MICROBIOLOGY- MYCOLOGY

Question 1

What are systemic mycoses?

Answer 1

Fungal infections that can cause pneumonia and disseminate

Mimic TB but can’t be transmitted from person to person

Question 2

What is a dimorphic fungi?

Answer 2

Fungus that takes two forms

1) Mold
2) Yeast

Remember, “Mold in the cold, yeast in the heat”

Question 3

What are the four systemic mycoses?

Answer 3

1) Histoplasmosis
2) Blastomycosis
3) Coccidioidomycosis
4) Paracoccididiodomycosis

Question 4

What type of fungi are the systemic mycoses?

Answer 4

Dimorphic, except for Coccididioidomycosis

Question 5

How are the systemic mycoses treated?

Answer 5

Local infection= fluconazole or itraconazole

Disseminated infection= Amphotericin B

Question 6

Where is Histoplasmosis endemic?

Answer 6

Mississippi and Ohio River valleys

Question 7

How is Histoplasmosis diagnosed?

Answer 7

Macrophages filled with Histoplasma

*Remember Histo Hides in macrophages

Question 8

What is Histoplasmosis associated with?

Answer 8

Bird or bat droppings

Question 9

Where is Blastomycosis endemic?

Answer 9

• States east of the Mississippi River

- Central America

Question 10

What disease is caused by Blastomycosis?

Answer 10

1) Inflammatory lung disease

2) Dissemination to skin and bone forming GRANULOTMOUS NODULES

Question 11

How is Blastomycosis diagnosed?

Answer 11

Broad Based Budding

Blasto buds broadly*

Question 12

Where is Coccidioidomycosis endemic?

Answer 12

Southwestern US and California

Question 13

What disease is associated with Coccidioidomycosis?

Answer 13

• Pneumonia and meningitis

- Also can disseminate to bone and skin

Question 14

What is Coccidioidomycosis associated with?

Answer 14

Spore release into the air after EARTHQUAKES

Question 15

How is Coccidioidomycosis diagnosed?

Answer 15

Spherules filled with endospores–will be much larger than a RBC

Question 16

What are “desert bumps?”

Answer 16

Erythema nodosum associated with Coccidioidomycosis dissemination to skin

Question 17

What is “Desert Rheumatism?”

Answer 17

Arthralgias associated with Coccidioidomycosis dissemination to bone

Question 18

Where is Paracoccidioidomycosis endemic?

Answer 18

Latin America

Question 19

How is Paracoccidioidomycosis diagnosed?

Answer 19

Budding yeast with “CAPTAINS WHEEL”

Question 20

What causes Tinea versicolor?

Answer 20

Malassezia furfur

Question 21

What is Tinea versicolor?

Answer 21

Fungal infection with Malassezia furfur that damages melanocytes–>hypopigmented patches

Question 22

What is Tinea versicolor associated with?

Answer 22

Hot humid weather

Question 23

How is Tinea versicolor treated?

Answer 23

Topical miconazole and selenium sulfide

Question 24

How is Tinea versicolor diagnosed?

Answer 24

Spaghetti and meatball appearance

Question 25

What is the colloquial term for tinea cruris?

Answer 25

Jock-itch

Question 26

What diseases are caused by Candida albicans?

Answer 26

1) Oral and esophageal thrush 2) Vulvovaginitis 3) Diaper rash 4) Endocarditis 5) Disseminated candidiasis 6) Chronic mucocutaneous candidiasis

Question 27

How are vaginal Candida albicans infections treated?

Answer 27

Topical azole

Question 28

How are oral and esophageal Candida albicans infections treated?

Answer 28

Fluconazole or Casopfungin

Question 29

How are systemic Candida albicans infections treated?

Answer 29

Fluconazole, Caspofungin, or Amphotericin B

Question 30

What diseases are caused by Aspergillus fumigatus?

Answer 30

1) Invasive aspergillosis 2) Allergic bronchopulmonary aspergillosis (ABPA) 3) Aspergillomas

Question 31

What is ABPA associated with?

Answer 31

- Asthma and CF | - May cause bronchiectasis and eosinophilia

Question 32

What toxin is produced by some species of Aspergillus fumigatus? What is this toxin associated with?

Answer 32

Alfatoxin that increases the risk of hepatocellular carcinoma

Question 33

How is Aspergillus fumigatus diagnosed?

Answer 33

Think "A" for Acute Angles

Question 34

What infections are caused by Cryptococcus neoformans?

Answer 34

1) Crytococcal meningitis | 2) Cryptococcosis

Question 35

Where is Cryptococcus neoformans found?

Answer 35

Soil and pigeon droppings

Question 36

How is Cryptococcus neoformans transmitted?

Answer 36

Inhaled and then spread hematogenously to the meninges

Question 37

What stain is pathognomonic for Cryptococcus neoformans?

Answer 37

India ink

Question 38

What imaging finding is pathognomonic for Cryptococcus neoformans?

Answer 38

Soap bubble lesions on brain

Question 39

What causes Mucromycosis?

Answer 39

Mucor and Rhizopus

Question 40

What patients are at risk for Mucromycosis?

Answer 40

1) Ketoacidotic DM | 2) Leukemia

Question 41

What is Mucromycosis?

Answer 41

Fungal infection that enters the brain via the cribriform plate causing: 1) Rhinocerebral and 2) Frontal lobe abscess

Question 42

What are the signs and symptoms of Mucromycosis?

Answer 42

- Headache - Facial pain - Black necrotic eschar on face

Question 43

How is Mucromycosis treated?

Answer 43

Amphotericin B

Question 44

What does Pneumocystis jirovecii cause?

Answer 44

Pneumocystis pneumonia (PCP)-- a diffuse intersitial pneumonia

Question 45

How is Pneumocystis jirovecii transmitted?

Answer 45

Inhalation

Question 46

What is the typical presentation of PCP?

Answer 46

Asymptomatic

Question 47

What predisposes one to symptomatic PCP infection?

Answer 47

Immune compromise

Question 48

How does Pneumocystis jirovecii infection appear on CXR?

Answer 48

Diffuse bilateral pneumonia

Question 49

How is Pneumocystis jirovecii diagnosed?

Answer 49

1) Lung biopsy 2) Lavage THEN silver stain to show disc-shaped yeast

Question 50

How is Pneumocystis jirovecii infection treated?

Answer 50

1) TMP-SMX 2) Pentamidine 3) Dapsone

Question 51

What drug used to treat PCP is used for prophylaxis?

Answer 51

Dapsone

Question 52

What circumstances would prompt PCP prophylaxis?

Answer 52

AIDS i.e. CD4 T-cell count in HIV+ that is under 200

Question 53

What disease is caused by Sporothrix schenckii?

Answer 53

Sporotrichosis

Question 54

Where is Sporothrix schenckii normally found?

Answer 54

Vegetation--hence "Rose Gardner's Disease"

Question 55

How does Sporotrichosis present?

Answer 55

Local pustule or ulcer at site of inoculation *May cause ascending lymphangitis*

Question 56

How is Sporothrix schenckii transmitted?

Answer 56

Traumatic inoculation into the skin e.g. thorn-prick

Question 57

How is Sporothrix schenckii infection diagnosed?

Answer 57

Cigar-shaped budding yeast

Question 58

How is Sporothrix schenckii infection treated?

Answer 58

Itraconazole or potassium iodide