Fungus 2 Lecture

Question 1

hyphae vs mycelium

Answer 1

multicellular filaments vs

multiple hyphae

Question 2

hylaine vs dematiaceous fungi

Answer 2

colorless vs brown-black

Question 3

saprophyte

Answer 3

any organism that lives on dead organic matter

Question 4

basidiobolomycosis

Answer 4

basidiobolus ranarum
children in tropics vis arthropod bite/trauma
solitary painless indurated subcu nodule or swelling of thigh/buttocks

Question 5

protothecosis

Answer 5

algea (not true fungus)
prototheca wickerhamii
tropics
cause of olecranon bursitis in immunocompetent
dissemination in immunocompromised

Question 6

sporotrichosis organism? forms? biopsy? treatment?

Answer 6

sporothrix schenckii
rose gardener’s ds (carnations, roses, sphagnum)
cats can be carriers

3 forms:

1. lymphocutaneous - naive
2. fixed cutaneous - prior exposure
3. disseminated/lung - immunocompromised

bx: asteroid bodies = eosinophilic material surrounding cigar bodies (yeast cells)
tx: potassium iodide (pot some roses) or itraconazole

Question 7

effect when increasing doses of exogenous iodide inhibit thyroid hormone pdtn –> hypothryoidsim

Answer 7

Wolff-Chaikoff effect

Question 8

DDx sporotrichoid lesions

Answer 8

SLANT
sporotrichosis
leishmaniasis
atypical mycobacterium
nocardosis
tularemia, toxoplasmosis, tuberculosis
(also glanders, cat scratch ds, anthrax)

Question 9

mycetoma - 3 types? 3 characteristics?

Answer 9

actinomycetoma, eumycetoma, botryomyosis
draining sinuses, grains, tumorfaction
often on foot as painless papule

Question 10

actinomycetoma bx? txt?

Answer 10

thin branching gram + filatments

a. israelii - PCN
n. asteroides & n. brasiliensis - sulfas

Question 11

eumycetoma cause? txt?

Answer 11

fungal
thick filamentous hyphae
txt: surgery, azole

Question 12

cause of lumpy jaw

Answer 12

a. israelii

Question 13

chromoblastomycosis 6 dematiaceous fungi

Answer 13

Fond of Pedro's Compact Monochromatic Car
Fonsecaea pedrosoi (mcc)
F. compacta
F. monophora
Phialophora verrucosa
Cladophialophora carrionii
Rhinocladiella aquaspera

Question 14

chromoblastomycosis presentation

Answer 14

foot/leg papule –> verruca –> granuloma
direct extension, regional LAD
rarely SCC in long standing lesions
bx: medlar bodies (copper pennies)

Question 15

lobomycosis aka? cause? presentation? bx?

Answer 15

aka keloidal blastomycosis
locazia loboi
chronic subcu infection resemble keloids
infects bottlenose dolphin
bx: thick walled refractile spherules, only one or two buds, child's pop beads

Question 16

rhinosporidiosis cause? presentation? txt? bx?

Answer 16

rhinosporidium seeberi
aquatic protozoan
nasal mucosa or conjunctiva papillomatous warty lesions with grayish white flecks
txt: cipro, excision
bx: endospores like raspberries in large spherules

Question 17

coccidiodomycosis

Answer 17

aka san joaquin valley fever, desert rheumatism
coccidioides immitis

southwest w/ disruption of soil to 20 cm –> inhalation arthroconidia

primary pulmonary(morbilliform), hypersensitivity rxn (see erythema nodosum, erythema multiforme), disseminated pulmonary (face-abscesses, granulomas), primary cutaenous (nodules that ulcerate)

bx: spherules, unencapsulated, thick refractile wall. look like barrel cacti
txt: amphotericin b, fluconazole for meningitis

Question 18

histoplasmosis

Answer 18

darling’s ds
histoplasma capsulatum

mississippi and ohio river valleys, pigeons, caves
inhaled spores (aleurioconidia)

primary pulm (EN & EM)
primary cutaneous (chancre-type)
progressive dismeninated (mucocutaneous ulcerating plaques, giant molluscum like, purpura)

Question 19

african histoplasmosis

Answer 19

histoplasma duboisii
skin lesions more common: granulomas, mucocutaneous, EN, osteomyelitic
bx: round bodies in cytoplasm of macros (parasitized histiocyte) look like crushed pingpong balls
macroconidia look like suns

Question 20

parasitized histiocytes

Answer 20

His Pen GRL
histoplamosis
penicillosis
granuloma inguinale
rhinoscleroma
leishmaniasis

Question 21

north american blastomycosis

Answer 21

gilchrist’s disease
blastomyces dermatitides

SE US after rain, bevear lodges, mississippi
systemic: skin most common site for dissemination. verrucous, granulomatous, thick brown hyperkeratotic plaque

dx: KOH. bx: big broad based budding yeast (snowmen). cx: small round conididia on conidiophores (lollipops) - distinguish from t. rubrum
txt: itraconazole

Question 22

south american blastomycosis

Answer 22

paracoccidioides brasiliensis
brazil, men. armadillos harbor ds
17B-estriol inhibits transion from mycelial to tissue
mucocutaneous: moriform stomatitis on gingiva
lymphatic: cerival LAD like hodgkin’s
viseral
dx: complement
bx: mariner’s wheel (one large cell surrounded by little buds) = narrow based buds

Question 23

aspergillosis

Answer 23

risks: neutropenia, prolonged steroids
vasculotropic and angioinvasive –> necrotic skin lesions
aspergillus fumigatus = secondary cutaneous
bx: splendore-hoeppli phenomenon, 45˚ branching, bubbling in hyphae

aspergillus flavus = primary cutaneous
IV sites, erythematous macules/plaques, hemorhagic and necrotic ulcers
conidia w/ conidiophores (fruiting heads), 45˚ branching, bubbles
txt: amphoteracin b

Question 24

zygomycosis

Answer 24

phycomycosis

entomopthorales (subcu) and mucorales (opportunistic)

Question 25

giant molluscum-like lesions

Answer 25

CCHIP
cyptococcosis
coccidioidiomycosis
histoplasmosis
penicillium