fungus 5

Question 1

inhalation of what dust borne spores causes histoplasmosis

Answer 1

histoplasma capsulatum

Question 2

where is histoplasmosis most common in the US

Answer 2

the Ohio and Mississippi River valleys

Question 3

what accelerates sporulation of histoplasma in soils

Answer 3

avian or bat guano contamination

Question 4

what are risk factors for histoplasmosis

Answer 4

1. spelunking
2. demolishing chicken coops or barns
3. exposure to forests with large bird roosts
4. farming
5. excavation

Question 5

what ingest and sequester histoplasma within the human immune system

Answer 5

macrophages

Question 6

how long after exposure to histoplasma does cellular immunity develop

Answer 6

10-14 days

Question 7

what do macrophages develop histoplasma into in an immunocompetent host

Answer 7

granulomas

Question 8

how does primary histoplasmosis infection occur

Answer 8

when granuloma formation fails or is overcome by massive inoculum

Question 9

how does reactivation of histoplasmosis infection occur

Answer 9

occurs when immune system wanes and granulomas dissipate

Question 10

what are the two clinical presentations of histoplasmosis

Answer 10

1. asymptomatic prirmary infection
2. acute pulmonary histoplasmosis
3. chronic pulmonary histoplasmosis
4. disseminated histoplasmosis

Question 11

how long does it take for an asymptomatic primary infection to resolve?

Answer 11

1 month without any therapy

Question 12

mediastinal granulomas, pericarditis and rheumatologic syndromes are possible with what type of histoplasmosis

Answer 12

acute pulmonary histoplasmosis

Question 13

what is the treatment for mild to moderate acute pulmonary histoplasmosis

Answer 13

less than 4 weeks = no therapy

longer than 4 weeks = itraconazole

Question 14

what is the treatment for moderately severe or severe acute pulmonary histoplasmosis

Answer 14

liposomal amphotericin B
followed by itrasconazole
and methylprednisolone (with inflammation)

Question 15

what is the treatment of chronic cavitary pulmonary histoplasmosis

Answer 15

itraconazole for 1 year (longer if immunocompromised)

Question 16

what is the treatment for mild to moderate disseminated histoplasmosis

Answer 16

itraconazole

Question 17

what is the treatment for moderately severe or severe disseminated histoplasmosis

Answer 17

liposomal amphotericin B (or any other form)

followed by itraconazole

Question 18

what is the treatment for dissimenated histoplasmosis in the CNS

Answer 18

liposomal amphotericin B

followed by itraconazole (for a year)

Question 19

what other fungus is very similar to histoplasmosis pathogenically

Answer 19

blastomycosis

Question 20

what are the different clinical presentations of bastomycosis

Answer 20

1. acute pulmonary blastomycosis
2. chronic pulmonary blastomycosis
3. disseminated/ extrapulmonary blastomycosis

Question 21

what does chronic pulmonary blastomycosis mimic?

Answer 21

TB

Question 22

what is the least common but most fatal form of blastomycosis

Answer 22

in the CNS

Question 23

how are the signs of cryptococcosis different from histoplasmosis and blastomycosis

Answer 23

cryptococcosis symptoms are generally in the CNS; not in the lungs

Question 24

skin lesions are often seen with what two fungi

Answer 24

histoplasmosis and blastomycosis

Question 25

True/False severe histoplasmosis and blastomycosis are both treated with liposomal amphotericin followed by itraconazole

Answer 25

true