Mycology

Question 1

Treatment for systemic mycoses locally

Answer 1

fluconazole, itraconazole

Question 2

systemic treatment

Answer 2

amphotericin B (granuloma formation, but no person-to-person transmission)

Question 3

histoplasmosis location + pathologic featuers

Answer 3

mississippi / ohio river valleys –> pneumonia.

macrophage filled w/ histoplasma

Question 4

blastomycosis

Answer 4

east of mississsippi river / central america –> inflammatory lung disease; disseminate to skin / bone –> granulomatous nodules

Question 5

coccidioidomycosis

Answer 5

southwestern US / CA –> pneumo / meningitis –> disseminates to bone / skin (arthralgias / erythema nodosum. increased rate after earthquakes. spherule filled w/ endospores

Question 6

tinea versicolor

Answer 6

malassezia furfur; degradation of lipids –> acids that damage melanocytes + cause hypopigmentation patches. hot humid weather.

treat: topical miconazole / selenium sulfide

Question 7

aspergillus fumigatus

Answer 7

allergic bronchopulmonary aspergillosis (ABPA); associations w/ bronchiectasis / eosinophilia.

Question 8

aflatoxins

Answer 8

hepatocellular carcinoma

Question 9

mucormycosis

Answer 9

ketoacidotic diabetic / leukemic patients. fungi proliferate in blood vessel walls when there is excess ketone / glucose, penetrate cribiform plate, enter brain.

rhinocerebral, frontal lobe abscess.

black necrotic eschar on face.

cranial nerve involvement.

treatment: amphotericin B

Question 10

pneumocystic jirovecci

Answer 10

diffuse interstitial pneumonia (disc-shaped yeast on methenamine silver stain ofl ung).

treatment: prophyalxis TMP-SMX, pentamidine.
prophylaxis: dapsone/atovaquone. start prophylaxis when CD4 < 200

Question 11

sporotrichosis

Answer 11

dimorphic cigar-shaped budding ease on vegetation. spores introduced traumatically –> pustule / ulcer w/ nodules along lymphatics.

treatment: KI / itraconazole