Micro Funcal and Parasitic Infections Flashcards
True Molds
Aspergillus (ubiquitous- burn pts)
Mucor
True Yeasts
Cryptococcus neoformans (AIDS assoc-meningitis) Candida albicans
Dimorphic Fungi
mold in the cold
yeast in the beast (pathogenic form)
Blastomyces
Coccidioides (super common- can go to brain)
Histoplasma
“can have both shapes”
inhaled from soil
Yeast: spherule
Coccidioides immitis
SW U.S., San Joaquin Valley “Valley fever”
Fever, cough, chest pain, weight loss (segmental or lobar pneumonia)- Typical Pneumonia
Progressive pulmonary disease (nodules can lead to cavitation)
PE: rales, pleural rubs, wheezing
Erythema nodosum*
Can disseminate (AIDS pts to the brain)
C. immitis
pac-man image
KOH prep of tissue
Sabouraud dextrose
Serology, CXR
Treatment C. immitis
Ketoconazole (or fluconazole alt.)
Amphotericin B for pregnancies
Decaying matter
Dimorphic fungus
yeast: broad based budding yeast
Blastomyces dermatitidis
mold: hyphae w/nondescript conidia
Acute onset, lobar infiltrates, higher fever cough
Skin (cover in derm) and bones
CNS in AIDS pts
Blastomyces dermatitidis
Microscopy (3Bs) followed by culture
serology available, not useful
Treatment of B. dermatitidis
very sick: Amphotericin B
Itraconazole used in immune competent adults
spelunking
Yeast: intracellular, infects WBC
Histoplasma capsulatum
inhale bat poo
Mold: hyphae w/ microconidia & tuberculate macroconidia
high intensity exposure:
acute: flu-like, cough, chest pain (CXR: patchy infiltrates)
Progressive: destruction and fibrosis of pulmonary tissue
Histoplasma capsulatum
Intracellular yeast in WBC(macrophages)
ELISA of plasma
Sabouraud dextrose agar
Treatment of H. capsulatum
severe: IV amphotericin B
mild: intraconazole
Sabouraud dextrose
grows fungi only
KOH prep of tissue
not bacteria not virus
Ohio, Mississippi River, Great Lakes
Ohio, Mississippi river basin, Missouri
Blastomyces Dermatidis
Histoplasma capsulatum
Fever, cough, chest pain, weight loss (segmental or lobar pneumonia)
Signs of Typical pneumonia
Are spherules infective?
no they just push on lung tissue causing issues.
-azoles
teratogenic
Pilot’s wheel-multiple budding yeast
South America
Paracoccidioidomycosis
treat itraconazole
How is aspergillosis transmitted?
inhaled: air soil, decaying matter
shower heads, water tanks, plants
Three types of allergic Aspergillosis
IgE-mediated asthma: eosinophilia
Allergic Bronchopulmonary aspergillosis (ABPA)
Farmer’s lung- Type 3 hypersensitivity Rxn
Hypersensitivity Pneumonitis
Farmer’s lung over and over again
they present with fever, chills, malaise, nausea, dry cough, chest tightness, dyspnea
you can shut down their immune response with long term steroids
Aspergillosis non-invasive
fungal ball
granuloma can erode and leave an empty space where the fungal can grow
underlying disease of: cystic fibrosis, chronic bronchitis, TB
Aspergillousis invasive
rapidly fatal; immunosuppressed host
clinically pt presents as: fever, pulmonary infiltrates, chest pain, hemoptysis
