and diagnosis of Blastomycosis
Similar to Histoplasmois
the mold form of Coccidioidomycosis
Arthroconidia
what happens to Arthroconidia of Coccidioidomycosis when in tissue
transform into Spherules filled with Endospores
is Arthroconidia or Spherules(yeast) of Coccidioidomycosis resistant to phagocytosis
Spherules
is Arthroconidia or Spherules(yeast) of Coccidioidomycosis infections
Arthroconidia (inhaled by lungs)
Life cycle of COccidioides
Hyphae differentiate into arthroconidia These break loose and suspend into air spread in soil and air in human differentiation produces cleavage and spherules spherules rupture and release endospores
Coccidiomycosis infections symptoms in healthy people
None or mild
What is a symptomatic Coccidiomycosis infection
Desert rheumatism or valley fever
Stages of Acute Pulmonary Coccidiomycosis infection
Chest pain, cough, fever, and chills Joint pain, stiff neck, muscle ache Erythema nodosum (rash and painful lumps in lower legs
What happens to Acute pulmonary infection
Usually self limiintg,
may become disseminated
Also may lead to A chronic Pulmonary infections
Control of Coccidiomycosis
Cell-mediated immunity (CD4 T cells)
Commonnes of Disseminated and Chronic Coccidiomycosis
less than 1%
Who is most likely to get Disseminated and CHronic Coccidiomycosis
Dark people
Pregnant women
Immunocompromises
Disseminated an Chronic Coccidiomycosis can lead to
Cutaneous, subcutaneous, and osteoarticular infections that spread to other organs
Result of Chronic Meningitis of Coccidiomycosis
Complication can be fetal
Treating Chronic Meningitis of Coccidiomycosis
Life time antifungal
Diagnosis of Coccidiomycosis
Cultured
Histopathological analyis to seee if presence of spherules in tissues
Problem with Culturing Coccidiomycosis
Mold is highly infectious and may infect lab workers
treatment of Coccidiomycosis if chronic pulmonary infections
Itraconazole or fluconazole for 12-24 months
Amphotericin B - if severe
