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Micro- Fungi + Parasites Flashcards

1
Q

Candida albicans

Morphology
Transmission and Reservoir

Diseases

Treatment and Prevention

A

yeast
———————–
- mouth, skin, GI tract, vagina
- occurs when there is a breach in the host immune defense
- usually endogenous infection
- can be passed between people in some instances
———————–
- oral thrush
- esophagitis
- vaginitis
- bloodstream infection
- abscesses
- catheter-associated UTI
- can disseminate to multiple organs
———————–
mucocutaneous:
- Nystatin
- oral or topical azoles
systemic:
- azoles
- Echinocandins
- Amphotericin B

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2
Q

Candida glabrata

Morphology
Transmission and Reservoir

Diseases

Treatment and Prevention

A

yeast

  • mouth, skin, GI tract, vagina
  • occurs when there is a breach in the host immune defense
  • seen when C. albicans is decreased by fluconazole treatment
  • oral thrush
  • esophagitis
  • vaginitis
  • bloodstream infection
  • abscesses
  • same as Candida albicans
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3
Q

Cryptococcus neoformans

Morphology
Transmission and Reservoir
Virulence Factors
Pathogenesis
Diseases
Diagnosis
Treatment and Prevention

A

yeast
———————–
- soil contaminated by bird droppings
- inhalation
- immunocompromised hosts
———————–
- polysaccharide capsule
- melanin to protect against oxidative stress
———————–
1) inhaled
2) travels to CNS and other organs
———————–
pneumonia
meningoencephalitis
- occurs in up to 10% of people with AIDS
- persistent, dull headache, malaise, fever, night sweats, meningeal signs may or may not be present
skin & bloodstream infections
———————–
- India ink stain of CSF
- Cryptococcal antigen test on blood or CSF: measuring polysaccharide antigen by ELISA or latex agglutination
- CSF culture
———————–
- Amphotericin B + 5-flucytosine, followed by fluconazole

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4
Q

Cryptococcus gattii

Morphology
Transmission and Reservoir
Virulence Factors
Pathogenesis
Diseases
Diagnosis
Treatment and Prevention

A

yeast
———————–
-inhalation
- tropical areas
———————–
- polysaccharide capsule
- melanin to protect against oxidative stress
———————–
1) inhaled
2) travels to CNS and other organs
———————–
pneumonia
meningoencephalitis
skin & bloodstream infections
———————–
- stain w/ India ink
———————–
- same as Cryptococcus neoformans

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5
Q

Pneumocystis jiroveci (Pneumocystis carinii)

Morphology
Transmission and Reservoir

Diseases
Diagnosis
Treatment and Prevention

A

yeast

lacks ergosterol
———————–
- inhalation of cyst in childhood
- reactivation when immunocompromised
———————–
Pneumocystis jiroveci Pneumonia (PJP)
- gradual onset of fever, dyspnea, and non-productive cough
———————–
- CXR with bilateral interstitial infiltrates, rarely focal or cavitary
———————–
- TMP/SMX

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6
Q

Aspergillus flavus

Morphology
Transmission and Reservoir
Virulence Factors

Diseases
Diagnosis
Treatment and Prevention

A

mold
———————–
- rotting plants
- inhalation
———————–
aflatoxin B1 is a powerful carcinogen
———————–
———————–
hepatocellular carcinoma
———————–
- branching, septate hyphae
———————–
- Amphotericin
- Voriconazole
- Posaconazole
- Itraconazole
- Echinocandins

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7
Q

Aspergillus perasiticus

Morphology
Transmission and Reservoir
Virulence Factors

Diseases
Diagnosis
Treatment and Prevention

A

mold
———————–
- rotting plants
- inhalation
———————–
aflatoxin B1 is a powerful carcinogen
———————–
———————–
hepatocellular carcinoma
———————–
- branching, septate hyphae
———————–
same as A. flavus:
- Amphotericin
- Voriconazole
- Posaconazole
- Itraconazole
- Echinocandins

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8
Q

Aspergillus fumigates

Morphology
Transmission and Reservoir

Pathogenesis
Diseases
Diagnosis
Treatment and Prevention

A

mold

  • rotting plants
  • inhalation
  • 1) inhalation of spores
    2) evasion of pulmonary macrophages or neutrophils
    3) local infection in the lung
    4) entry into blood vessels
    5) dissemination to other sites (e.g. brain)
  • airway colonization
  • allergic bronchopulmonary aspergillosis (ABPA)
  • treacheobronchitis
  • sinusitis
  • aspergilloma (fungus ball)
  • invasive pulmonary aspergillosis
  • disseminated aspergillosis
  • branching, septate hyphae
  • same as A. flavus
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9
Q

Aspergillus niger

Morphology
Transmission and Reservoir
Diseases
Diagnosis
Treatment and Prevention

A

mold
———————–
- rotting plants
- inhalation
———————–
chronic otitis externa
———————–
- branching, septate hyphae
———————–
- same as A. flavus

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10
Q

Zoophilic Dermatophyte:
Microsporum canis

Morphology
Transmission and Reservoir

Pathogenesis
Diseases
Diagnosis
Treatment and Prevention

A

mold
———————–
- animals
- contact
———————–
infect keratinized layer of skin
———————–
tinea corpis (ring worm), tinea capitis (scalp infection)
———————–
- skin scrapings or nail clippings can be examined microscopically or cultured
- fluoresces green under UV light
———————–
- Imidazoles
- Terbinafine
- Azoles

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11
Q

Anthropophilic Dermatophyte:
Trichophyton rubrum

Morphology
Transmission and Reservoir

Pathogenesis
Diseases
Diagnosis
Treatment and Prevention

A

mold
———————–
- humans
- contact
———————–
infect keratinized layer of skin
———————–
tinea pedis (athlete’s foot), tinea cruris (jock itch)
———————–
- skin scrapings or nail clippings can be examined microscopically or cultured

  • Imidazoles
  • Terbinafine
  • Azoles
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12
Q

Zygomycetes:
Mucor
Absidia
Rhizopus
Rhizomucor

Morphology
Transmission and Reservoir
Diseases
Diagnosis
Treatment and Prevention

A

mold
———————–
- inhalation
- risk factors: immune deficiency, diabetes, hemochromatosis
———————–
pneumonia
sinusitis
brain abscess
thrombosis
infarction
———————–
- non-septate hyphae that branch at right angles
———————–
- Amphotericin B
- Posaconazole

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13
Q

Sporothrix schenckii

Morphology
Transmission and Reservoir
Diseases

A

dimorphic fungi
(mold at ambient temperature, yeast at 37C)
———————–
soil, infected plant products, wood, roses
- puncture wound
———————–
cutaneous disease with local lymphatic spread

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14
Q

Histoplasma capsulatum

Morphology
Transmission and Reservoir

Pathogenesis
Diseases

A

dimorphic fungi
———————–
- soil in Mississippi & Ohio River Valleys
- inhalation
———————–
-disseminated from respiratory tract
———————–
histoplasmosis
pulmonary infection; can be disseminated

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15
Q

Coccidioides spp.

Morphology
Transmission and Reservoir

Pathogenesis
Diseases

A

dimorphic fungi
———————–
-soil in SW US
- inhalation
- no person-to-person transmission
———————–
1) mycelia (infectious) form in soil
2) spores within humans convert to spherules
3) spherules rupture and release endospores, which form more spherules
- disseminated from respiratory tract
———————–
valley fever:
- can be asymptomatic
- primary disease usually resolves spontaneously
- immunocompromised patients are more susceptible to chronic or disseminated infection
- complications:
1) cavity formation
2) dissemination to skin
3) meningitis
4) pneumonia

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16
Q

Blastomyces dermatitidis

Morphology
Transmission and Reservoir

Pathogenesis
Diseases

A

dimorphic fungi
———————–
- soil in Mississippi & Ohio River Valleys
- inhalation -
———————–
disseminated from respiratory tract
———————–
blastomycosis:
pulmonary infection that spreads to skin and bone

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17
Q

Dermatiaceous molds

Morphology
Diseases

A

mold

black or brown pigment due to melanin
———————–
cutaneous & subcutaneous infection,
fungal meningitis

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18
Q

Penicillium marneffei

Transmission and Reservoir

A
  • SE Asia
  • immunocompromised hosts
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19
Q

Fusarium

Transmission and Reservoir

A
  • patients with hematological malignancies and bone marrow transplantation
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20
Q

Scedosporium

Transmission and Reservoir

A
  • post-traumatic infection in immunocompetent
  • disseminated infection in immunocompromised
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21
Q

Entamoeba histolytica

Morphology
Transmission and Reservoir
Virulence Factors
Pathogenesis
Diseases

Treatment and Prevention

A

protazoa
———————–
- fecal-oral
- contaminated food or water
- rarely found in US
———————–
- cysts
———————–
1) cyst is excreted by a person
2) fecally contaminated food or water is ingested
3) becomes a trophozoites in the gut and attaches to colonic mucosa
4) may penetrate mucosa and travel to the liver via the portal circulation, forming liver abscesses
5) more cysts are formed in the gut and shed
———————–
bloody diarrhea
liver abscess
incubation time of 2-4 weeks
———————–
Metronidazole

22
Q

Entamoeba histolytica

Morphology
Transmission and Reservoir
Virulence Factors
Pathogenesis
Diseases

Treatment and Prevention

A

protazoa
———————–
- fecal-oral
- contaminated food or water
- rarely found in US
———————–
- cysts
———————–
1) cyst is excreted by a person
2) fecally contaminated food or water is ingested
3) becomes a trophozoites in the gut and attaches to colonic mucosa
4) may penetrate mucosa and travel to the liver via the portal circulation, forming liver abscesses
5) more cysts are formed in the gut and shed
———————–
bloody diarrhea
liver abscess
incubation time of 2-4 weeks
———————–
Metronidazole

23
Q

Acanthamoeba

Morphology
Transmission and Reservoir
Diseases

A

protozoa
———————–
- contaminated water
- contact lenses
———————–
lens opacity;
can lead to blindness

24
Q

Naegleria fowleri

Morphology
Transmission and Reservoir
Virulence Factors
Pathogenesis
Diseases
Diagnosis
Treatment and Prevention

A

protazoa

  • warm freshwater & soil
  • southern US
  • enters the nose when swimming
  • brain infection
  • fatal
25
Giardia ## Footnote Morphology Transmission and Reservoir Virulence Factors Pathogenesis Diseases Diagnosis Treatment and Prevention
protazoa - ---------------------- - reservoir: wild animals, farm animals, pets - fecal-oral - contaminated water or food - occurs in US - IgA deficiency is pre-disposing factor - ---------------------- - cysts - ---------------------- 1) trophozoites multiply in duodenum 2) cysts form in colon and are excreted 3) intestinal inflammation and malabsorption of fats and carbohydrates - ---------------------- - explosive diarrhea involving foul-smelling, greasy stool - significant weight loss in children - chronic diarrhea in adults - relapses are common - incubation time: 1-4 weeks - ---------------------- - trophozoites or cysts in stool - ---------------------- - Metronidazole
26
Cryptosporidium parvum ## Footnote Morphology Transmission and Reservoir Virulence Factors Pathogenesis Diseases Diagnosis Treatment and Prevention
protazoa - ---------------------- - reservoir: farm animals, pets - fecal-oral - contaminated water - occurs in US - ---------------------- - oocysts - ---------------------- 1) sporozoites penetrate enterocytes and develop into trophozoites 2) oocytes form and are shed in stool 3) inflammation and malabsorption - ---------------------- - ranges from mild diarrhea to severe dysentery in immunocopromised - relapses can occur - 5-10 day incubation - ---------------------- - oocysts in stool - modified acid-fast stain - ---------------------- - Nitazoxanide
27
Microsporidia ## Footnote Morphology Transmission and Reservoir Diseases
protazoa ----------------------- - affects immunocompromised - occurs in US ----------------------- diarrhea
28
Trichomonas vaginalis ## Footnote Morphology Transmission and Reservoir Diseases Diagnosis Treatment and Prevention
protazoa ----------------------- - STD - occurs in US ----------------------- asymptomatic in men; vaginal discharge with fish-like odor in women ----------------------- - pear-shaped, flagellated organisms with characteristic twitching motility ----------------------- - Metronidazole
29
Plasmodium | (vivax, ovale, and falciparum) ## Footnote Morphology Transmission and Reservoir Virulence Factors Pathogenesis Diseases Diagnosis Treatment and Prevention
protazoa ----------------------- - mosquito bites - occurs outside of US - vivax & ovale found in temperate zones (mosquitoes during warmer months) - falciparum found in tropical regions (mosquitoes year round) - sickle cell anemia is protective - unexposed people are most susceptible ----------------------- -PfEMP in falciparum: variable protein that can cause binding of RBC to many different host proteins; causes RBC sequestration and obstruction to tissue perfusion; avoids clearance by the spleen ----------------------- 1) sporozoites from mosquito infect humans 2) travel to liver and invade hepatocytes 3) differentiate into tissue schizonts and multiply 4) live in the liver as latent hypnozoites (only occurs in vivax & ovale) 5) differentiate into merozoites and exit hepatocytes 6) merozoites invade RBCs (falciparum can invade RBCs of any age, but vivax & ovale only invade reticulocytes) 7) RBCs lyse and release merozoites 8) some differentiate into gametocytes and are taken up by mosquitoes to complete the cycle - cyclic fevers occur b/c RBCs lyse to release merozoites every 48 hours ----------------------- malaria - vivax & ovale - cyclic fevers severe malaria - falciparum - 7-90 day incubation - cyclic or non-cyclic fevers - microvascular disease - hypoglycemia - cerebral malaria - renal failure - pulmonary edema - anemia - multiorgan failure - coma ----------------------- - blood smear - rings only seen with falciparum ----------------------- - Chloroquine: usually ineffective due to resistance - Quinine - Primaquine: only drug active against hypnozoites - Artemisinin derivatives: use for resistant strains as combination therapy - Mefloquine (Lariam): prophylaxis & treatment - Atovaquone/ proguanil (Malarone): prophylaxis & treatment
30
Babesia ## Footnote Morphology Transmission and Reservoir Pathogenesis Diseases Diagnosis
protazoa - ---------------------- - reservoir: deer & white-footed mice - vector: ticks - asplenia is a risk factor - NE US, Nantucket Island, Martha’s Vineyard, Cape Cod - ---------------------- - infects erythrocytes Babesiosis (malaria-like disease) - ---------------------- - Maltezer cross
31
Leishmania ## Footnote Morphology Transmission and Reservoir Pathogenesis Diseases
protazoa ----------------------- - vector: sandflies - found in Central and South America, Middle East, and Africa ----------------------- - invade macrophages in humans ----------------------- cutaneous leishmaniasis visceral leishmaniasis (kala azar): - fevers - hepatosplenomegaly
32
Trypansoma cruzi ## Footnote Morphology Transmission and Reservoir Virulence Factors Pathogenesis Diseases
protazoa ----------------------- - kissing bugs - contaminated fruit juice - blood transfusions - mother-to-child transmission - Central and South America ----------------------- - does not undergo antigenic shift - evades complement - escapes phagosome to live in cytoplasm ----------------------- - blood stage and intracellular stage (in phagosomes) ----------------------- Chagas disease - esophageal and colon dysmotility - cardiomyopathy
33
Trypansoma brucei ## Footnote Morphology Transmission and Reservoir Virulence Factors Pathogenesis Diseases Diagnosis Treatment and Prevention
protazoa ## Footnote flagellated ----------------------- - tsetse fly - Africa ----------------------- - variable surface glycoprotein (VSG): covers surface; antigenic shift through gene conversion ----------------------- - extracellular parasite - spreads systemically ----------------------- African sleeping sickness - stage 1: lymphadenopathy, fever, anemia, edema, rash - stage 2: meningoencephalitis, CNS symptoms including sleeping during the day, coma, death
34
Toxoplasma gondii ## Footnote Morphology Transmission and Reservoir Pathogenesis Diseases Diagnosis Treatment and Prevention
protazoa ## Footnote obligate intracellular - ---------------------- - found in cat feces & undercooked meat - can cross the placenta - reactivation in T-cell immunocompromised patients - - ---------------------- 1) infected rodents are eaten by cats 2) parasites undergo sexual cycle in cats 3) sporozoites in cat feces are ingested by humans 4) sporozoites penetrate the intestinal wall 5) tachyzoites (replicative form) infect macrophages) 6) disseminate via hematogenous spread 7) can cross the placenta 8) can form cysts with bradyzoites (latent form) in brain 9) if immunocompromised, cysts can release tachyzoites into brain and induce inflammation - ---------------------- - common latent infection in many countries - congenital toxoplasmosis - acute infection during pregnancy can lead to retinitis & CNS disease in babies - Toxoplasma encephalitis or ocular toxoplasmosis in immunocompromised (e.g. AIDS patients) - ---------------------- - head CT shows ring-like structure in brain - ---------------------- - TMP/SMX
35
Enterobius vermicularis (Pinworm) Morphology Transmission and Reservoir ## Footnote Diseases Treatment and Prevention
intestinal nematode ----------------------- - ingestion of infective eggs - not associated with any specific socioeconomic level ----------------------- perianal itch ----------------------- - Albendazole / Mebendazole - Pyrantel
36
Necator americanis (Hookworm Morphology Transmission and Reservoir Diseases
intestinal nematode ----------------------- - penetration of skin by larval forms - impoverished rural areas ----------------------- itchy feet with rash anemia
37
Ancylostoma duodenale | (Hookworm) ## Footnote Morphology Transmission and Reservoir Diseases
intestinal nematode ----------------------- - penetration of skin by larval forms - impoverished rural areas ----------------------- itchy feet with rash anemia
38
Trichuris trichiura Morphology Transmission/Reservoir Disease Treatment | (Whipworm)
intestinal nematode - ingestion of infective eggs - impoverished rural areas - - non-specific abdominal discomfort and/or anemia - - Albendazole / Mebendazole - Ivermectin
39
Ascaris lumbricoides ## Footnote Morphology Transmission and Reservoir Diseases Treatment and Prevention
intestinal nematode ----------------------- - ingestion of infective eggs - impoverished rural areas ----------------------- non-specific abdominal discomfort and/or anemia ----------------------- Albendazole / Mebendazole Ivermectin
40
Onchocerca ## Footnote Morphology Transmission and Reservoir Pathogenesis Diseases Treatment and Prevention
tissue nematode (filaria) ----------------------- - mosquito/ insect bite - non-US ----------------------- infection of lymphatics ----------------------- river blindness ----------------------- Ivermectin
41
Wucheria Morphology Transmission and Reservoir Pathogenesis Diseases
tissue nematode (filaria) ----------------------- mosquito/ insect bite - non-US - ----------------------- infection of lymphatics ----------------------- elephantiasis
42
Brugia Morphology Transmission and Reservoir Pathogenesis Diseases
tissue nematode (filaria) ----------------------- mosquito/ insect bite - non-US - ----------------------- infection of lymphatics ----------------------- elephantiasis
43
Trichinella ## Footnote Morphology Transmission and Reservoir Pathogenesis Diseases
tissue nematode (filaria) ----------------------- - contaminated food (undercooked pig, boar, or bear meat) - occurs in US ----------------------- 1) ingestion 2) migrate through intestine 3) migrate to muscles 4) immune-mediated inflammatory reaction ----------------------- fever, myalgias, edema 3-30 day incubation
44
Schistosoma spp. ## Footnote Morphology Transmission and Reservoir Pathogenesis Diseases Treatment and Prevention
fluke (trematode) ----------------------- - grow in snails - skin contact with contaminated water - occurs everywhere except North America, Europe, & Australia ----------------------- snail → fresh water → human skin → lungs & liver → GI tract or bladder ----------------------- acute schistosomiasis: Katayama fever chronic schistosomiasis: liver disease, hematuria, bladder cancer, neurologic disease ----------------------- eggs in urine (S. hematobium) or feces (S. japonicum or mansoni)
45
Taenia solium Morphology Transmission and Reservoir Diseases Treatment and Prevention
tapeworm (cestode) ----------------------- - reservoir: pigs - ingestion of T. solium eggs or undercooked pork ----------------------- cysticercosis neurocysticercosis (seizures) ----------------------- Albendazole/ Mebendazole
46
Taenia saginata ## Footnote Morphology Transmission and Reservoir Diseases
tapeworm (cestode) ----------------------- - reservoir: cows - ingestion of undercooked beef - ----------------------- abdominal symptoms - -
47
Echinococcus Morphology Transmission and Reservoir Pathogenesis Diseases Treatment and Prevention
tapeworm (cestode) ----------------------- - reservoir: dogs - dog fecal-oral ----------------------- 1) ingestion of eggs 2) eggs hatch to form oncospheres that penetrate the intestinal mucosa and enter the circulation 3) cysts formin organs, particularly the liver ----------------------- Hydatid disease - liver cysts ----------------------- Albendazole / Mebendazole
48
Lice Morphology Diseases Treatment and Prevention
ectoparasite ----------------------- nits - scalp hair infestation body lice - body hair infestation crabs - pubic hair infestation ----------------------- Ivermectin - Permethrin - Malathion
49
Sarcoptes scabei Morphology Diseases Treatment and Prevention
ectoparasite ----------------------- scabies - itchy rash between fingers ----------------------- Ivermectin - Permethrin
50
maggots ## Footnote Morphology Diseases
ectoparasite ----------------------- myiasis (maggots under the skin)

Micro ORganisms So far (3 decks)

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