Fungi: Systemic Mycoses

Question 1

List the 4 systemic mycoses

Answer 1

1. Histoplasma
2. Blastomyces
3. Coccidiodes
4. Paracoccidoides

Question 2

Histoplasma capsulatum is associated with

Answer 2

bat and bird droppings (cave, chicken coops)

Question 3

Histoplasma capsulatum is endemic to

Answer 3

the midwestern and east central United States near the Ohio and Mississippi River valleys

Question 4

Histoplasma capsulatum is transmitted via

Answer 4

inhalation of mold spores

Question 5

Histoplasma and the lungs

Answer 5

macrophages phagocytize the yeast form of Histoplasma capsulatum in the lungs (small oval yeast forms can be seen within macrophages on microscopy)

Question 6

Histoplasma capsulatum antigen can be detected in body fluids such as ________ during infection

Answer 6

1. serum

2. urine

Question 7

Histoplasma capsulatum yeast cells (intracellular oval bodies smaller than red blood cells) are seen within

Answer 7

macrophages on microscopy

Question 8

Histoplasma capsulatum is a

Answer 8

dimorphic fungus (grows as mold at 25-30°C and yeast at body temperature (35-37°C))

Question 9

Histoplasma capsulatum can cause

Answer 9

a variety of calcific deposits in the lungs (i.e. calcified mediastinal/hilar lymph nodes)

Question 10

the signs and symptoms of chronic histoplasmosis

Answer 10

the signs and symptoms of chronic histoplasmosis (cough, fatigue, weight loss, cavitations in the upper lobes of the lungs) clinically resemble reactivation (secondary) tuberculosis

Question 11

Histoplasma capsulatum infection is associated with

Answer 11

erythema nodosum (painful skin nodules that most commonly form on the shins)

Question 12

disseminated histoplasmosis can cause

Answer 12

hepatosplenomegaly

Question 13

disseminated histoplasmosis is primarily seen in

Answer 13

immunocompromised patients

Question 14

__________ are effective against histoplasmosis

Answer 14

azoles

Question 15

____________ is used to treat severe histoplasmosis

Answer 15

amphotericin B

Question 16

Blastomyces dermatitidis is endemic to the

Answer 16

eastern and central United States near the Ohio and Mississippi River valleys and the Great Lakes region

Question 17

Blastomyces dermatitidis is

Answer 17

a dimorphic fungus (grows as mold at 25-30°C and yeast at body temperature (35-37°C))

Question 18

Blastomyces dermatitidis is transmitted via

Answer 18

inhalation of mold spores

Question 19

the yeast form of Blastomyces dermatitidis

Answer 19

the yeast form of Blastomyces dermatitidis produces a single broad-based bud with a double refractile cell wall approximately the same size as red blood cells

Question 20

chest X-ray findings of blastomycosis are

Answer 20

chest X-ray findings of blastomycosis are highly variable, but most commonly include patchy opacities or densities

Question 21

blastomycosis can lead to

Answer 21

pulmonary granuloma formation

Question 22

disseminated blastomycosis

Answer 22

disseminated blastomycosis (skin, bone, and genitourinary involvement) occurs in immunocompromised patients

Question 23

in immunocompromised patients, disseminated blastomycosis can affect the

Answer 23

1. skin (often manifesting as papules, pustules, ulcers, and verrucous lesions)
2. bones (often manifesting as bone pain caused by lytic lesions)

Question 24

Blastomyces dermatitidis antigen can be detected in body fluids such as

Answer 24

urine

Question 25

_______ are used to treat mild to moderate blastomycosis

Answer 25

azoles (particularly itraconazole and fluconazole)

Question 26

_______ is used to treat severe blastomycosis

Answer 26

amphotericin B

Question 27

Coccidioides immitis a dimorphic fungus that causes

Answer 27

San Joaquin Valley fever

Question 28

Coccidioides immitis is endemic to the

Answer 28

southwestern United States and northern Mexico

Question 29

Coccidioides immitis is transmitted via

Answer 29

inhalation of mold spores

Question 30

mold spores of Coccidioides immitis are found in

Answer 30

mold spores of Coccidioides immitis are found in soil and can become airborne when the ground is disturbed (i.e. earthquakes, dust storms, farming)

Question 31

Coccidioides immitis is a

Answer 31

dimorphic fungus (grows as mold at 25-30°C and forms yeast-like spherules at body temperature (35-37°C))

Question 32

in tissue sample, Coccidioides immitis can be seen as

Answer 32

large, yeast-like spherules containing endospores

Question 33

the spherules of Coccidioides immitis

Answer 33

the spherules of Coccidioides immitis (large yeast-like structures containing endospores) are larger than red blood cells

Question 34

common manifestations of coccidioidomycosis

Answer 34

community-acquired pneumonia (usually presenting with chest pain, cough, and fever) and arthralgia are common manifestations of coccidioidomycosis

Question 35

chest radiography in primary coccidioidomycosis

Answer 35

may show unilateral infiltrates, ipsilateral hilar adenopathy, or pulmonary nodule formation, though it is unremarkable in up to half of patients

Question 36

coccidioidomycosis is associated with

Answer 36

erythema nodosum (painful skin nodules that most commonly form on the shins)

Question 37

extrapulmonary coccidioidomycosis

Answer 37

(most commonly skin, bone, joint, and CNS involvement) occurs in immunocompromised patients

Question 38

in immunocompromised patients, disseminated coccidioidomycosis can affect the

Answer 38

1. skin

2. bones

Question 39

in immunocompromised patients, disseminated coccidioidomycosis can cause

Answer 39

1. meningitis

Question 40

_________ are used to treat mild to moderate coccidioidomycosis

Answer 40

azoles (particularly itraconazole and fluconazole)

Question 41

_______ is used to treat severe coccidioidomycosis

Answer 41

amphotericin B

Question 42

Paracoccidioides brasiliensis is endemic to

Answer 42

Central and South America

Question 43

the multipolar budding yeast form of Paracoccidioides brasiliensis resembles a

Answer 43

captain’s wheel

Question 44

Paracoccidioides brasiliensis is a

Answer 44

dimorphic fungus (grows as mold at 25-30°C and yeast at body temperature (35-37°C))

Question 45

the multipolar budding yeast form of Paracoccidioides brasiliensis is

Answer 45

typically much larger than a red blood cell

Question 46

Paracoccidioides brasiliensis is transmitted via

Answer 46

inhalation of mold spores

Question 47

paracoccidioidomycosis can lead to

Answer 47

pulmonary granuloma formation

Question 48

disseminated paracoccidioidomycosis can cause

Answer 48

lymphadenopathy (most frequently cervical)

Question 49

chronic paracoccidioidomycosis often presents with

Answer 49

oral mucocutaneous lesions (painful ulcers with ragged borders and spots of hemorrhage)

Question 50

_______ are used to treat mild to moderate paracoccidioidomycosis

Answer 50

azoles (particularly itraconazole)

Question 51

_______ is used to treat severe paracoccidioidomycosis

Answer 51

amphotericin B