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
Very small yeast, usually in macrophages | Urine antigen test
Histoplasmosis
26
KOH of ulcers or sputum | Biopsy (“mickey mouse” or “pilot wheel” appearance)
Paracoccidioidos
27
Coccidioidomycosis making the DDx
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
Blastomycosis making the DDx
- KOH of skin or sputum (find in 60%) - Culture - Biopsy - Serology - DNA probe - Urine antigen test
29
Hyperendemic in peru Introduced by skin trama Mostly in Men and Kids
Sporothrix schenckiiSporothrix brasiliensis Big outbreak in rio de janeiro from cats at the moment
30
Only Zoonosis dimorphic
Sporothrix schenckiiSporothrix brasiliensis
31
Disseminated sporotrichosis
Joint Bone Lung Meninges
32
Disseminated sporotrichosis | Host Risk Factors
Host Risk Factors ETOH Diabetes Late HIV COPD
33
Southeast Asia Bamboo rat range HIV patients
Talaromyces (Penicillium) marneffei
34
Red diffusible pigment “Skeleton hands” Yeast conversion
Talaromyces (Penicillium) marneffei
35
Treatment of Sporotrichosis
Itraconazole Bad= Liposomal amphotericin