ID Medical Mycology II - Dimorphic Fungi Flashcards

1
Q

Dark, moist habitat
Moderate temperature
Do not attack mammals (CMI)

A

Fungi

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2
Q
  • Restricted habitat
  • Convert to yeast to survive at higher temperatures (thermal dimorphism)
  • May infect normal and IC hosts
  • Most commonly a granulomatous response
A

Dimorphic fungi

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3
Q

Dimorphic Fungi- Often more clinical disease in _____

A

males

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4
Q

Mississippi and Ohio River basins

Also Africa/ India

A

Blastomyces dermatitidis

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5
Q

Is blasto usually symptomatic

A

not usually

can go to lungs (fever/cough)

disseminates to skin/bone

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6
Q

Blasto buzz words

A

Pyogranulomatous response

Broad-based budding yeast

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7
Q

We thought it was Coccidioides immitis, we saw it in AZ and NM, but now we call this new thing

A

Coccidioides posadasii

disease: Pulmonary coccidioidomycosis

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8
Q

Coccidioidomycosis usually present with ?

A

erythema nodosum

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9
Q

Coccidioidomycosis disiminates to

A

bone and skin

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10
Q

Coccidioidomycosis makes what form in body

A

Spherules

can be full of spores

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11
Q

Coccidioidomycosis buzzwords

A

Diagnostic forms
Spherules
Alternating arthroconidia
confirmed by positive DNA probe

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12
Q

Highest in Mississippi-Ohio River Valley region

A

Blastomycosis

B. dermatidis

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13
Q

Any detectable antibody for coccidioides is what?

A

Active disease

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14
Q

Histoplasmosis

Disease

A

–Primary pulmonary infection: mild flu-like; may have erythema nodosum

–Chronic pulmonary infection: chronic calcified nodules (looks like TB on CXR)

–Disseminated: rare, usu immunocompromised: oropharyngeal ulcers (tongue), bone, liver, spleen and adrenals

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15
Q

Soil saprophyte found in dry, sandy, and alkaline soils associated with hot summers and mild winters

A

Coccidioidomycosis

Coccidioides immitis

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16
Q

Paracoccidioidomycosis
Paracoccidioides brasileinsis
Disease

A

–1o pulm disease: cough dyspnea, fever, weight loss or asymp

–2o disease: –> acute pulmonary disease (usually in immunocompromised), but more commonly chronic progressive; loves mucocutaneous surfaces; regional LAD

17
Q

Soil saprophyte found in subtropical humid mountain forests of South America; GI tract of bats

A

Paracoccidioidomycosis

Paracoccidioides brasileinsis

18
Q

Seen in rural areas, often where coffee is grown

Affects Adults and Males

A

Paracoccidioides brasiliensis

19
Q

Frequently assoc with birds, esp starlings or bat excreta

Highest in Ohio-Mississippi Valley (lots of starlings)

A

Histoplasmosis

Histoplasma capsulatum/ Ajellomyces capsulatus

20
Q

Paracoccidioidomycosis

Disease

A

Edentulous
Cervical Lymphadenopathy
Chronic pulmonary disease

21
Q

What 2 fungi can you treat with Bactrim

A

PCP

and

Paracoccidioidomycosis

22
Q

hematogenous spread from lungs; most commonly affects skin (50%) > bone (25-50%) >GU system, esp prostate (5-22%)

A

Systemic Blastomycosis

B. dermatidis

23
Q

may manifest lung nodules, chronic cavitary disease and coccidiosis (granulomas with caseating necrosis); most commonly disseminates to bone > meninges > skin

A

Systemic Coccidioidomycosis

24
Q

Unusual fungal organism that lacks ergosterol (used to be thought of as protozoan)

A

Pneumocystosis

Pnemocystis jiroveci/carinii

25
Q

Very small yeast, usually in macrophages

Urine antigen test

A

Histoplasmosis

26
Q

KOH of ulcers or sputum

Biopsy (“mickey mouse” or “pilot wheel” appearance)

A

Paracoccidioidos

27
Q

Coccidioidomycosis making the DDx

A

Mycelial phase

  • Macro: glabrous but become white
  • Micro: alternating “barrel-shaped” arthrospores
Yeast phase: thick walled spherules with endospores
KOH of skin, sputum
-PCR
-Serology
-Complement fixation titer
28
Q

Blastomycosis making the DDx

A
  • KOH of skin or sputum (find in 60%)
  • Culture
  • Biopsy
  • Serology
  • DNA probe
  • Urine antigen test
29
Q

Hyperendemic in peru
Introduced by skin trama
Mostly in Men and Kids

A

Sporothrix schenckiiSporothrix brasiliensis

Big outbreak in rio de janeiro from cats at the moment

30
Q

Only Zoonosis dimorphic

A

Sporothrix schenckiiSporothrix brasiliensis

31
Q

Disseminated sporotrichosis

A

Joint
Bone
Lung
Meninges

32
Q

Disseminated sporotrichosis

Host Risk Factors

A

Host Risk Factors

ETOH
Diabetes
Late HIV
COPD

33
Q

Southeast Asia
Bamboo rat range
HIV patients

A

Talaromyces (Penicillium) marneffei

34
Q

Red diffusible pigment
“Skeleton hands”
Yeast conversion

A

Talaromyces (Penicillium) marneffei

35
Q

Treatment of Sporotrichosis

A

Itraconazole

Bad= Liposomal amphotericin