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Endocrine System > Opportunistic Fungal Infections (Medical Mycology) > Flashcards

Opportunistic Fungal Infections (Medical Mycology) Flashcards

1
Q

What are edible mushrooms?

A

They are fungi

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2
Q

What are fungi?

A

Fungi are eukaryotes that exist that exist as unicellular or multicellular

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3
Q

What is the cellular organization of fungi?

A

They have complex cellular organization but lack chlorophyll thus, they differ from plant cells

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4
Q

What are the organelles of the fungi?

A

Nucleus where DNA is wrapped around histones
Mitochondria
Ribosomes
Cell wall
Plasma Membrane

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5
Q

What does the cell wal of the fungi contain?

A

Chitin,
Glucans
Mannans
Polysaccharides

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6
Q

What does the fungal cell membrane contain?

A

Ergosterol
(Mammalian cells contain cholesterol)

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7
Q

How many fungi species have been identified?

A

More than 200 000 fungal species have been identified, however, less than 300 can cause disease in human

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8
Q

What are the different fungal morphologies?

A
  1. Yeast
  2. Yeast-like fungi
  3. Filamentous fungi
  4. Dimorphic fungi
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9
Q

What are the differences between bacteria and fungi?

A

Bacteria: prokaryotes, smaller, cell wall peptidoglycan, growth pH 6.5to 7, cell cycle 20 minutes, motile with flagella, 70S ribosomes, pili, no cytoskeleton

Fungi: eukaryotes, bigger, chitin cell wall, pH value 4 to 6, cell cycle 12 to 24 hours, immobile, 80S ribosomes, no pills, microtubules

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10
Q

What are the different types of medically important fungi?

A

Dimorphic
Opportunistic

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11
Q

What are the two kinds of dimorphic fungi?

A

Mold form at 25°C (environmental temperature)
Yeast form at 37°C (body temperature)

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12
Q

What are he examples of dimorphic fungi?

A

Bastomyces Dermatitis
Coccidiiodes Immitis
Histoplasma capsulatum
Paracoccidioides brasiliensis

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13
Q

What are examples of opportunistic fungi?

A

Candida albicans
Cryptococcus neoformans
Aspergillus fumigatus

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14
Q

What are the virulence factors of fungal pathogens (surface components)? (3)

A
  1. Cell wall glycoproteins: facilitate adherence.
  2. Capsule: prevent phagocytosis by immune cells
  3. Melanin pigment: antioxidant, detoxify, reactive oxygen radicals released by immune cells
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15
Q

What are the virulence factors of fungal pathogens (immune evasion)? (3)

A
  1. Thermo-tolerance: grow in different shapes at 37
  2. Resist killing by phagocytosis
  3. Cytocidal activity against epithelial and monocytic cells
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16
Q

What are the virulence factors of fungal pathogens (exoenzymes)?

A
  1. Elastase: degrades elastin and enhances invasion of lung, skin, and blood vessels
  2. Alkaline protease: degrades collagen and elastin, enhances invasion of lung tissues
  3. Acid proteases: cleaves IgA2 immunoglobulin
  4. Keratinase: degrades scleroprotein in the skin
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17
Q

What are the virulence factors of fungal pathogens (toxins and toxic metabolites)?

A
  1. Aflatoxin: causes liver toxcity and carcinogenic
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18
Q

What is candidiasis?

A

Caused by yeast candida
Candidiasis can occur in the mouth and throat, vagina, or the bloodstream (esophageal candidiasis, nail infection, thrush)

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19
Q

What is the C. neoformans infection?

A

Caused by cryptococcus neoformans, which can infect the brain (meningitis) in people with HIV/AIDS (cryptococcus meningitis and skin infections)

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20
Q

What is aspergillosis?

A

Caused by the fungus Aspergillus and usually occurs in people with lung diseases or weak immune systems (nail infections, lung infection and burn infection)

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21
Q

What is mucormycosis?

A

A rare infection that m(rhinocerebral mucormycosis and skin infections)

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22
Q

What is pneumocystis pneumonia? (PCP)

A

Caused by the fungus Pneumocystis jirovecii and mainly affects people with weakened immune systems (lung infections)

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23
Q

What is Blastomycosis?

A

Caused by the fungus Blastomyces, which lives in moist soil in parts of the US and Canada (skin infections)

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24
Q

What is Sprotrichosis?

A

Caused by the fungus Sporothrix, which lives throughout the world in soil and on plants (skin and subcutaneous infections)

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25
Q

What is histoplasmosis?

A

Caused by the fungus Histoplasma, which lives in the environment, often in association with large amounts of bird or bat droppings (skin and lung infections)

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26
Q

What is ringworm?

A

Infect immune-competent people, a common fungal skin infection that often looks like a circular rash (athlete’s foot, scalp infection, ringworm circle)

27
Q

What fungus causes ringworm?

A

Tinea fungus

28
Q

What are fungal eye infections?

A

Different types of fungi can cause eye infections, these are rare but can develop after an eye injury (fungal keratitis, infection of the cornea, periorbital fungal infection)

29
Q

What are the opportunistic fungal infections in Cushing’s? (6)

A
  1. Candidiasis –> esophageal, endocarditis
  2. Cryptococcosis –> pulmonary, meningitis, disseminated disease
  3. Histoplasmosis –> pulmonary, adrenal
  4. Aspergillosis –> invasive pulmonary, endophthalmitis, disseminated disease
  5. Pneumocystosis –> pneumoniaa
  6. Scedosporiosis –> osteomyelitis, arthritis
30
Q

What are the important clinical findings of candida?

A

Thrush in mouth and vagina, endocarditis in intravenous drug users

31
Q

What are the important clinical findings of cryptococcus?

A

Meningitis

32
Q

What are the important clinical findings of aspergillus?

A

Fungus ball in lung, wound and burn infections; indwelling catheter ingfection, sinusitis

33
Q

What are the important clinical findings of mucor and rhizopus? What are the predisposing factors?

A

Necrotic lesion formed when mold invades blood vesself; predisposing factors are diabetic ketoacidosis, renal acidosis and cancer

34
Q

What are the lab findings of candida?

A

Gram (+), culture grows yeast colonies, candida albicans form germ tubes

35
Q

What are the lab findings of cryptococcus?

A

India ink stain shows yeast with a large capsule; the culture grows very mucoid colonies

36
Q

What are the lab findings of aspergillus?

A

Culture grows mold with green spores and conidia in radiating chains

37
Q

What are the lab findings of mucor and rhizopus?

A

Culture grows mold with black spores; conidia enclosed in a sac called sporangium

38
Q

Which kind of species cause monilial thrush?

A

C. albicans and other candida

39
Q

What else do candida species cause?

A

Bloodstream infections

40
Q

What are the main candida species?

A

C. albicans
C. auris
C. tropicalis
C. glbrata
C. krusei
C. parapsilosis

41
Q

What is the range of infections caused by the candida species?

A

Infections range from superficial mucosa and cutaneous candidiasis to widespread hematogenous dissemination involving target organs

42
Q

What is candida auris?

A

A superbug!
An emerging fungal infection as hospital-acquired infection in immune-compromised patients

43
Q

Why is candida auris considered a superbug?

A

Due to its antifungal resistance

44
Q

What is mucor and rhizopus?

A

Mold

45
Q

What does mucor and rhizopus cause (mucrmycosis)?

A

Extensive tissue damage in immune-suppressed people
Spreads from the nasal mucosa to paranasal sinuses orbital and brain

46
Q

What is the prognosis of mucor and rhizopus?

A

Rapidly fatal if left untreated

47
Q

What are the types of infections that are caused by mucor and rhizopus?

A
  1. Mucormycosis
  2. Rhinocerebral mucormycosis
  3. Cutaneous mucormycosis
  4. Periorbital fungal infection
47
Q

What is the enzyme found in mucor and rhizopus? What is its function?

A

Ketone reductase, allows them to thrive in high glucose, acidic conditions. Serum from healthy individuals inhibits the growth of Rhizopus, whereas serum from individuals in diabetic ketoacidosis stimulates growth

47
Q

What is cryptococcus neoformans?

A

A spherical to oval, encapsulated yeast-like organism, 2 to 20μM in diameter, which replicates by budding

47
Q

What do the c. neoformans subspecies and the gatti subspecies cause?

A

Cryptococcosis in the lung and CNS thus manifests as pneumonia and/or fungal meningitis

48
Q

What is the major virulence factor of cryptococcus neoformans?

A

The capsule

49
Q

What is the function of the capsule of C. neoformans?

A
  1. Inhibits phagocytic function
  2. Downregulates cytokines
  3. Induces suppressive T cells
  4. Inhibits antigen presentation
50
Q

What are the other virulence factors of C. noeformans?

A

Melanin production –> serves as an antioxidant
Exoenzymes –> facilitate tissue invasion

51
Q

What temperatures do C. neoformans have the ability to grow in?

A

Ability to grow at 37oC

52
Q

What are Aspergillus species?

A

They are abundant indoors and outdoors, spores are breathed and cause allergic reactions, infections, and invasive disease

53
Q

What population do the Aspergillus species target?

A

Immune-compromised people and individuals who suffer from COPD

54
Q

What is the target organ of the Asergillus species?

A

It mainly in the lungs but also infects sinuses and skin

55
Q

What are the different types of Aspergillus? (6)

A
  1. Allergic bronchopulmonary aspergillosis (ABPA) –> symptoms similar to asthma
  2. Allergic aspergillus sinusitis
  3. Aspergilloma
  4. Chronic pulmonary Aspergillosis
  5. Invasive Aspergillosis
  6. Cutaneous Aspergillosis
56
Q

What are the lab diagnoses of fungal infections?

A
  1. Potassium hydroxide wet mount
  2. Lactophenil cotton blue wet mouth
  3. Other staining methods: gram stain, papanicolau stain, PAS, immunofluorescence detection, antigen detection, histology
  4. Fungal culture on Sabouraud’s dextrose agar
57
Q

What is the potassium hydroxide wet mount?

A

Skin scrapping mounted with 10% KOH solution, KOH increases rigidity of cell wall

58
Q

What is the Lactophenol cotton blue wet mount?

A

LActic acid preserves fungal structures, phenol kills live fungus, cotton blue stain chitin in cell wall

59
Q

What is fungal culture on Sabouraud’s dextrose agar?

A

pH 5.6 to prevent bacterial growth and antibiotics like cyclohexamide

60
Q
A

Endocrine System (25 decks)

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