[Lec] MU5.1: Systemic Mycoses Flashcards
T/F:
Any fungus, in an immunocompromised host, has the potential to become invasive and disseminate to sites far removed from the portal of entry.
T
T/F:
The teleomorph of H. capsulatum is named Ajellomyces dermatitidis.
F; Ajellomyces capsulatus
T/F:
Histoplasmosis is also known as Spelunker’s Disease
T
T/F:
People get paracoccidioidomycosis after breathing in the fungus Paracoccidioides from the environment in certain parts of Central and South America.
T
T/F:
Vaccine is already available for Valley fever.
F;
there is no approved vaccine for Valley fever (coccidioidomycosis), although research is ongoing to develop one
fungal infections of the which can overcome the physiological and cellular defenses of the normal human host
Systemic Mycoses
Systemic Mycoses:
infection occurs by?
inhalation of airborne conidia
Fungal infection of internal organs
Systemic Mycoses
Agents of Systemic Mycoses
- Blastomyces dermatitidis
- Coccidioides spp. (C. immitis, C. posadasii)
- Histoplasma capsulatum
- Paracoccidioides brasiliensis
2 Coccidioides spp.
Coccidioides immitis
Coccidioides posadasii
Blastomycosis:
Causative agent
Blastomyces dermatitidis
What disease:
a chronic infection with granulomatous and suppurative lesions that is initiated in the lungs
Blastomycosis
Blastomyces dermatitidis:
most prevalent in?
middle-aged men
Blastomycosis:
symptoms are often similar to ____
flu
T/F:
Blastomycosis’ pathogenesis includes fever, malaise, night sweats, cough, myalgias
T
What disease:
when dissemination occurs, skin lesions on the exposed surfaces
Blastomycosis
What disease:
when dissemination occurs, ulcerated granulomas with advancing border and central scarring
Blastomycosis
What disease:
when dissemination occurs, border with abscesses and sharp, sloping edge
Blastomycosis
Odd One Out:
Specimen for Blastomycosis
a. Sputum
b. Pus
c. Exudates
d. Blood
e. Urine
f. Biopsies from Lesion
d. Blood
What disease:
Microscopic morphology:
round, multinucleated, budding cells with double refractile wall
Blastomycosis
Blastomycosis:
Culture medium: cultivation in SDA
Morphology of colonies: ______
white or brownish colonies
Blastomycosis:
Culture medium: cultivation in enriched BAP
Morphology of colonies: ______
wrinkled, waxy and soft colonies
Blastomycosis:
2 Serological tests
CFT
immunodiffusion tests
Blastomycosis:
3 Clinical Types
- Pulmonary
- Cutaneous
- Disseminated
Blastomycosis:
mold that produces ________ ________, released into air, enter lungs, transform into _________
fungal spores
yeast
T/F:
Blastomycosis occurs in certain humid, high-rainfall areas of Central and South America, particularly in countries such as Brazil, Colombia, and Venezuela
F; Paracoccidioidomycosis
T/F:
Blastomycosis, Cocciodioidomycosis, Histoplasmosis, and paracoccidioidomycosis are contagious.
F; all are not contagious
(no person-to-person transmission)
T/F:
Blastomycosis, Cocciodioidomycosis, Histoplasmosis, and paracoccidioidomycosis cannot be acquired by pets.
F; all can be acquired by pets
T/F:
Blastomycosis can be prevented by reduced exposure to high-risk environments, use of protective gear, and limiting pets’ access to contaminated areas.
T
Blastomycosis:
Treatment
Amphotericin B
Itraconazole
Coccidioidomycosis:
also known as?
Valley fever or San Joaquin Valley fever
Coccidioidomycosis:
Causative agents
Coccidioides immitis
Coccidioides posadasii
What species:
probably the most virulent of all human mycotic agents
Coccidioides spp.
What species:
causes Coccidioidomycosis
Coccidioides spp.
What species:
asymptomatic pulmonary disease and allergic manifestations
Coccidioides spp.
T/F:
Coccidioides spp: primary disease usually resolves with therapy and confers a weak specific immunity to reinfection.
F;
resolves WITHOUT therapy
confers a STRONG specific immunity
T/F:
In Coccidioidomycosis, infection is self-limited.
T
T/F:
In Coccidioidomycosis, dissemination is rare but maybe fatal.
T
T/F:
In Coccidioidomycosis, patients with primary infection are symptomatic.
F;
asymptomatic
Odd One Out:
Coccidioidomycosis’ signs and symptoms
a. myalgia
b. fever
c. malaise
d. cough
e. headache
a. myalgia
Coccidioidomycosis:
Late-stage patient forms a hypersensitivity reaction
in the form of __________ or __________
erythema nodosum
erythema multiforme (rashes)
What disease:
Many develop influenza-like fever
Coccidioidomycosis
What disease:
clinical features include allergic manifestations
Coccidioidomycosis
What disease:
< 1% develop chronic progression disseminated disease
Coccidioidomycosis
What disease:
Clinical features include:
skin: granuloma, cold abscess
Coccidioidomycosis
What disease:
Clinical features include:
osteomyelitis & synovitis
Coccidioidomycosis
What disease:
Clinical features include:
CNS (meningitis)
Coccidioidomycosis
Odd One Out:
Specimen for Blastomycosis
a. Sputum
b. Blood
c. Pus
d. CSF
e. Tissue Biopsy Material
b. Blood
What disease:
mold with septate hyphae
Coccidioidomycosis
Coccidioidomycosis:
septate hyphae fragment into ________, inhaled and become _________
arthroconidia
spherules
Coccidioidomycosis:
spherules contain _________ which disseminate within surrounding tissues and develop into new spherules
endospores
What disease:
Microscopic morphology:
spherule with thick, double refractile wall and endospores form within the spherule and fill it
Coccidioidomycosis
Coccidioidomycosis:
Culture medium: cultivation in SDA
Morphology of colonies: ______
white to tan colony
Coccidioidomycosis:
2 Serological tests
immunodiffusion
latex agglutination test
T/F:
Higher risk of acquiring Valley fever depends on geographic location, immunocompromised status, age, and occupation.
T
T/F:
If you had Valley fever before, you can acquire it again.
T; previous infection does not guarantee immunity against future infections
T/F:
Histoplasmosis can be prevented by avoiding dust exposure and use protective measures in endemic areas.
T
T/F:
There is a vaccine for valley fever.
F; no vaccine
Valley Fever:
Treatment
Amphotericin B
Itraconazole
Histoplasmosis:
causative agent
Histoplasma capsulatum
What disease:
an intracellular infection of the reticuloendothelial system caused by the inhalation of the fungus
Histoplasmosis
What species:
present in soil, rotting areas and in feces of chicken, bats, other birds (high Nitrogen content)
Histoplasma capsulatum
What species:
endemic in parts of the USA
Histoplasma capsulatum
Histoplasma capsulatum:
first described by?
Samuel Darling
What disease:
an intracellular mycosis of the reticulo-endothelial system
Histoplasmosis
T/F:
Histoplasmosis is self-limited
T
Odd One Out:
Histoplasmosis signs and symptoms:
a. fever
b. chills
c. rash
d. myalgias
e. headaches
f. non- productive cough
c. rash
What disease:
severe disseminated ___________ -> RES involved, with lymphadenopathy, enlarged spleen, liver, high fever, anemia
Histoplasmosis
Odd One Out:
Specimens of Histoplasmosis:
a. Plasma/ Serum
b. Sputum
c. Urine
d. Scrappings from lesions
e. Bone Marrow biopsy
f. Skin
g. Lymph node
a. Plasma/ Serum
What species:
small, ovoid cells intracellularly in histologic section stained with Gomori methanamine silver or Giemsa stain
Histoplasma capsulatum
Histoplasma capsulatum:
stains
Gomori methanamine silver or Giemsa stain
Histoplasma capsulatum:
Cultivation in SDA
Colony morphology: ___________
white to tan cottony colonies
Histoplasma capsulatum:
Serological tests
latex agglutination
precipitation
immunodiffusion test
Choose 2: Histoplasmosis
a. persistent
b. limited
c. symptomatic
d. asymptomatic
Histoplasmosis
b. limited
d. asymptomatic
What disease:
acute pulmonary disease,
reactivation occurs
Histoplasmosis
What disease:
Chronic pulmonary ________ in patients with chronic obstructive pulmonary disease (COPD)
Histoplasmosis
What disease:
Cutaneous and Mucocutaneous
Histoplasmosis
What disease:
Mold with aerial hyphae
Histoplasmosis
What disease:
The hyphae produce macroconidia and microconidia
Histoplasmosis
T/F:
Individuals with weakened immune systems acquire histoplasmosis
T
T/F:
If you had histoplasmosis, you can get it again.
T; reinfection can occur, especially in individuals with weakened immune systems.
T/F:
Pets can acquire histoplasmosis.
T; While it is rare, pets, particularly dogs, can become infected
T/F:
Histoplasmosis can be prevented by avoiding high-risk areas, protective equipment, good hygiene practices
T
Histoplasmosis:
treatment
Itraconazole
Paracoccidioidomycosis:
causative agent
Paracoccidioides brasiliensis
What disease:
a chronic progressive fungal disease endemic to Central and South America
Paracoccidioidomycosis
What species:
geographic areas of highest incidence are typically humid, high-rainfall areas, with acidic soil conditions
Paracoccidioides brasiliensis
What species:
the organism produces multiple blastoconidia from a single cell
Paracoccidioides brasiliensis
What species:
signs and symptoms include oral mucous membrane lesion
Paracoccidioides brasiliensis
What species:
dissemination to spleen, liver, mucous membrane and skin
Paracoccidioides brasiliensis
Odd One Out:
Specimens for Paracoccidioidomycosis
a. Sputum
b. Blood
c. Exudates
d. Material from Lesion
b. Blood
What species:
thick-walled yeast cell with multiple buds
Paracoccidioides brasiliensis
Paracoccidioidomycosis:
serological tests
CFT
Immunodiffusion test
What disease:
usually unapparent and asymptomatic acute or chronic, granulomatous infection
Paracoccidioidomycosis
Paracoccidioidomycosis:
primarily of what organ?
lungs
T/F:
Paracoccidioidomycosis disseminates to skin, mucosa, lymph nodes and other internal organs.
T
T/F:
People exposed to moist, wounded environments in endemic regions, particularly middle-aged men, outdoor workers, and immunocompromised individuals have a higher risk of acquiring Paracoccidioidomycosis.
F; Blastomycosis
T/F:
Paracoccidioidomycosis can be prevented by avoiding high risk areas, wearing PPE, education and awareness, and health monitoring.
T
T/F:
Sources of Paracoccidioidomycosis include environmental sources, soil, animal reservoir, fecal matter
T
Paracoccidioidomycosis:
Treatment
Itraconazole
Amphotericin B
SXT
Ketoconazole
What disease:
Mycotic agent is usually recovered from soil that contains bird or bat droppings.
Histoplasmosis
What disease:
North America Blastomycosis is also known as?
Gilchrist disease
What species:
Teleomorphic state of H. capsulatum
Ajellomyces capsulatus
What disease:
Mycotic agent reside in a narrow ecologic niche known as the Lower Sonoran life zone
Coccidioidomycosis