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Microbiology Exam 1 > Lecture 14: Mycology 1 > Flashcards

Lecture 14: Mycology 1 Flashcards

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1
Q

Direct examination for diagnosis of fungi
KOH
PAS
GMS
H&E
GRAM
INDIA INK
Culturing

A

KOH: easier identification/ cheap/ quick
PAS: contrast b/w yeast/hyphae; pink-red
GMS: Fungal cell wall black
H&E: Fungi cytoplasm stains pink w/ blue nuclei
GRAM: stains mostly everything (dark purple) -bacteria
INDIA INK: for seeing capsule (stains background instead of fungal)
CULTURING: TO ID A PATHOGEN; agar plates- size, texture, color, colony

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2
Q

Most common oral fungal infection in humans and cause various opportunistic infections

A

Candidiasis

Risk factor- immuno compromised
Transmitted- person- to- person, nosocomial, fomites

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3
Q

Which fungal infection would cause sudden tooth mobility, perforation of hard palate, necrotic ulcerations, gingival thickening and halitosis

A

Mucormycosis

opportunistic pathogens
-canidiasis
-mucormycosis
-asperigillus

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4
Q

Which fungal infection can be invade and affect the soft palate, tongue and Gingiva. And is also known as an allergic fungal sinusitis?

A

Aspergillosis

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5
Q

Which fungal infection would show a proliferation or ulcerated oral lesions on the hard palate, gingiva, tongue, or lips?

A

Blastomycosis

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6
Q

Which fungal infection presents as acute, chronic, pulmonary or progressive disseminated disease?

A

Histoplasmosis

true pathogen
-blastomycosis- acute pulmonary/chronic pneumonia… diss- idk
-histoplasmosis- acute/chronic pulmonary disease
… diss- acute/subacute
-cocciodiomycosis

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7
Q

Which fungal infection presents as oral lesions, which may be verrucous and present w/ ulceration, can result from either primary or secondary infection?

A

Coccidioidomycosis

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8
Q

Which fungal infections are considered opportunistic?
Which fungal infections are considered true viral infections?

A

Opportunistic
-candidiasis
-mucormycosis
-aspergillosis

True viral infection
-blastomycosis
-histoplasmosis
-Coccidioidomycosis

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9
Q

Which fungal infections are considered opportunistic?
Which fungal infections are considered true viral infections?

A

Opportunistic
-candidiasis
-mucormycosis
-aspergillosis

True viral infection
-blastomycosis
-histoplasmosis
-Coccidioidomycosis

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10
Q

Candida infections in oral and perioral tissue (10)

A

-pseudomembranous candidiasis (oral thrush)= lesions on the palate
-chronic erythematous candidiasis= palatal mucosa on denture wearing
-plaque like/nodular candidiasis= at the commissary of upper and lower lips (mucosal)
-angular cheilitis
-acute atrophic candidiasis: “antibiotic sore mouth”, “bald tongue”=diffuse loss of Filiform papillae
-median rhomboid glossitis: “central papillary atrophy” = “kissing lesion” - chronic
-denture stomatitis: mild inflammation of oral mucosa membranes= chronic

-circumoral dermatitis: topical steroid over-use around the mouth
-generalized cutaneous candidiasis: diffused popular rash (infants)
-Intertrigo: ass. W/ obesity (in folds of skins)

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11
Q

Which candidiasis infection is known as “kissing lesion” on soft palate and known as a chronic infection?

A

Median rhomboid glossitis
Aka central papillary atrophy

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12
Q

Which candidiasis infection is known as “bald tongue”?

A

Acute atrophic
“Antibiotic sore mouth”
Diffuse loss of Filiform papillae
Xerostomia

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13
Q

Which candidiasis is known as oral thrush ?

A

Pseudomembranous candidiasis
-lesions on the palate

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14
Q

What candidiasis is involved w/ obesity due to an infection in creases and folds of skin

A

Intertrigo

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15
Q

What infection is known to newborn and its involved in a diffused erythematous popular rash?

A

Generalized cutaneous candidiasis

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16
Q

What infection is known to be associated with topical steroids over-use around the mouth?

A

Circumoral dermatitis = CANDIDIASIS INFECTION

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17
Q

What infection is known to be associated with topical steroids over-use around the mouth?

A

Circumoral dermatitis = CANDIDIASIS INFECTION

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18
Q

What is the term for when a candidiasis infection becomes systemic?

A

Candidemia
=the most common form and may disseminate to nearly any organ in the body.
=signs of sepsis, tachycardia, altered mental status, hypotension

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19
Q

What strain of candidia is newly emerging, drug-resistant and causing serious outbreaks?

A

C. Auris

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20
Q

Diagnosis for candidiasis vs. candidemia

A

Candidiasis
-clinical evaluation + infected tissue/blood will have budding yeast cells and pseudohyphae w/ contstrictions at the septa

Candidemia (systemic- invasive)
-blood culture- GOLD STANDARD TO ID
-B-D-Glucan detection

T2 candida panel= identification of species
PCR= identification of species

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21
Q

What is the gold standard to ID Candidemia?

A

BLOOD CULTURES

22
Q

Treatment for candiadiasis

A

-Amphotericin B
-Echinocandins
-fuconazole - (cocco-mycoses)
-nystatin

23
Q

Mucormycosis Is part of what species

A

Rhizopus

24
Q

Risk factors for Mucormycosis

A

DIABETES, LUNGS, GI, SKIN
-uncontrolled diabetes & severe COVID-19= Rhinocerebral Mucormycosis (most revenant to dentist)
-Immunocompromised = pulmonary Mucormycosis
-extreme malnutrition =GI Mucormycosis
-burn patients, wounds, and IV drug users = cutaneous Mucormycosis
different infection based on its localized

25
Q

Rhinocerebral Mucormycosis
-what is it?
-initial symptoms
-late symptoms

A

-severe infection of the facial sinuses extending into the brain (prevelenat in dentistry)
Initial symptoms: headache, facial pain, fever, hyposmia (smell decrease) nasal congestion/obstruction… BLACK DISCHARGE
Late: vision pobzzz, necrotic on nasal, palate face. Reduced level of consciousness

26
Q

Pulmonary mucormycosis
-risk factor
-symptoms

A

-immunocompromised
-bloody cough, fever, labored breathing
>70% death

27
Q

Gastrointestinal Mucormycosis
-risk factor
-symptoms

A

Extreme malnutrition
>70% mortality
Distension
Bloody stool
Abdominal pain
Bowel obstruction*
Vomiting/nausea

28
Q

Cutaneous mucormycosis
-risk factor
-symptoms

A

Burn patients
Cellulitis and progresses to dermal necrosis and black Escher formation

29
Q

Mucormycosis Pathogenesis
What type of WBC?

A

-hyphae invade vasculature and neuronal structures
NEUTROPHILS ARE KEY DEFENSE
-Innate immunity

30
Q

Diagnosis of Mucormycosis

A

-combo of observed symtoms and microscopic identification in tissue biopsy
-“twisted” “ribbon-like” appearance of broad, coenocytic hyphae

31
Q

Treatment Mucormycosis
Treatment of rhinocerebral disease

A

-Amphotericin B
-excision of orbital contents and involved brain

32
Q

Aspergillosis
-transmission

A

-inhalation transmission
-ubiquitous in air, soil, decaying matter

we breathe it in everyday

33
Q

Inhalation of conidia (aspergillus) with a lung disease patient

A

ASPERGILLOMA

34
Q

Inhalation of conidia In a asthma/cystic fibrosis patient

A

ALLERGIC BRONCHO-PULMONARY ASPERGILLOSIS

35
Q

Inhalation of conidia with chronic lung disease or mildly immunocompromised patient

A

Chronic pulmonary aspergillosis

36
Q

Inhalation of conidia in a immunocompromised host (severe) patients

A

Invasive pulmonary aspergillosis (increase mortality rate)

37
Q

ASPERGILLOMA
-occurs when?

A

You have to have a lung disease (like TB)
-mycetoma (fungus ball) forms in the cavity
Asymptomatic, caugh +fever

38
Q

ABPA allergic bronchopulmonary aspergillosis

A

-patients w/ asthma, and/or cystic fibrosis
-allergic reaction
-cough, wheezing, produce mucus plugs, shortness of breath
-bronchial casts
-little fungus in plugs

39
Q

Chronic pulmonary aspergillosis (CPA)

A

IN PATIENTS who are mildly immunocompromised w/ steroid-dependent COPD, or have chronic lung disease
-manifests as subacute pneumonia = fever, night sweats, cough, fever

40
Q

Invasive pulmonary aspergillosis (IPA)

A

PATIENTS that are severely immunocompromised host
-w/ or w/o blood cough, chest pain
-mortality increase even w/ treatment
-often disseminates (spleen most commonly infected)

41
Q

Pathogenesis for CPA & IPA

A

CPA= chronic pulmonary aspergillosis
IPA= invasive pulmonary aspergillosis
-inhaled conidia
-lack of innate immunity.. aspergillus will cause infection
NEUTROPENIA = BIGGEST RISK FACTOR

42
Q

Biggest risk factor for aspergillus

A

NEUTROPENIA

43
Q

Diagnosis of aspergillus

A

-ELISA = galactomannan
-B-D-GLUCAN

44
Q

ASPERGILLOMA diagnosis

A

Radiology and positive serology (IgG, IgE)

45
Q

ABPA diagnosis

A

Elevated total and aspergillus-specific IgE

46
Q

CPA diagnosis

A

Anti-aspergillus antibody testing (IgG or IgE) combined with/ radiology

47
Q

IPA diagnosis

A

Positive histology from affected organ = Hyphae have frequent septa
Positive culture from a normally sterile site

48
Q

CPA/IPA TREATMENT

A

Voriconazole

49
Q

ABPA TREATMENT

A

Itraconazole and
Oral corticosteroids

50
Q

ASPERGILLOMA treatment

A

Surgery
Yet 10% will spontaneously cough the fungus ball out

51
Q

Mucormycosis vs. aspergillosis identification differences

A

Aspergillosis = septa
Mucormycosis = no septa, irregular branching

Microbiology Exam 1 (16 decks)

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