Mycology Flashcards
Culture medium of fungi
Saboraud’s agar
Low pH 5.6 inhibits growth of bacteria but permits growth of filamentous fungi and yeast
Impregnated with chloramphenicol and gentamicin to inhibit growth of other bacteria
Saboraud’s agar
Used to dissolve tissue material leaving the alkali resistant fungi intact
10% KOH
Fungal wall constituent
Chitin
Ergosterol
Beta glucan
Mannoproteins
Protein found in exoskeleton and wall of fungi
Chitin
Sterol of the cell membrane of fungi and cell wall of protozoans regulates permeability and fluidity of fungal cell wall
Ergosterol
Most abundant polysaccharides of the fungal wall
Betaglucans
Opportunisitc mycosis
Candidiasis
Cryptococcus neoformans
Histoplasma
Pneumocystis carinii
Fungi that infect only the keratinized tissue (skin, hair and nails)
Cutaneous mycosis
Cutaneous mycosis
Microsporum
Trichophyton
Epidermophyton
Affects skin, hair and nails
Trichophyton three
Affects only skin and hair
Microscporum
Affects only skin and nails
Epidermophyton
Ringworm of scalp
Tinea capitis
Ringworm of bearded region
Tinea barbae
Ring worm of glabrous skin
Tinea corporis
Jock itch
Tinea cruris
Athlete’s foot
Tinea pedis
Most serious of tinea capitis
Tinea favosa/favus
Most common cause of outbreaks of tinea capitis in children
Main cause of endothrix
Trichophyton tonsurans
Dermatophyte infections that invade hair shaft and internalize into hair cell
Endothrix
Dermatophyte infectikn confined to the hair surface
Ectothrix
Severe tinea capitis
Tinea favosa
Trichophyton schoenleinii
Causes tinea favus
Tinea capitis presenting with crust on the scalp
Most serious form causing permanent scarring and scalp hair loss
Trichophyton schoenleinii
Tinea favus
Zoophilic tinea capitis
Microsporum canis
Trichophyton mentagrophytes
Young child showing a large circular erythematous scaly lesion with a raiser border on the nose
Microsporum gypseum
Tinea barbae
Trichophyton verrucosum
Trichophyton mentagrophytes
Trichophyton rubrum
Most prevalent systemic mycosis
Candidiasis
Candida albicans
Appear as yeast or pseudohyphae
Germ tube formation in serum at 37 deg
Candida albicans
Grow as oval, budding yeast cell (3-6 um in size)
Also form pseudohyphae when buds continue to grow
Candida albicans
On agar media or within 24h at 37 deg or room temperature
Soft, cream-colored colonies with a yeasty odor
Candida albicans
Can infect kidneys
Attach to prosthetic heart valves or produce candidal infections almost anywhere (eg arthritis, meningitis, endopthalmitis)
Oral candidiasis
Vaginal
Candida
Cottage cheese discharge
DM
Vaginal candidiasis
Esophageal candidiasis risk factor
Radiation
Chemotherapy
Candida tx
Nystatin
Thrush and mucocutaneous form of candidiasis Tx
Topical Nystatin
Oral Ketoconazole or Fluconazole
Systemic candidiasis tx
Amphotericin +/- oral flucytosine
AIDS
Pigeon
Yeast from CSF stained with india ink
Meningitis
Cryptococcus neoformans
Bird or bat dropping
Histoplasma
Pigeon dropping
Eucalyptus tree
Encapsulated yeast cell (India ink)
Meningitis
Cryptococcus neoformans
Cryptococcus neoformans Dx
India ink
Cryptococcal antigen latex agglutination (CALAS)
HIV defining illness (CD <200)
CD <100 this infection sets in
Cryptococcus neoformans
Severe interstitial pneumonia in immunocompromised patients especially AIDS patients
Previously protozoan -> 1988 yeast
Pneumocystis carinii
Pneumocystis jiroveci
P jiroveci Dx
Gomori methenamine Silver stain of lung tissue broncheoalveolar lavage
Transbronchial lung biopsy
P jirovecii Tx
Trimethoprim-sulfamethoxazole
Pentamidine (aerosol)
P jiroveci Hallmark of xray
Severe hypoxemia
Ground glass opacities
Pneumonia
TMP SMZ SE
No 1 cause
SJS
Transmitted by droplet inhalation, close contact
Immunosupression
Pneumonitis spreading from hilar areas
Gomori’s mehanamine silver stain
Pneumocystis carinii
Common cause of death in HIV patients
Pneumocystis jiroveci
Hypopigmented spots on chest and back
Malasezzia furfur
Pityriasis Tinea versicolor
Malasezzia furfur pathognomonic histology
Spaghetti and meatballs budding yeast cells and hyphae
Oval macules and patches with fine scaling
Light brown/pink in light skin; white in dark skin
Back, upper trunk, upper arms, axillae, thighs
Asymptomatic or mild pruritus
Malassezia furfur
Malassezia furfur Dx
KOH - spaghetti and meatballs (filamentous hyphae and budding yeast)
Malassezia pityriasis versicolor Tx
Selenium sulfide (selson blue) shampoo
Ketoconazole shampoo
Azole cream
Fluconazole and ketoconazole oral
Lice: difficult to find
Nits: oval, gray/white egg capsules (1mm), firmly cemented to the hair, recent infestation, nits are near the scalp, long standing infection
Pediculosis humanis capitis
Lays 5-6 nits a day
Eggs hatch and in 7-10 days become nymph
Later adult
Pediculosis
Pediculosis Dx
Microscopy of nits and lice
Pediculosis Tx
Permethrin lotion
Ivermectin
Excoriated erythematous papules
Lice and nits on clothing seams
On the body
Pediculosis corporis
Pediculosis humanus humanus
Sexually transmited
1-2mm brownish gray specks in hairy areas
Nits attached to hair shafts
Papular urticaria, maculae ceruleae (dlste colore macule)
Pediculosis pubis
Pthirus pubis
Pthirus pubis Tx
1% Permethrin lotion
Mousse containing pyrethrins and piperonyl butoxide
Scabies is caused by
Sarcoptes scabei
Caused by mites which cause extreme nocturnal itching (tunnels and lays eggs)
Scabies
Scabies site of predilection
Interdigital web Wrist Penile shaft Genitals Buttocks Axillae Abdomen
Appears as dark lines between fingers and toes, body flexures, nipples and genitalia
Excoriated papules, burrows, inflammatory nodules
Scabies
Seven year itch
Scabies Tx
Permethrin 5% with corticosteroids
Washing of beddings and clothes is necessary
Topical corticosteroids may be necessary to treat itching
Unbranched sporangiophores that arise opposite rhizoids
Rhizopus
Hyaline to faintly pigmented
Simple or sometimes branched arising solitary
Rhizopus
> 90 degree branching mold
Mucormycosis
Ketoacidosis
Leukemia
Black nasal discharge
are encountered in
Mucormycosis
Dimorphic fungus (exists in yeast or mold form)
Rose gardener’s disease
Sporothrix schenckii
Sporotrichosis
Sporothrix scheckii is seen in tissue soecinens as
Cigar shaped budding yeast
Flowerette arrangement of conidia
Packs of cigar on examination
M leprae
Sporothrix form at temperature less than 37 degrees
Hyphal
Sporothrix form more than 37 deg
Budding yeast
Central fungus cell with eosinophilic material radiating from cell of Sporotrix
Asteroid body
Initial lesion develops as granulomatous nodule that may progress to form a necrotic or ulcerative lesion
Draining lymhpatics become thickened and cord-like
Botanist, flower shop
Cutaneous sporotrichosis
Acid fast stain for Cryptosporidium modified
Kinyoun stain
Most common symptom of Cryptosporidium
Watery diarrhea
Stomach cramps Dehydration Nausea Vomiting Fever Weight loss
Cryptosporidium
Immunocompromised
HIV/AIDS
Cancer
Inherited deficiency
Cryptosporidium Tx
Nitazoxanide
Ixodes tick
Maltese on blood smear
Babesia microti
Lyme disease
Ixodes tick
Borellia burgdorferi
Two hosts in life cycle of babesia
Rodent (white footed mouse)
Ixodes tick
Fever Chills Sweating Myalgia Fatigue Hepatosplenomegaly Hemolytic anemia
Babesiosis
Babesia Tx
Atovaquone + azithromycin
Typical brown diffusable pigment in agar
On the foot
Madurella mycetomatis
Caused by actinomycotic mycetoma or actinomycetoma
Madurella
Farmers, hunter gatherer, chronic granulomatous soft tissue infection
Madura foot
Madura foot Tx
Itraconazole
Ketoconazole
Barrel shaped arthroconidia
Coccidioides immitis
Highest endemism in semiarid areas
San Joaquin Valley Fever
Coccidioides immitis
Mold in soil, spherule in tissue
In soil it forms hyphae with arthrospores and empty cells
Coccidiodes immitis
Desert areas of Western US and Northern Mexico
Transmission: respiratory
Dimorphic fungus
Mycelia forms with spores at 25 deg celsius
Yeast forms at 37 deg Celsius
Coccidioides immitis
Coccidiodes immitis Tx
Fluconazole
If it disseminate in CNS causing meningitis
Mariner pilot’s wheel
Thick walled yeast with multiple buds
Armadillo
Fruit bat
Coccidioides brasilienses
Coccidioides brasiliensis Dx
Direct sputum examination
BAL fluids
Scrapings from mucocutaneous ulcer
Oral lesions Weight loss Lymph adenopathy Cough Fever SOB
Coccidioides brasiliensis
Diff dx
TB
HIV
Paracoccidioides Tx
Itraconazole
Amphotericin
With or without Trimethroprim-sulfamethoxazole
Dichotomously branching hyphae
Aspergillus fumigatus
Invasive pulmonary aspergillosis
Aspergillons
Otomycosis
Aspergillosis
Forms fungus balls in the lungs
Seprate hyphae that form V shaped dichotomous branches
Aspergillus fumigatus
Most common form of fungal sinusitis
Aspergillus
Broad based budding yeast
Blastomyces dermatitidis
North American Blastomycosis
Chicago disease
Gilchrist disease
Systemic blastomycosis
Most common extrapulmonary manifestation of blastomycosis
Skin disease
Tuberculate macroconidia and micronidia
Soil contaminated with bird droppings
Oval yeast cells
Bird droppings in caves
Histoplasmosis capsulatum
Spelunker’s disease
Histoplasmosis
Mimics pulmonary TB in xray
Cough, hemoptysis, DOB
Histoplasmosis
Fungi used in making bread, beer and wine
Saccharomyces cerevisiae