Mycology Part 2 Flashcards

1
Q

What is Coccidioidomycosis?

A
  • Caused by: Coccidioides immitis
  • C. posadasii - in TX, NM, AZ
  • Causes disease in animals and humans that can be inapparent to disseminated and fatal
  • Marked variation in susceptibility between animals
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2
Q

What is the geographic distribution of Coccidioidomycosis?

A
  • Endemic areas in the US
    • Southwest: CA (San Jaoquin valley, southern desert counties) Neveda, Utah, AZ, NM, TX
    • Cases reported in other states too
  • Outside US
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3
Q

What are the characteristics of Coccidioides immitis?

A
  • a dimorphic fungus
  • Grows in the mycelial phase in culture and soil
  • Grows in the yeast phase in the tissue of an infected animal
    • has not yet been grown in the yeast phase in culture
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4
Q

What is the prevalence of Coccidioidomycosis?

A
  • Most individuals living in endemic areas are exposed to the agent
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5
Q

What is the pathogenesis of Coccidioidomycosis?

A
  • Inhalation of arthrospores which are formed in soil causes primarily a pulmonary disease
    • Dogs sniffing at rodent burrows
    • Wind and dust storms
  • Adhesins, urease, chitinase
  • Granulomas (may resemble tuberculosis) form in the pulmonary tissue and adjacent lymph nodes
  • May disseminate to liver, spleen, kidneys, and bones
  • Sub-cutaneous abscesses may develop with draining sinus tracts in rare cases
  • Yeast-like organism in tissues
    • Spherules - 10-80 microns, some up to 200 microns
  • Spherules contain few to several hundred endospores - 2-5 microns in diameter (RBC)
    • mature spherules rupture and release endospores, which infect adjacent tissues or spread to other body parts
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6
Q

What are the clinical manifestation of Coccidioidomycosis?

A
  • Severe disease
    • dogs, humans, primates
  • In cattle, swine, sheep, horses and cats, localized in the thoracic lymph nodes and/or lungs
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7
Q

What are the clinical manifestations of Coccidioidomycosis in dogs?

A
  • Primarily respiratory problems due to inhalation of spores (tracking and digging/sniffing rodents burrows)
  • Listlessness, poor appetite, intermittent diarrhea, cough, weight loss, lameness, enlarged joints, skin lesions
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8
Q

How is Coccidioidomycosis clinically diagnosed?

A
  • X-ray
  • Clinical signs
  • Demonstration of the agent
  • Serology - Precipitation test
  • Intradermal Sensitivity Test - CMI - Coccidioidin
  • Fluorescent Antibody test on tissue biopsy
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9
Q

How is Coccidioidomycosis Diagnosed in the Laboratory?

A
  • Direct examination
    • spherules in wet mounts of urine, exudates, pleural or peritoneal fluids
  • Cultural examination
    • DTM, Sabouraud, and Mycobiotic
    • Only grows in mycelial phase in culture
    • Fluffy white mycelium in 2-4 weeks
    • Arthrospores (alternating and barrel-shaped) become airborne very easily
      • Formalize culture before doing tease mount
      • attempt culture only in a safety glove box
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10
Q

What is the Epidemiology of Coccidioidomycosis?

A
  • Survive in hot weather with little or no rainfall
  • Windy weather and blowing dust spreads with spores
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11
Q

What is the treatment for Coccidioidomycosis?

A
  • Ketoconazole, Fluconazole, and triazole
  • Amphotericin B
    • Very toxic, monitor kidney function closely
  • No vaccine
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12
Q

What is Histoplasmosis?

A
  • Caused by: Histoplasma capsulatum
  • Primarily in pulmonary tissue or intestinal tract
    • disseminated form involves spleen and liver
    • Yeast cells in circulating monocytes and neutrophils
  • Dogs are more susceptible than other animals
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13
Q

What are the general characteristics of Histoplasma capsulatum?

A
  • Dimorphic fungus
    • At 25C and in the environment in the mycelial phase
    • At 37C and in the animal body, the yeast phase
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14
Q

What is the Geographic Distribution of Histoplasmosis?

A
  • Worldwide
  • Very prevalent in OH, MS, MI river valleys
  • Endemic in Southeast Kansas
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15
Q

What is the prevalence of Histoplasmosis?

A
  • Is the most frequently diagnosed systemic fungal disease
  • Many in endemic areas are infected and sensitized
    • few contract disease
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16
Q

What is the Pathogenesis of Histoplasmosis?

A
  • Inhalation of spores (Conidia)
  • Development of granulomas in the lungs
    • spread to other tissues of the body
  • Enlarged spleen, lymph nodes, and liver
  • Monocytes and neutrophils are infected
  • Adhesins for adherence to host cells
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17
Q

What are the clinical manifestations of Histoplasmosis in dogs?

A
  • Chronic cough
  • Gradual weight loss
  • Diarrhea when intestinal tract affected
  • Irregular fever
  • Ascites
  • Lymphadenopathy
18
Q

How is Histoplasmosis Diagnosed clinically?

A
  • Characteristic clinical signs
  • Look for yeast bodies in the monocytes and/or neutrophils from a blood smear or buffy coat smear
  • Intradermal sensitivity test - Histoplasmin
  • Serologic tests - Precipitin, Complement fixation, ELISA
19
Q

How is Histoplasmosis diagnosed in the laboratory?

A
  • Direct examination
    • Look for yeast cells in biopsy material
    • Look for yeast cells in feces
    • Tissue impression smears of liver, spleen, lung
  • Culture:
    • On Mycobiotic
      • At 25C Mycelial phase
      • at 37C Yeast phase
    • Blood sample or buffy coat
    • Tease Mount only after formalizing the culture
    • Conidia with cocklebur appearance - in the mycelial phase
20
Q

What is the epidemiology of Histoplasmosis?

A
  • Fungus in mycelial phase in the soil
  • Requires very high nitrogen content and low pH in order to survive
  • Frequently found in areas where wild birds roost or in bat caves because of an abundance of fecal material
  • Infection acquired by inhalation o spores
21
Q

What is the treatment for Histoplasmosis?

A
  • Ketoconizole
  • Itraconazole
  • Miconazole
  • Fluconazole
  • Amphotericin B
    • Renal toxicity
22
Q

What is Blastomycosis?

A
  • Caused by: Blastomyces dermatitidis
  • Granulomatous and suppurative disease
  • Primary pulmonary lesions which may disseminate to other organs such as skin, eye, and bone
  • Dogs most susceptible
23
Q

What are the general characteristics of Blastomyces dermatitidis?

A
  • Diphasic fungus
  • Budding yeast cells (figure 8) in tissue and when grown at 37C in culture
  • Mycelial phase in soil and when grown at 25C in culture
24
Q

What is the prevalence of Blastomycosis?

A
  • Most cases reported in dogs
  • Cats and horses are also susceptible
25
Q

What is the pathogenesis of Blastomycosis?

A
  • Primary pulmonary infection due to inhalation of spores
  • Adhesin
26
Q

What are the Clinical Manifestation of Blastomycosis?

A
  • Eye lesions
  • Enlarged Thoracic lymph nodes
    • lymphadenopathy
  • Bone and skin lesions may develop
  • In disseminated disease, lesions throughout the body
  • Granulomatous and suppurative
  • Signs:
    • Cough and dyspnea
    • Skin furuncles (small abscesses) large abscesses, and may ulcer
27
Q

How is Blastomycosis Diagnosed?

A
  • Clinical:
    • Respiratory disease, differentiate from Nocardiosis and Actinomycosis
    • Blastomycin skin test
    • Precipitin test
  • Laboratory:
    • Direct Examination:
      • Large budding (Figure 8) yeast cells in exudate or tissue
      • Yeast cells are thick-walled and 5-30 microns in diameter
      • Not capsulated
    • Cultural Examination:
      • Mycobiotic Agar
      • Grow Slow (10-14 days)
      • Hold for 30 days before discarding as negative
      • Mycelial phase 25C
        • Characteristic conidia, 3-4 microns in diameter, smooth
        • Non-pathogenic fungi may have similar appearance, but do not convert to yeast phase at 37 C
        • Yeast phase at 37 C on blood agar
28
Q

What is the Epidemiology of Blastomycosis?

A
  • Saprophyte in the soil
  • Infection by inhalation of conidia
29
Q

How is Blastomycosis treated?

A
  • Ketoconazole
  • Itraconazole (drug of choice)
  • Amphotericin-B
30
Q

What is cryptococcosis?

A
  • Caused by: Cryptococcus neoformans
  • Causes subacute to chronic granulomatous disease
  • In dogs and cats:
    • pulmonary disease, central nervous system involvement in some cases
    • Localized infections or oral and nasal mucosa
  • In Cattle:
    • mastitis
  • In horses:
    • Nasal granulomas -with discharge and respiratory distress
    • CNS - A somewhat bland lesion with little inflammatory response
30
Q

What is cryptococcosis?

A
  • Caused by: Cryptococcus neoformans
  • Causes subacute to chronic granulomatous disease
  • In dogs and cats:
    • pulmonary disease, central nervous system involvement in some cases
    • Localized infections or oral and nasal mucosa
  • In Cattle:
    • mastitis
  • In horses:
    • Nasal granulomas -with discharge and respiratory distress
    • CNS - A somewhat bland lesion with little inflammatory response
31
Q

What is Cryptococcus neoformans?

A
  • Causes Cryptococcosis
  • Yeast-like fungus
  • only seen in the yeast phase
  • unable to produce mycelial phase in culture
  • Has a very thick capsule
32
Q

What is the Geographic distribution of cryptococcosis?

A
  • Worldwide
  • Associated with pigeon droppings
  • likes high nitrogen
  • low pH for survival
33
Q

What is the pathogenesis of Cryptococcosis?

A
  • Primarily by inhalation of the blastospores
  • Capsule, lipases, melanin
34
Q

What are the clinical manifestations of Cryptococcosis in Dogs and Cats?

A
  • Pulmonary infections
    • Mediastinal and bronchial lymph nodes
  • Granulomas of the oral and pharyngeal mucosa
  • Granulomas of the nasal cavity and adjacent structures
  • Invasion of the bone on rare occasions
  • Eventually goes to the CNS
35
Q

What are the clinical manifestations of Cryptococcosis in horses?

A
  • Most cases nasal granulomas
  • lesions on the lips
  • CNS
36
Q

What are the clinical manifestations of Cryptococcosis in cattle?

A
  • Mastitis
37
Q

How is Cryptococcosis diagnosed?

A
  • Laboratory:
    • Direct Examination
      • Spinal fluid, milk, tissue biopsy impression, et
      • India ink wet mount - Negative staining
      • Look under microscope for yeast cells with thick capsule
    • Cultural examination:
      • Grow on Sabouraud Dextrose agar or BHI
      • Biochemical tests are of no value
      • API system - commercial test kit
      • 4 antigenic types based on capsular polysaccharide
38
Q

What is the epidemiology of Cryptococcosis?

A
  • Ubiquitous organism, isolated from a wide variety of locations:
    • Surface of fruit
    • Pigeon droppings
    • Healthy human skin
    • air conditioners at KSU
    • bat feces
    • Butter
    • Grass
    • Insects
    • Milk
    • Soil
  • Humans who come down with cryptococcosis have a history of association with pigeons. Pigeons carry the organism in their digestive tracts, does not cause disease
39
Q

How is Cryptococcosis treated?

A
  • Fluconazole and Itraconazole are drug of choice
  • Amphotericin-B - Toxicity
  • 5-Fluorocytosine