Fungus 2 Lecture Flashcards
hyphae vs mycelium
multicellular filaments vs
multiple hyphae
hylaine vs dematiaceous fungi
colorless vs brown-black
saprophyte
any organism that lives on dead organic matter
basidiobolomycosis
basidiobolus ranarum
children in tropics vis arthropod bite/trauma
solitary painless indurated subcu nodule or swelling of thigh/buttocks
protothecosis
algea (not true fungus) prototheca wickerhamii tropics cause of olecranon bursitis in immunocompetent dissemination in immunocompromised
sporotrichosis organism? forms? biopsy? treatment?
sporothrix schenckii
rose gardener’s ds (carnations, roses, sphagnum)
cats can be carriers
3 forms:
- lymphocutaneous - naive
- fixed cutaneous - prior exposure
- disseminated/lung - immunocompromised
bx: asteroid bodies = eosinophilic material surrounding cigar bodies (yeast cells)
tx: potassium iodide (pot some roses) or itraconazole
effect when increasing doses of exogenous iodide inhibit thyroid hormone pdtn –> hypothryoidsim
Wolff-Chaikoff effect
DDx sporotrichoid lesions
SLANT sporotrichosis leishmaniasis atypical mycobacterium nocardosis tularemia, toxoplasmosis, tuberculosis (also glanders, cat scratch ds, anthrax)
mycetoma - 3 types? 3 characteristics?
actinomycetoma, eumycetoma, botryomyosis
draining sinuses, grains, tumorfaction
often on foot as painless papule
actinomycetoma bx? txt?
thin branching gram + filatments
a. israelii - PCN
n. asteroides & n. brasiliensis - sulfas
eumycetoma cause? txt?
fungal
thick filamentous hyphae
txt: surgery, azole
cause of lumpy jaw
a. israelii
chromoblastomycosis 6 dematiaceous fungi
Fond of Pedro's Compact Monochromatic Car Fonsecaea pedrosoi (mcc) F. compacta F. monophora Phialophora verrucosa Cladophialophora carrionii Rhinocladiella aquaspera
chromoblastomycosis presentation
foot/leg papule –> verruca –> granuloma
direct extension, regional LAD
rarely SCC in long standing lesions
bx: medlar bodies (copper pennies)
lobomycosis aka? cause? presentation? bx?
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
rhinosporidiosis cause? presentation? txt? bx?
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
coccidiodomycosis
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
histoplasmosis
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)
african histoplasmosis
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
parasitized histiocytes
His Pen GRL histoplamosis penicillosis granuloma inguinale rhinoscleroma leishmaniasis
north american blastomycosis
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
south american blastomycosis
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
aspergillosis
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
zygomycosis
phycomycosis
entomopthorales (subcu) and mucorales (opportunistic)
giant molluscum-like lesions
CCHIP cyptococcosis coccidioidiomycosis histoplasmosis penicillium
