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I3 Fungi-Yeasts, Molds, Dimorphics > Fungi-Yeasts, Molds, Dimorphics > Flashcards

Fungi-Yeasts, Molds, Dimorphics Flashcards

1
Q
  • Can cause superficial, localized or systemic infections.
  • Are free-living in nature and are usually acquired from the environment
  • Cause damage by eliciting inflammation or by direct invasion of tissue
A

Pathogenic Fungi

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2
Q

Where do pathogenic fungi live?

(exogenous)

A
  • Decaying Vegetation - Aspergillus
  • Pigeon Droppings - Crytococcus neoformans
  • Soil wih Bird and Bat Excreta - Histoplamsa capsulatum
  • Rose and Barberry Thorn - sporothrix Schenckii
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3
Q

Where do pathogenic fungi live?

(endogenous)

A
  • Skin and GI tract - Candida
  • Human skin rich in sebaceous glands - Malassezia
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4
Q

Primary Pathogenic Fungi Include…

A
  1. Blastomyces dematitidis
  2. Coccidioides Immitis
  3. Histoplamsa Capsulatum
  4. Spopthrix Schenckii
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5
Q

Opportunistic pathogenic fungi include…

A
  1. Aspergillus species
  2. Candida species
  3. Pneumocystis jirovecii
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6
Q

Compromised host defense that results in defective or low number of neutrophil may experience fungal invasion. What fungi are most likely responsible in this case?

A

Candida

Aspergillus

Mucor

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7
Q

Descibe superficial mycoses.

A

Limited to the outermost layers of the hair or skin. Mild infections with no or minimal inflammation.

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8
Q

What are some examples of Superficial Mycoses?

A
  • Black Piedra
  • White Piedra
  • Tinea Nigra
  • Tinea or pityriasis versicolor
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9
Q

What is this and how would you treat it?

A

This is an image of white piedra, a superficial mycosest, that causes white granules on hair shafts of genital and beard areas due to TRICHOSPORON BEIGELII

TX = shaving all hair; does not recur

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10
Q

How would you diagnose a superficial mycoses infection?

A

Wet monut of hair or skin with 10% KOH

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11
Q

What is this and how would you treat it?

A

Black Piedra, mild infection with no/minimal inflammation, superficial mycoses, that produces hard,gritty brown-black concentration on sclap hair due to PIEDRAIA HORTAE

TX= Shaving all hair; don’t recur

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12
Q

What is this and how would you treat it?

A

Tinea Nigra- a mild infection with no/minimal inflammation, superficial mycoses, that produces brown-black macules on palms>soles due to EXOPHIALA WERNECKII

TX = topical keratolytic agent or azole

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13
Q

What is this and how would you treat it?

A

Tinea or pityriasis versicolor, superficial mycoses, a mild infection with no/minimal inflammation that produces hyper- and hypo-pigmented confluent scaly macules on torso due to MALASSEZIA FURFUR

TX= Selenium sulfide sulfide 2.5% solution

Other keatolytic agents

Topical azole

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14
Q

How would you diagnose Cutaneous mycoses ?

A

Wet mount using 10% KOH with skin hair or nail scraping

Culture in media with cycloheximide and cloramphenicol to inhibit overgrowth of saprobic fungi and bacteria

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15
Q

Describe cutaneous mycoses.

A

Infect the keratinized tissues (epidermis, hair and nails) may elicit a cellular immune respons.

Consist of dermatophytes belonging to 3 genera:

  1. Microsporum
  2. Trichophyton
  3. Epidermophyton
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16
Q

What is this and how would you treat it?

A

Tinea Capitis, cutaneous mycoses

an infection of the keratinized tissue that may elicit a cellular immune response.

TX= oral terbinafine

itraconazole

ketoconazole & griseofulvin (rarely used)

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17
Q

What is this and how would you treat it?

A

Tinea Corporis, cutaneous mycoses

An infection of the keratinized tissues that may elicit a cellular immune response.

TX= topical terbinafine

naftifine

topical azoles

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18
Q

What is this and how would you treat it?

A

“Jock Itch” Tinea cruris, cutaneous mycoses

An infection of the keratinized tissues that may elicit a cellular immune response.

TX= topical terbinafine

naftifine

topical azoles

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19
Q

What is this and how would you treat it ?

A

Tinea Unguium (nails), cutaneous mycoses

An infection of the keratinized tissues that may elicit a cellular immune response.

TX= topical terbinafine

naftifine

topical azoles

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20
Q

What is this and how would you treat it?

A

Tinea Barbae, cutaneous mycoses

An infection of the keratinized tissues that may elicit a cellular immune response.

TX= topical terbinafine

naftifine

topical azoles

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21
Q

What is this ?

A

Trichophyton mentagrophytes

Dermatophyte of the Trichophyton genre of cutaneous mycoses

22
Q

What is this

A

Microsporum Gypseum in hair shaft

Dermatophyte of the Microsporum genre of cutaneous mycoses

23
Q

Describe Subcutaneous Mycoses.

A

Involves the dermis and subcutaneous tissue. Usually involves trauma for entry

Some infection may not respond to antifungal therapy and my need surgery.

Includes the following disease:

  1. Lymphocutaneous sporotrichosis
  2. Chromoblastomycosis
  3. Phaeohyphomycosis
  4. Eumycetoma mycetoma
24
Q

What is this?

A

DSZ= Lymphocutaneous Sporotrichosis

Causitve agent= Sporothrix Scheneckii (Dimorphic fungus)

Entry= implanted into skin by trauma

Clinical Manifestation= Nodule at site of entry ulcerates and form other nodules along lymphatic drainage channels

25
Q

A patient who presents like this. what would you do to diagnose and treat the patient? What would you see?

A

This patient ahs Lymphocutaneous sporotrichosis caused by the dimorphic fungus sporothrix schenckii.

Diagnose = culuture, You will see white mould that will darken to brown black with prolonged incubationat 25C and cigar shaped yeasts on biopsy

TX= Saturated solution of KI (potassium iodide)

Itraconazole

Amphotericin B

26
Q

What is this ?

A

Chromoblastomycosis, a subcutaneous mycoses

Causitive agent = Fonsecaea or Cladosporium

A warty, vegatative, caulifower like lesion.

27
Q

How would you diagnose and treat Chromoblastomycosis?

A

Diagnosis = histophathology with epithelil cell hyperplasia and copper colored spherical fungi, sclerotic or Medlar bodies

Treatment = surgical excision or cryosurgery, intraconazole, terbinafine

28
Q

What is this ?

A

Eumycotic mycetoma, subcutaneous mycoses

Causative agent = Pseudallescheria boydii and Madurall grisea (and also actinomyctes and bacteria)

Purulent drainae from sinus tracts

29
Q

A patient has eumycotic mycetoma. How would you diagnose and treat this?

A

Diagnosis = histopathology of grains from sinus tracts show fungal elements; culture

Treatment = surgical excision or amputation for extensive dsz with wide margins to prevent recurrence

* limited success with itraconazole and ketoconazole

30
Q

Describe Deep Tissue Fungal Infections

A

These infections are acquired from endogenous or environmental sources.

May invade the organs of the entire body.

Enter the bloodstream and disseminate.

This group of infections includes:

  1. Blastomyces dermatitidis
  2. Aspergillus species
  3. Coccidioides immitis
  4. Histoplasms capsulatum
  5. Candida species
  6. Cryptococcus neoformans
31
Q

Describe Primary Fungal Pathogens.

A

Infection that can affect a healthy host.

Often have geographic prdilection

Are inhaled and may cause chronic lung infection similar to TB

May cuase system or disseminated disease in the immunocompromised host

Include:

  1. Blastomyces dermatitidis
  2. Coccidioides immitis
  3. Histoplasma capsulatum
  4. Paracoccidioides brasiliensis
32
Q

Blastomyces dermatitidis

A

Dimorphic fungus

Entry = inhaled spores enter the lund

Dogs may develop similar diseases

Clinical manifestations =

Primary lung infection amy be unapparent

Chronic pneumonia and cavity

Disseminate to skin, bone, and urogential tract

33
Q

What is this and how would you treat it?

A

Blastomyces dermatitidis ( a primary fungal pathogen)

TX= itraconazole better then fluconazole for lung infection; ketoconazole rarely used

Amphotericin B for azole failures and disseminated infection

34
Q

These lab findings would confirm diagnosis of what primary fungal infection.

A

Blastomyces dermatitis

35
Q

These histological findings would suggest what primary fungal infection?

A

Balstomyces Dermititdis

36
Q

Coccidioidomycosis

A

Dimorphic fungus

Entry = inhaled spores enter lung

Clincial manifestations: Symptomatic lung infection in 40%

Chronic infection may result in lung cavity

Disseminates to CNS, Bone, Skin

Predispositions for dissemination: AIDS, Dark skinned individuals, pregnancy

37
Q

Coccidioides Immitis Diagnosis would include:

A

Diagnosis:

Culture

Biopsy

Complement fixation antibody: for disseminated disease and relapse

38
Q

Describe Coccidioides immitis pathology.

A

endospores (2-5micron) within spherules seen in pyogenic and granulomatous reaction

39
Q

How would you treat Coccidioides immitis?

A

Fluconazole better than itraconzale for lung infection; ketoconazole rarely used

Amphotericin B for azole failures and disseminated inection

40
Q

How would you treat this ?

A

This is coccidioides immitis.

Fluconazole better than intraconazole for lung infection: ketoconazole. Amphotericin B for azole failures and disseminated infection

41
Q

Histoplasma capsulatum

A

Dimorphic fungus

Found in soil contaminated by bird or bat excreta

Entry = inhaled spores lung

Clinical manifestations =Primary lung infection may be symptomatic in 5%

Lung lesion heals with calcification and fibrosis

Chronic pneumonia and lung cavity

Disseminate via bloodstream to all organs, esp in immunocompromised host

42
Q

Describe the pathology of Histoplasma capsulatum.

A

phasocytosed ovoid yeast found within monocytes and histiocyte; granulomatous reaction

43
Q

How would you treat this patient?

A

This patient has disseminated histoplasmosis.

TX = itraconazole better than fluconazole for lung infection; ketoconazole rarely used.

44
Q
A

Histoplasma capsulatum

45
Q
A

Histoplasma capsulatum

46
Q
A

Histoplasma capsultum

47
Q

“yeast like vessicle like mariner’s wheel”

A

Paracoccidioides brasiliensis

48
Q
A

Disseminated Blastomyces

49
Q
A

Disseminated Coccidioidomycosis

50
Q

Dimorphic fungus

Found in soil contaminated by bird or bat excreta

Entry: inhaled spores lung

Clinical manifestations:

» Primary lung infection may be symptomatic in 5%

» Lung lesion heals with calcification and fibrosis

» Chronic pneumonia and lung cavity

» Disseminate via bloodstream to all organs, especially in immunocompromised host

A

Histoplasma capsulatum

51
Q
A

Pulmonary Histoplasmosis

52
Q
A

Disseminated Histoplasmosis

I3 Fungi-Yeasts, Molds, Dimorphics (1 decks)

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