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Microbiology > L31: Fungal Infections of the Respiratory Tract > Flashcards

L31: Fungal Infections of the Respiratory Tract Flashcards

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Biology 101 flashcards
1
Q

Zygomycoses (mucormycosis)

A

Group of uncommon but potentially fatal infection caused by fungi belonging to Zygomycetes class; infection rare in normal healthy individuals but can occur in people with immunosuppression, diabetes, or burns

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2
Q

3 main genera of zygomycetes

A
  1. Rhizopus
  2. Absidia
  3. Mucor
    - -All have non-septate hyphae
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3
Q

Rhinocerebral zygomycosis

A

Most common form of zygomycosis, primarily diabetic patients, originates in sinuses

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4
Q

Where else can zygomycotic infections occur?

A

Zygomycotic infections of the lungs, skin and GI tract can occur in immunosuppressed or burn patients

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5
Q

Diagnosis of zygomycoses

A

In tissue section, broad aseptate hyphae are frequently observed branching at right angles

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6
Q

Treatment of zygomycoses

A

Amphotericin B

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7
Q

What causes candidiasis?

A

Yeast of the genus Candida (mostly Candida albicans)

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8
Q

Candida albicans

A

Considered normal flora and present in environment, exists in yeast, pseudohyphal, and hyphal forms

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9
Q

Oral candidasis (thrush)

A

Seen in infants, adults after steroids/antibiotics, AIDS patients

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10
Q

How does thrush present?

A

Diffuse erythema and white cheesy patches on the surface of the buccal mucosa, throat, tongue, and gums; plaques can be scraped or wiped away revealing lesion

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11
Q

Diagnosis of thrush

A

Direct observation of Candida in clinical material (generally don’t need cultures)

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12
Q

Treatment of thrush

A

Oral formulations (mouth washes or lozenges) of nystatin and azole compounds

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13
Q

Basic info about systemic mycoses

A

ALL present initially as pulmonary infection – diverse group of presentations, not opportunistic, found in environment, acquired by inhalation of fungal elements

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14
Q

Systemic mycoses that are dimorphic fungi (4 types)

A

Histoplasma capsulatum, Blastomyces dermatitidis, Paracoccidioides brasiliensis, Coccidioides immitis

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15
Q

Systemic mycoses that is encapsulated yeast

A

Cryptococcus neoformans (also has a worldwide distribution)

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16
Q

Regional trends of histoplasmosis

A

Most prevalent in distinct regions of North/Central America, endemic in Mississippi and Ohio River valleys

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17
Q

Cause of histoplasmosis

A

Histoplasma capsulatum; found in soil under humid climate conditions, infection acquired by inhalation of micro- or macroconidia from environment

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18
Q

Histoplasmosis transmission

A

From bird/bat droppings, gets inhaled and can survive in macrophages (converts to yeast form and replicates there) – normally immune system takes care of it on its own

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19
Q

Pulmonary histoplasmosis

A

Mild flu-like illness with dry cough, fever, fatigue – can sometimes cause small calcifications on CXR

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20
Q

Chronic pulmonary and disseminated histoplasmosis

A

Typically occur in immunocompromised individuals – experience fever, night sweats, anorexia, weight loss, fatigue and respiratory symptoms – also hepatomegaly, splenomegaly, and lymphadenopathy

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21
Q

Diagnosis of histoplasmosis

A

Direct observation of organisms (yeast form) in tissues or clinical samples, cultivation of organisms from clinical samples, serology (detected Ag or Ab)

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22
Q

Treatment of histoplasmosis

A

Amphotericin B (but AIDS patients/immunosuppressed individuals need lifelong suppressive therapy with azoles)

23
Q

Regional trends of blastomycosis

A

Endemic in Ohio and Mississippi river valley and a little bit in Missouri and Arkansas river basins

24
Q

Cause of blastomycosis

A

Blastomyces dermatitidis (very large with very thick cell walls)

25
Q

Disease process of blastomycosis

A

Pulmonary disease with potential to disseminate, acquired through inhalation of spores from environment, normally asymptomatic

26
Q

Symptoms of acute blastomycosis

A

Cough, fever, chills, arthralgia, myalgia (may also mimic bacterial pneumonia with chest pain and sputum)

27
Q

Symptoms of chronic pulmonary blastomycosis

A

Cough, fever, night sweats, weight loss, sputum production (mimics TB)

28
Q

Symptoms of disseminated disease

A

Skin lesions and bone infections – must be treated

29
Q

Diagnosis of blastomycosis

A

Observation of distinct yeast forms in sputum or biopsy material

30
Q

Treatment of blastomycosis

A

Amphotericin B, azoles for uncomplicated pulmonary disease (if treated at all)

31
Q

Regional trends of paracoccidioidomycosis

A

Limited to tropical regions of South and Central America (90% of disease occurs in men)

32
Q

Cause of paracoccidioidomycosis

A

Paracoccidioides brasiliensis; forms ship’s wheel or Mickey Mouse ears

33
Q

Disease process of paracoccidioidomycosis

A

Most infections asymptomatic, pulmonary infection and disseminated disease possible

34
Q

Diagnosis of paracoccidioidomycosis

A

Observation, cultivation, and serology

35
Q

Regional trends of coccidioidomycosis

A

Throughout Western hemisphere, highly endemic in San Joaquin Valley (CA) and southern Arizona – follow drought-rain-drought pattern

36
Q

Life cycle of coccidioidomycosis

A

Arthrocanidia (big hyphae) break in pieces and blow around; once inside forms spherules (look like bags of yeast) inside body

37
Q

Disease process of coccidioidomycosis

A

Most individuals asymptomatic, pulmonary disease can be mild to moderate influenza-like syndrome – normally spontaneously resolves

38
Q

Disseminated disease in coccidioidomycosis

A

Rare, develops within one year of infection, infects bones, joints, skin, and CNS (“desert rheumatism”)

39
Q

Coccidial meningitis

A

Develops slowly with increasing headache, fever, stiff neck, and other neurological signs

40
Q

Diagnosis of coccidioidomycosis

A

Observation (spherule!), cultivation, serology

41
Q

Treatment of coccidioidomycosis

A

Azole or Amphotericin B

42
Q

Cryptococcosis basics

A

Found throughout the world, leading form of fungal meningitis

43
Q

Cause of cryptococcosis

A

Cryptococcus neoformans (NOT DIMORPHIC, encapsulated yeast), can be isolated from environment – comes from pigeon/bird droppings

44
Q

Fungal meningitis

A

Most commonly recognized form of cryptococcal infection, develops slowly and causes intermittent bouts of headache, irritability, dizziness and other CNS – life-threatening (common in AIDS patients)

45
Q

Diagnosis of cryptococcosis

A

India ink stain, cultivation, serology

46
Q

Pneumocystis jiroveci (carinii) pneumonia (PCP)

A

Highly lethal, occurs mostly in immunocompromised (AIDS)

47
Q

P. jiroveci

A

Eukaryotic organism, related to fungi – not much known about it

48
Q

Presentation of PCP

A

Initiated through inhalation of cysts, asymptomatic infection in healthy individuals but when symptomatic = dyspnea, nonproductive cough, fever

49
Q

Diagnosis of PCP

A

Identification of organisms (trophozoite, sporozoites, cysts) in clinical material

50
Q

Basics of aspergillosis

A

Aspergillus (many diff. species), rarely pathogenic in normal individual, wide range of clinical disease in immunocompromised individuals

51
Q

2 main fungal causes of aspergillosis

A

A. fumigatus and A. flavus – not dimorphic, septic hyphae that grow inside our tissues

52
Q

Acute pulmonary infection (aspergillosis)

A

Colonization of pre-existing lung lesions with “fungus balls” that are typically unilateral and asymptomatic

53
Q

Invasive/disseminated/systemic infection

A

Occurs primarily in leukemia, neutropenia, or organ/marrow transplant patients, often fatal if not detected

Microbiology (20 decks)

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