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Skin > Fungi > Flashcards

Fungi Flashcards

1
Q

Basic character of fungi

A

Mold or yeast forms

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2
Q

Cell type of fungi

A

Eukaryotic with outer wall and cell membrane

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3
Q

Classification of fungi

A

spores; typical disease caused

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4
Q

Cell wall of fungi

A

Rigid composed of chitin and glucan

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5
Q

Cell/particle membrane of fungi

A

Cell membrane has ergosterol instead of cholesterol

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6
Q

Reproduction of fungi

A

Sexual and/or asexual; spores; yeast budding

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7
Q

Coencytic hyphae

A

Hyphae with no septa

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8
Q

Septate hyphae

A

Hyphae with septa

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9
Q

Mycelium

A

Vegetative part of a fungus that is network of hyphae (mold)

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10
Q

Fruiting bodies

A

Macroconidia (with released conidia spores)

Endospores (conidia enclosed in a sporangium sac)

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11
Q

Yeasts fungal growth and morphology

A

Unicellular; reproduce - asexually by budding (blastoconidia) or sexually by fusion; growth on solid culture plates resembles bacterial colonies; most fungal pathogens can grow as yeast in the body

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12
Q

Molds fungal growth and morphology

A

Multicellular, grow as long, tube-like extensions of the cell wall; hyphae

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13
Q

What infection is associated with mycelia?

A

Mycetoma infection - chronic infection of skin and subcutaneous tissue (causes masses underneath the skin)

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14
Q

Reproductive structures of mold

A

Asexual: conidia and arthroconidia
Sexual: ascospores and basidiospores

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15
Q

Conidia

A

Produced by budding

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16
Q

Arthroconidia

A

Hyphal segments fragment into individual cells

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17
Q

Ascospores

A

produced in ascus sac

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18
Q

Basidiospores

A

produced in basidium

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19
Q

Dimorphism

A

Ability of a fungus to grow as a yeast or a mold depending on environmental conditions; dimorphic pathogens generally grow as yeasts at body temp (37C), molds in their natural soil environment (25C)

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20
Q

Superficial mycoses

A

Colonize outermost layers (keratinized) of skin, nails, and hair

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21
Q

Malassezia furfur labs and morphology

A

Spaghetti and meatball organization; KOH, calcofluor, PAS, standard medium with olive oil (cream)

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22
Q

Pityriasis (tinea) versicolor

A

hypo/hyperpigmented, irregular, well-demarcated macules (can be raised or scaled); predisposing factors - folliculitis, dacryocystitis (infection of lacrimal sac)

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23
Q

Hortaea (exophiala) werneckii labs and morphology

A

Black fungus, dematiaceous, branched hyphae, arthroconidia and elongate budding cells; KOH, H&E, sabouraud dextrose agar media = black mold

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24
Q

Tinea nigra

A

Palms and soles; solitary, irregular pigmented macule, no scaling or invasion into hair follicles; asymptomatic

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25
Q

Malassazeia furfur clinical disease

A

Pitariasis (tinea) versicolor

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26
Q

Hortaea (exophiala) werneckii clinical disease

A

Tinea nigra

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27
Q

Hortaea (exophiala) werneckii epidemiology

A
  • Less than 1% of fungal infections
  • (Sub)tropical
  • children and young adults
  • trauma in dermis
  • associated with water
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28
Q

Tricosporon spp. cause…

A

White piedra

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29
Q

Trichosporon spp. morphology and lab

A
  • Hyaline septate hyphae
  • Arthroconidia and some blastoconidia
  • Standard medium - cream-colored colonies
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30
Q

Piedraia hortae causes…

A

Black piedra

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31
Q

Piedraia hortae morphology and lab

A
  • Spindle-shaped ascospores within asci
  • Branched, pigmented hyphae
  • standard medium - velvety
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32
Q

White piedra

A
  • Groin, axillary, and less commonly scalp hair involved
  • hair stem covered with white fungus
  • no damage to hair shaft
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33
Q

Black piedra

A

Small, dark nodules on hair shaft (mostly involve the scalp)

34
Q

Cutaneous mycoses clinical disease

A

Cause dermatophytosis (tinea, ringworm)

35
Q

Symptomatic infections of cutaneous mycoses

A

Invasion of skin (corneum), hair, and nails (keratinized layers too)

36
Q

Morphology of cutaneous mycoses

A
  • Hyaline (translucent) septate hyphae

- Macroconidia vs micro help in identification

37
Q

Hair infection where arthroconidia form on outside of hair

A

Ectothrix

38
Q

Hair infection where arthroconidia form in inside of hair

A

Endothrix

39
Q

Hair infection where hyphae, arthroconidia, form in empty spaces of hair (air bubble appearance)

A

Favic

40
Q

Major symptoms of cutaneous mycoses

A

Itching
↑ inflammation – contracted from animals
↓ inflammation – contracted from human

41
Q

Tricophyton spp. cause which diseases…

A
  • Tinea pedis
  • Tinea corporis
  • Tinea cruris
  • Tinea capitis
  • Tinea barbae
  • Tinea unguium
42
Q

Epidermophyton floccosum cause which diseases…

A
  • Tinea pedis
  • Tinea cruris
  • Tinea unguium
43
Q

Microsporum spp. cause which diseases…

A
  • Tinea corporis

- Tinea capitis

44
Q

How can cutaneous mycoses be identified in general?

A

By microscopy (aided by KOH and stain)

45
Q

Tinea corporis

A

Ringworm of trunk and legs

46
Q

Tinea pedia

A

Athlete’s foot

47
Q

Tinea capitis

A

Scalp, eyebrows, lashes ringworm

48
Q

Tinea barbae

A

Ringworm of the beard

49
Q

Tinea unguium

A

Onychomycosis (nail infection)

50
Q

Fruiting bodies of microsporum canis

A
  • Macroconidia

- rough-walled, spindle-shaped (ends pointed)

51
Q

Fruiting bodies of trichophyton mentagrophytes

A
  • Macroconidia

- short, thin-walled, cigar-shaped (ends rounded)

52
Q

Fruiting bodies of trichophyton rubrum

A
  • Macroconidia

- Long, narrow, thin-walled pencil shape

53
Q

Fruiting bodies of epidermophyton floccosum

A
  • Macroconidia

- Smooth-walled, club-shaped

54
Q

Sporothrix schenckii morphology

A
  • Ubiquitous in soil
  • Dimorphic fungus
    • Room temp – Mold
    • 37°C – pleomorphic yeast
55
Q

Sporothrix schenckii mold phase morphology

A
  • Septate hyphae
  • Oval conidia
  • Conidiophore (stalk that carries conidia) rosette-shaped
56
Q

Sporothrix schenckii yeast phase morphology

A

Cigar-shaped bud

57
Q

Sporothrix schenckii epidemiology

A
  • Japan, North America, and South America - warmer climates
  • Most common in individuals who work outside (gardeners)
  • trauma (finger prick, cut)
  • Cats and armadillo – zoonotic transmission
58
Q

Sporothrix schenckii disease

A

Sporotrichosis

59
Q

Sporothrix schenckii labs

A
  • Culture is gold standard (SDA) and associated morphology

- Appearance of Splendore-Hoeppli material in H&E (asteroid body)

60
Q

Sporotrichosis

A
  • Primary nodule site presents as small nodule that may ulcerate
  • Secondary nodules present as a linear chain of painless subcutaneous nodules
    • Spread along lymphatic drainage
    • Nodules may ulcerate with pus discharge
61
Q

Chromoblastomycosis epidemiology

A
  • Rural areas of tropics
  • Involves legs and arms
  • In the Americas – F. pedrosoi – lower extremities
  • In Australia – C. carrionii – upper extremities
62
Q

Chromoblastomycosis biology and morphology of causative fungi

A
  • All species are dematiaceous (pigmented) molds
  • Morphologically diverse
  • In tissue, all spp form muriform cells (sclerotic bodies)
    • Chestnut brown due to melanin in cell wall
    • Divide by internal septation – cells have vertical and horizontal lines
  • Pigmented hyphae may be seen
63
Q

Chromoblastomycosis

A

-Chronic infection of skin and subcutaneous tissue; pruritic
Indolent (slow) growing verrucous nodules/plaques
-Presentation indicates a well-established infection
-Early lesions:
-Small, warty papules that grow slowly
-Established infection:
-Multiple, large cauliflower-like growths
-Hyperkeratotic lesions and fibrosis
-Complications
-Squamous cell carcinoma
-Bacterial infection

64
Q

Chromoblastomycosis labs

A
  • Scrapings from lesions
  • Microscopy (Muriform** cells)
    • 20% KOH treatment
    • Biopsy – H&E
  • Cayenne pepper appearance of lesions**
  • Fungal cultures
    • Slow-growing colonies
    • Dark pigments
    • Velvety appearance
65
Q

Mycetoma epidemiology

A
  • Predominant in tropics with low rainfall
    • Africa, India, Brazil, Middle East
  • Usually enters body through traumatic implantation**
  • Foot** most common location
66
Q

Mycetoma general biology and morphology

A
  • Result in granuloma formation that contain hyphae aggregates termed granules or grains**
  • Dematiaceous (black grain) or hyaline (pale or white grain)
  • Septate and branching hyphae** may be embedded in cement-like coating
  • Splendore-Hoeppli material present
67
Q

Mycetoma chronic disease

A
  • Clinical Triad: tumor, sinus tracts, granules
  • Early lesions:
    • Small, painless, subcutaneous nodules/plaques
  • Established infection:
    • Granulomas enlarge and sinus tracts form on surface
    • Serosanguineous fluid drainage (can send to lab)
    • Muscle and bone destruction – deformations
68
Q

Mycetoma complications

A

S. aureus infection

69
Q

Mycetoma immune reaction

A

Pseudoepitheliomatous hyperplasia

  • Hyperplasia (increased cell production) of the epidermis
  • Chronic inflammation
  • Generally benign
70
Q

Mycetoma labs

A
  • Scrapings from lesions
    • Microscopy (septate, branching hyphae with large swollen cells on edge)
      • 20% KOH treatment
    • Gram stain to eliminate bacterial infection
  • Histopathology
    • H&E stain
  • Fungal cultures
    • RT and 37°C for six to eight weeks
71
Q

Candida spp.

A

Opportunistic pathogen, yeast; normal commensal in human GI, vaginal tract, and skin

72
Q

Candida transmission

A
  • Endogenous – involves commensals on self

- Exogenous – hospital acquired

73
Q

Candida morphology

A
  • Oval yeast-like cells that produce buds (blastoconidia) and chlamydospores
  • Produce pseudohyphae** and hyphae
  • C. albicans forms germ-tubes**
74
Q

Candida virulence factors and pathogenesis

A
  • Adherence – Hyphal Wall Protein (attachment protein to epithelial cells)
  • Proteinases – hydrolyze host proteins (collagen and fibronectin) that are involved with host protection
  • Phospholipases – lecithinase that cleaves fatty acids from glycerol backbone of membrane phospholipids
  • Phenotypic switching** – expression of cell wall glycoproteins, proteolytic enzyme secretion, decreased susceptibility to oxidative damage by neutrophils
75
Q

Candida diseases

A

Cutaneous candidiasis, diaper dermatitis, paronychia**, perianal candidiasis, balanitis (balanoposthitis if prepuce), chronic mucocutaneous candidiasis

76
Q

Cutaneous candidiasis

A
  • Develops in folds of skin (intertrigo); armpits, groin, between fingers, and under the breasts
  • Warm, moist environments
77
Q

Diaper dermatitis

A
  • Secondary infection after bacterial infection

- Beefy red plaques, satellite papules, and pustules

78
Q

Paronychia

A

Nail-skin interface

79
Q

Predisposing factors to candidiasis

A
  • Immunosuppression (drug-induced, AIDS)
  • Neutropenia (WBC < 500/mm3)**
  • Burn victims
  • Assisted ventilation, indwelling catheters
  • Diabetics – high glucose impairs neutrophil function
  • Broad-spectrum antibiotic use
80
Q

Candida labs

A

KOH with calcofluor, PAS, GMS, Gram stain**
Cultures: smooth, white, creamy, domed colonies
Germ tube test:
-Cells incubated in serum for a few hours at 37C
-A slender structure protrudes out or cell (looks like a comma)

81
Q

Tinea cruris

A

Jock itch

Skin (9 decks)

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