Mycology: endemic mycoses Flashcards
Histoplasma capsulatum causes
histoplasmosis
Blastomycoces dermititidis causes
blastomycosis
Coccidiodes immitis causes
coccidiodomycosis
All three fungs undergo
phoenotype switching
all three fungs are: di/mono/poly
dimorphic
in envir all three fungus exsist as
free living molds
hypae or mycelia frow as a mat
In the host, these two convert to a budding yeast
histoplasma cap. and bastomyces
In host this converts to a large endosporulationg sperule with many endospores
Coccidiodes immitis
Coccidiodes immitis in host:
endosporulationg spherule with many endospores
infection occurs most often via this route
respiratory route via inhalation
primary site of infection for histo/blasto/cocci
lungs–can disseminate to blood
another primary site of infeciton other then ariway
cutaneous (but this can also be reslut of dissemination)
these ind more at risk for disease
immunocompromised
definitive diagnostics must be done
via microscope
Histoplasma capsulatum location
acid soil in tennesse or louisiana or IL
this guy has exceeded histoplamsin culture in 85% pt of people tha tlive near
endemic areas
birds and guano can carry this endemic mycoses
histoplasmodium
envir: hyphae with microconidia and macroconidia or wart protrubances= tuberculate
histoplasma capsulatum
in host: conidia convert to uninucleated oval budding yeast with NARROW BUD neck
histoplasma capsulatum
found with narrow bud neck inside phagocytes
histoplasma capsulatum
most common result of infection is astymotomatic and then 3-17 days if they do occur
histoplasma capsulatum
pulmonary sydnroe from histoplasma can be seen on
X-ray but reselmbed TB
Acute pericarditis or pleural effusions in 5% of these pts
histoplasma capsulatum
in 4-27% of pts that are immunocompormissed we get disseminattion d/t
histoplasma capsulatum
loss of vision with histoplasma capsulatum d/t
ocular histoplasmosis syndome
this is an abnormal immunologic inflammatory response leading to fibrosis in pts with histoplasmosis
fibrosing medisatinus
These guys ahve receptros for CD2/CD18 so they get engulfted by phagocytes
microconidia on histoplamo capsulatum
therapy for histoplamsa
antifungal as adjuct to own immune
This disease can be mistaken for TB
histoplasmin
this can be seen in PAS or GMS stained specimens
histoplasmin
this is found in rich soil along mississippi and ohio river , more north
blastomycosis
reporete in wisconsin
blastomycosis
host: make large multinucleat budding yeast with broak neck bud
blastomycosis
in envir they are uninucleate hypae with microconidia
blastomycosis
incubation time for blatomycosis after inhilation
4-6 wks
can present as benign or chronic granulomatous
blastomycosis
this will happen in patients with bronchogenic carcinoma, histoplasmosis, TB or other pulm disease
blastomycosis
This can devo cutaneously as a nodule or papule
blastomycosis dermatidis
site of most common disseminated disease of blastomycosis
skin
this cannot be engulfed bc it’s yeast cells are too big
blastomycosis
On a differential this represents pneomina or TB or a primary metastatic cutaneous lesion
blastomycosis
Coccidiodioes is fount in
hot, arid climates, during windy dry seasson
when considering this, must thnk about people traveling to arizona or utuh…ext
coccidiodes
about 20,000 cases reported/year so it’s a notifiable disease
coccidiodes
Envir: septate multicell hyphae with alt cells devo into barrel shaped arthioconidia
coccidiodoes
In host arthroconidia–> larger spherules w/ 72 hours
coddiciocdoes
What do spherules contain in coccidiocdes
endospores
how do you test for coccidiocodes
hypersensitivty test reaction to coccidiodin
symptosm in pt with coccidiodoes
mild flu, fever, cough, rash about 7-21 dayts post exposure
cattleworkers, farmers and ag workers supseptible to this endemic mycoce
coccidiococes
When is it dangerous to get coccidiocoese
pregnancy at 3rd trimester DONT give azoles
3rd most life threathing opportunistic infeciton in AIDS pts in endemic areas
coccidiocoses
what happes to most acute episodes of primary pulmonary coccidiomycosis
tx w/ bed rest and self resolves
TX for mild-mod histoplamosis (pulmonary disease)
none or Itraconozole
TX for mild-mod blastomycosis (pulmonary disease)
Itraconazole
TX for nmild-moderate pulmonary disease of coccidiodomycosis
none
TX for severe disease (including CNS) of any endemic mycoces
Ampothericin B
