Opportunistic Fungal infections Flashcards

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1
Q

Fungal organisms responsible for Opportunistic infections

A

Cryptococcus
Candida
Aspergillus
Mucor (Zygomycetes)
Pneumocystis

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2
Q

Cryptococcus is classified on based of Morphology

A

True yeast - Budding

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3
Q

Pathogenic organism known to cause Cryptococcus

A

Cryptococcus Neoformans

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4
Q

Serotypes of Cryptococcus

A

A,D, AD - C. Neoformans
B,C - C. Gatti

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5
Q

Geographical distribution of C. Neoformans and C. Gatti

A

C Neoformans - all over world
C Gatti - Tropical and subtropical

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6
Q

Isolation of Cryptococcus Neoformans is done on

A

Soil with pigeon dropping

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7
Q

Isolation of C. Gatti is done on

A

Soil around Eucalyptus trees

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8
Q

C. Neoformans and C. Gatti known to effect what type of immunity

A

C Neoformans - Immunocompromised
C Gatti - Both immunocompromised and immunocompetent pt.

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9
Q

Which Cryptococcus needs prolonged treatment

A

C Gatti

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10
Q

How C Neoformans enters human body

A

Soil with Pigeon dropping - inhalation - Lungs - Blood - cause Meningitis - causes Cryptococcal Meningitis

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11
Q

Stain used for diagnosis of Cryptococcal Meningitis

A

CSF - Negative stain (India ink, Nigrosin)

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12
Q

Biopsy sample in case of Cryptococcal Meningitis is stained with

A

Mucicarmine - Rose pink

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13
Q

Culture media used for diagnosis of Cryptococcal infection

A

SDA - Mucoid colony
Niger seed agar/Bird seed agar/Caffeic seed agar

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14
Q

Finding of Cryptococcal infection on Niger seed agar/Bird seed agar or Caffeic seed agar

A

Melanin (brown ) due to Phenol oxidase/laccase

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15
Q

Confirmatory test for Cryptococcal Meningitis

A

LAT (Latex agglutination test)

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16
Q

Treatment of Cryptococcal Meningitis

A

Liposomal Amphotericin B with Flucytosine - DOC

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17
Q

Candida is classified in which group according to morphology

A

Yeast like - Both bud and Pseudohyphae

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18
Q

Candida Includes which organisms and Most common

A

Candida albicans - M/C
Candida dupliniensis
Candida galbrata
Candida auris
Candida krussei
Candida kefyr

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19
Q

Which candida species doesn’t have pseudohyphae

A

Candida glabrata

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20
Q

Which candida species are resistant to Azoles

A

Candida auris
Candida krussei

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21
Q

Which candida species are used as control in susceptibility tests

A

Candida kefyr

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22
Q

Sites at which Candida is normally present

A

Normal Flora - GIT, Genital tract
Mucosa
Skin
Nails
Internal organs

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23
Q

Mucosal clinical features of Candida infection

A

Oral thrush - Curdy white discharge
Esophagitis
Vulvovaginitis
Balanitis
Ocular Candidiasis

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24
Q

Other clinical manifestations of Candida

A

Paronychia
Onychomycosis
Diaper rash
UTI
Endocarditis
Meningitis
Pulmonary involvement

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25
Q

Pap smear finding in case of Candida infection

A

Shish kebab effect

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26
Q

Predisposing factors for Candida infection

A

Decreased immunity
Infancy - Diaper rash
Old age
DM
Steroids
Pregnancy
Immunocompromised states/Immunodeficiency diseases
Immunosuppressant drugs
Neutropenia pt.

27
Q

Culture used for diagnosis of Candida

A

SDA
Corn meal agar
Chrom agar

28
Q

Finding of Candida on SDA agar

A

Creamy pasty yeasty colonies

29
Q

Finding of Candida on Corn meal agar

A

Chlamydospores (double wall configuration)

30
Q

Specific phenomenon or test done in case of Candida infection

A

Reynolds braude phenomenon or Germ tube test

31
Q

Germ tube test is positive for which infections

A

C. Albicans and C. Dubiliensis

32
Q

Chlamydospores can be seen in which Candida species

A

Both Candida albicans and Dubiliensis

33
Q

Which candida can grow above 45°C and in hypertonic saline

A

Candida albicans

34
Q

Treatment of Oral thrush and vulvovaginal candidiasis in case of Candida

A

Topical Nystatin

35
Q

Treatment of Severe Candidiasis

A

Fluconazole/Nystatin

36
Q

Treatment of Deep Candidiasis

A

Liposomal Amphotericin B
Azoles

37
Q

Aspergillus is known to cause which conditions

A

ABPA (Allergic Bronchopulmonary Aspergillosis)
Aspergilloma - grows in prexisting cavity
Invasive Aspergillosis - disseminated
Superficial - Otomycosis

38
Q

ABPA (Allergic Bronchopulmonary Aspergillosis) is Combination of which HS Reactions

A

Combination of Type 1 and 3 HS reaction
Due to repeated/heavy exposure to spore

39
Q

Type of hyphae and type of branching seen in Aspergillus

A

Septate hyphae
Shows acute angle Dichotomous branching

40
Q

Aspergillus includes which Organisms

A

A. Fumigatus
A. Flavus
A. Niger
A. Terreus

41
Q

Colonies and LPCB Stain finding in case of A. Fumigatus

A

Smoky green colonies - LPCB Stain - Conidia along upper part

42
Q

Colonies and LPCB stain finding in case of A. Flavus

A

Yellow green colonies - LPCB Stain - Conidia all around

43
Q

Culture and LPCB Finding in case of A. Niger

A

Black colonies - LPCB stain - Blackish/Brown color

44
Q

Culture finding in case of A. Terreus

A

Beige/Cinnamon color

45
Q

Toxin found in Aspergillus Fumigatus

A

Aflatoxin - Groundnut/Peanut contaminant

46
Q

Aflatoxin can cause mutation at

A

Codon 249 of p53 gene and can lead to Hepatocellular carcinoma

47
Q

Type of Hyphae in case of Zygomycetes/Glomerulomycetes

A

Aseptate hyphae

48
Q

Organisms involved in Zygomycetes/Glomerulocytes

A

RAM
Rhizopus - fungus with root (just below)
A - Absidia/Leicthemia - root in between organism
M - doesn’t have root

49
Q

Rhizopus Oryzae is known to cause

A

Rhino-oculo-cerebral disease

50
Q

Triad seen in case of Rhizopus infection

A

Nasal discharge
Proptosis
Delirium
2nd M/C - Lung

51
Q

Treatment of Rhizopus infection

A

Surgical resection
Amphotericin B
Alternative - Posaconazole

52
Q

Which fungus is known as Black fungus

A

Mucor - clinically black lesion

53
Q

Hyphae and branching seen on tissue biopsy in case of Mucor infection

A

Obtuse/perpendicular branching
Aseptate hyphae

54
Q

Mucor Finding on SDA Agar

A

Cotton wool growth or Salt and pepper appearance

55
Q

Mucor AKA and shape

A

AKA Lid lifters
Shape - broader and ribbon like

56
Q

Beta D glucan

A

Polysaccharide cell wall component of many Fungi
Not seen in Mucor, Blastomyces and Cryptococcus

57
Q

Galactomannan

A

Major polysaccharide constituent of Aspergillus cell walls
Mucor -ve and +ve in rest all

58
Q

Which fungus doesn’t have Ergosterol in it’s cell membrane

A

Pneumocystis carinii

59
Q

Clinical features and Microscopic finding in Pneumocystis carinii

A

Pneumonia - Dry cough
Bronchoalveolar lavage - on M/E : Plasma cells ++

60
Q

Stain used and Finding for Pneumocystis carinii

A

Gomori Methanamine stain - Crushed Ping pong ball appearance/Helmet appearance/Cup and saucer appearance

61
Q

Is pneumocystis carinii cultivable

A

No

62
Q

Treatment of Pneumocystis carinii

A

Cotrimoxazole
Pentamidine - in sever cases

63
Q

Pneumocystis carinii Mnemonic

A

PCP - Pneumocystis carinni pneumonia
PCP - Plasma cell Pneumonia
PCP - Ping Pong Crushed ball
PCP - Pneumocystis, Cotrimoxazole, Pentamidine