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ID exam 2 > Mycology random facts > Flashcards

Mycology random facts Flashcards

1
Q

cryptococcus usu seen in what type of patients?

A

majority have problem with cell mediated immunity (but can affect anyone)

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2
Q

cryptococcus

A

pigeon and kowala poo, soil

  • -inhalation –> hematog spread –> dissemination
  • 5-10um
  • havily encapsulated
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3
Q

cyptococcal meningitis

A

-prompt tx (100% fatal without)
-hematog spread from apparent lung infx
-NON-inflammatory –> do not get influx of PMNs
-Obstruction of CSF flow and INCREASE ICP due to cells clogging up plumbing
Tx: amphotericin B +flucytosine, f/u with flucon

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4
Q

rapid diagnostic test for cryptococcus

A

CRAG (cryptococcal antigen test)–> looks for surface antigen

  • high sens/spec
  • quick and rapid test, cheap
  • urine, serum, CSF
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5
Q

candida

A
  • part of normal flora
  • dimorphic (buds at 20, germ tubes at 37)
  • problem in ICUs/hospitals
  • major cause of bacteremia via catheters, trachs
  • can travel to multiple organs
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6
Q

diagnostic tests for candida (tl:dr- its a bad test)

A

1,3-beta-D-glucan

  • NOT specific for candida
  • binds cell wall component of candida and a lot of other things
  • NOT cyrto, mucorales, blastomyces derm
  • has a lot of false positives
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7
Q

aspergillus

A
  • mold
  • acute angle (45 deg), septate, hyphae
  • common in the air, can get into AW easily
  • casue dz in vulnerable pops
  • propensity to grow in cavitary lesions (old TB)
  • “halo sign” on imaging
  • causes dz in pt with neutropenia, CGD
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8
Q

hyphae

A

-grows TOWARDS food source

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9
Q

aspergillus fumigatus

A 
-responsible for majority of dz
narrow hyphae
-45 degree branching
-septate 
- conidiophores
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10
Q

diagnostic test for aspergillus

A
  • look for galactomanna (crosslinks wall)
  • has cross reactivity, no specific
  • b-d-galactan –> same test used for candida (not good)
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11
Q

C. neoformans morphology (uworld)

A

yeast form
round/oval
HEAVILY encapsulated cells with narrow base buds

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12
Q

c neo virulence (uworld)

A

thick polysac capsule

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13
Q

c neoformans epi (uworld)

A
  • soil and pigeon poop
  • opp infx
  • resp transmission
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14
Q

c neoformans infx

A

primary= lung
most common= meningoencephalitis
*can show hematogenous dissemination

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15
Q

c neoformans dx (uworld)

A

india ink of CSF (halo cells)
latex agglutination for polysach capsule (CSF)
culture on Sabouraud’s agar
methenamine silver (GMS) stain or mucicarmine (red)

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16
Q

c neo tx (uworld)

A

amphotericin B and flucytosine (acute meningitis)

*fluconozole for lifelong prophylaxis

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17
Q

CNS infection in HIV+ patient is likely…..

A

cryptococcus neo. most common cause of fungal meningitis

18
Q

mucorales

A

mold

  • NONseptate hyphae, 90 degree angles
  • MUCORMYCOSIS –> pt with DKA, DM (likes high glucose)
  • pt with hemachromatosis, or treated with deferoxamine –> likes iron
  • FAST growth
19
Q

rhinoorbitalcerebral mucor

A

gains entry through cribiform plate, gets into frontal lobes

20
Q

3 major dz of aspergillus

A

1) allergic bronchopulmonary aspergillosis (ABPA) –> type I hypersensitivty, assoc with asthma (increased IgE, eos) and CF
2) Angioinvasive aspergillosis –> immunocomp patients/ CGD, disseminates to heart, kidney and brain (ring enhanced lesions). Tx= AmphoB
3) aflatoxins –> HCC

21
Q

Dematiaceous moulds

A

black molds

  • soil saprophytes
  • DIRECT innoculation
  • melanin (makes it black) –> bad.
  • can disseminate –> can cause meningitis
22
Q

dimorphic fungi (geographic fungi)

A
  • use phenotypic switching to grow in human body –> THERMAL DIMORPHISM
  • cold= mold
  • yeast= heat (body)
  • histoplasmosis
  • blastomycosis
  • coccidio (spherule, not yeast)
  • paracoccidio
23
Q

blastomycosis

A
  • eastern US, ohio river valley, great lakes
  • central america
  • inhaled
  • Blasto Buds Broadly (cannon balls)
  • same size as RBC
  • 8-15um
  • disseminates in IC –> to skin and bone (general lee)
24
Q

is blastomyces in CO?

A

dogs can get it from praire dogs

25
Q

What are the two most common forms of dz of blastomyces?

A

PULMONARY –> (hematogenous dissemination) –> CUTANEOUS BLASTO
-cutaneous can be confused for skin cancer

26
Q

what type of immune response do you see in blastomyces? what type of immune response do you generally see for fungi?

A

pyogranulomatous response

fungi= cell mediated

27
Q

coccidiomycoses

A

-grows in SPHERULES filled with endospores
-alternatin arthroconidia
-BIG 50-100 um
-southwestern US, Cali, DESERTS
-

28
Q

dz manifestations of coccidiomycoses

A
  • PNA (turns cavitary) , meningitis
  • hemog dissem to skin and bone
  • san jaquin valley fever
  • “desert bumps” –> erythema nodosum
  • desert rhuematism –> arthralgias

***fever, cough, arthralgia

29
Q

Serology of coccidioides

A

If you have ab to coccidio, you HAVE INFX

early: immunodiffusion
>1 mo –> Complement fixation (CF)
-CF titer predicts extrapulm dz
-CF titer tells if tx is working

30
Q

histo

A

mississippi and ohio river valleys

  • ANYTHING to do with birds
  • resp tract transmition
  • Histo Hides in macrophages
  • MUCH smaller than RBC
  • rapid serum, urine antigen
31
Q

dz from histo

A

PNA

  • calcifications
  • late chronic looks like TB
  • may see elevated inflamm markers (LDH, ferritin, non specific)
  • targets RES –> HSM
32
Q

do you get blood cultures for histo? what kind?

A

Takes weeks to grow. do LYSIS CENTRIFUGATION. Spin it down, then try to culture it

33
Q

how long do you treat these disseminated diseases?

A

like years.

34
Q

sporothrix schenckii

A
  • dimorphic assoc with ZOONOTIC transmission –> dogs and cats
  • cigar shaped
  • budding yeast
  • grows in branching hyphae with rosettes of conidia
  • lives on vegetation –> “ROSE GARDER dz”
  • ascending lymphangitis
35
Q

how do you usually get sporothricosis? how do you treat sporothricosis?

A

DIRECT innoculation (roses).

itraconazole or potassium iodide

36
Q

sporothrix (slide from class)

A

aggriculture
children, men
world wide + hyperendemic (peru)
zoonotic

37
Q

preogression of sporo

A

skin ulcer –> ascending lymphangitis –> these areas up the lymph chain become necrotic

38
Q

does sporo disseminate? is it common? what are risk factors?

A

yes, uncommon

where: joint, bone, lung, meninges
who: EtoH, DM, late HIV, COPD

39
Q

paracoccidiodies

A
  • rare
  • latin america
  • sub tropical, mountainous climates where coffee can grow
  • agg workers on coffee plantations
  • LONG incubation (decades)
  • adults
  • males
  • can present like COPD
40
Q

why would culture of open skin wounds be discouraged?

A

they generally just grow normal skin flora

ID exam 2 (16 decks)

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