Mycoses - opportunistic fungi infections Flashcards
type of fungal infections
- systemic mycoses
- Cutaneous mycoses
- opportunistic fungal infections
opportunistic fungal infections - bugs?
- Candida ablicans
- Aspergillus Fugimatus
- Cryptococcus neoformans
- Mucor and Rhizopus spp.
- Pneumocystis jirovecii
- Sporothrix schenckii
Candida ablicans causes ….. infection (generally) / name meaning
systemic of superficial
alba = white
Candida ablicans causes …. (and situations)
- Oral and esophageal thrush (immunocompromised –> neonates, steroids, diabetes, AIDS)
- vulvovaginitis (diabetes, antibiotics)
- diaper rash
- endocarditis (iv drug users)
- disseminated candidiasis
- chronic mucocutaneous candidiasis
- osteomyelitis (IV drugs)
situations that increase the risk for opportunistic infections by candida
- immunocompromised –> neonates, steroids, diabetes, AIDS
- diabetes
- antibiotics
- IV drug users
Candida ablicans and antibiotics –>
vulvovaginitis
Candida ablicans and diabetes
vulvovaginitis, Oral and esophageal thrush
Candida ablicans - morphology
DIMORPHIC
pseudohyphae and budding yeast at twenty c.
germ tubes at thirty seven c
Candida ablicans - treatment
topical azole for vagina
nystatin, fluconazole or caspofungin for oral/esophageal
fluconazole or amphotericin B for systemic
Aspergillus fugimatous causes … (and situations)
- invasive aspergillosis (immunocompromised and with chronic granulomatous disease)
- Allergic bronchopulmonary aspergillosis (associated with asthma, cystic fibrosis) –> bronhiectasia and eosinophilia
- Aspergillomas in lung cavitieus (esp after TB)
- produce aflatoxins –> hepatocellular CA
Aspergillus fugimatous - invasive aspergillosis esp in
immunocompromised and with chronic granulomatous disease
Allergic bronchopulmonary aspergillosis is associated with
asthma, cystic fibrosis
Aspergillus fugimatous - morphology
NOT dimorphic (only as a mold) Septate yphae that branches at 45 angle conidophore with radiating chains of spores
Cryptococcus neoformans causes
- meningitis
- cryptococcosis
- cryptococcal encephalitis
Cryptococcus neoformans - morphology
heavily encapsuled yeast. NOT DIMORPHIC
5-10μm (NARROW BASED BUD)
MCC of meningitis in AIDS
Cryptococcus neoformans
Cryptococcus neoformans - rout for meningitis
Acquired through inhalation with hematogenous dissemination to meninges
Cryptococcus neoformans is found in
soil
pigeon dropping
Cryptococcus neoformans - lab
Culture on Sabouraud agar
Stain with india ink and mucocarmine
latex agglutination test detects polysaccharide capsular antigen
soap bubble lesion in brain image (in cryptococcal encephalitis)
Cryptococcus neoformans - lab - most specific test
latex agglutination test detects polysaccharide capsular antigen
Cryptococcus neoformans - culture on
Sabouraud agar
Cryptococcus neoformans - stain with
Stain with india ink and mucocarmine
Cryptococcus neoformans - brain image
soap bubble lesion (in cryptococcal encephalitis)
Mucor and Rhizopus spp. cause
Mucormycosis
Mucor and Rhizopus spp. cause … (and situations)
Mucormycosis, a disease mostly in ketoacidotic diabetic and/or neuropenic patient (e.g. leukemia)
Mucormycosis - pathophysiology
fungi proliferation on blood vessel walls, pemetrate cribiform plate and enter brain
Mucormycosis –> (causes, symptoms)
Rhinocerebral frontal lobe abscess, carvenous sinus thrombosis, headache, facial pain, black necrotic eschar on face, may have cranial nerve involvement
Mucormycosis treatment
- surgical debridement
2. amphotericin B
Mucor morphology
NOT DIMORPHIC
irregular, broad nonseptae hyphae at wide angles
Pneumocystis jirevecii causes (situations)
Pneumonocystis pneumonia (PCP), a diffuse interstitial pneumonia (immunosuppression eg. AIDS)
Pneumocystis jirevecii - morphology / originally classified as
yeast like fungus (disc shape)
originally classified as protozoan
originally classified as protozoan
Pneumocystis jirevecii in immunocompoment - symptoms
asymptomatic
situation that predispose to disease with Pneumocystis jorevecii
immunosuppression eg. AIDS
Pneumonocystis pneumonia (PCP) - CXR/CT
diffuse, bilateral ground glass opacities
Pneumonocystis pneumonia (PCP) is diagnosed by
lung biopsy or lavage
Pneumocystis jirevecii - staining
Disc-shaped yeast forms on methamine silver stain on lung tissue
Pneumocystis jirevecii - shape
disc shape
Pneumocystis jirevecii - type of stain
methamine silver stain
Pneumocystis jirevecii - Treatment/prophylaxis
- TMP-SMX
- Pentamidine
- dapsone (only prophylaxis)
- atovaquone
Pneumocystis jirevecii - start prophylaxis when
CD4 cound drops under 2 hundred cells/mm3 in HIV patients
Sporothrix schenckii causes
Sporotrichosis
Sporotrichosis?
Nodules, postules and ulcers extending along path of lymphatic drainage (ascending lymphangitis)
if immunocompromised –> disseminated disease
Sporothrix schenckii - morphology
Dimorphic, cigar shaped budding yeast that grows in branching hyphae with rosettes of conidia
Sporothrix schenckii leaves on
vegetations
Sporothrix schenckii - Sporotrichosis - mechanism
when spores are traumatically introduced into the skin, typically by a thorn, causes local postules or ulcers with nodules along draining lymphatics (ascending lymphangitis)
Sporothrix schenckii - treatment
intraconazole or potassium iodide
Sporotrichosis is AKA
rose gardener’s disease
opportunistic fungal infections - dimorphic fungi
- Candida ablicans
2. Sporothrix schenckii
Oppostunistic fungal infection - morphology of every fungus
- Candida ablicans - dimorphic: pseudohyphae and budding yeast at 20c. germ tubes at 37c
- Aspergillus Fugimatus - not dimorphic (only as a mold). Septate hyphae that branches at 45 angle
conidophore with radiating chains of spores - Cryptococcus neoformans: heavily encapsuled yeast. not dimorphic, 5-10μm (NARROW BASED BUD)
- Mucor and Rhizopus spp: not dimorphic, irregular, broad nonseptae hyphae at wide angles
- Pneumocystis jirovecii: Disc-shaped yeast-like
- Sporothrix schenckii: Dimorphic, cigar shaped budding yeast that grows in branching hyphae with rosettes of conidia
Oppostunistic fungal infection - pseudohyphae fungus
Candida
Oppostunistic fungal infection - hyphae fungus
- Mucor and Rhizopus (nonseptate)
- Aspergillus (septate)
- Sporothrix scenckii (branching)