Pulmonary Fungi Infections Flashcards

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1
Q

What are the general characteristics of agents causing systemic mycosis?

A

Inherently virulent; Exhibit biochemical and morphological features enabling evasion of host defenses; Four dimorphic, one grows as yeast

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2
Q

What is the primary focus of infection for agents causing systemic mycosis?

A

Lungs

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3
Q

What are the characteristics of Histoplasma capsulatum’s parasitic phase?

A

Small budding yeast found almost exclusively in macrophages; Ovoid yeast form measuring 1.5-2.9um; Mould has both micro and macro conidia

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4
Q

What is the most common disease caused by Histoplasma capsulatum?

A

Histoplasmosis

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5
Q

What is the African variant of Histoplasma capsulatum?

A

Histoplasma duboisii

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6
Q

What is the parasitic phase of Histoplasma capsulatum?

A

Tuberculate macroconidia formed on short, hyaline, undifferentiated conidiophores

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7
Q

What is the habitat of Histoplasma capsulatum?

A

Soil, especially in areas contaminated with bat and bird droppings

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8
Q

What is the clinical syndrome in an immunocompetent host infected with Histoplasma capsulatum?

A

Asymptomatic or mild flu-like illness in immunocompetent hosts

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9
Q

What are the clinical syndromes in an immunocompromised host infected with Histoplasma capsulatum?

A

Disseminated histoplasmosis in immunocompromised hosts; Chronic pulmonary histoplasmosis in chronic obstructive pulmonary disease patients

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10
Q

How is Histoplasma capsulatum diagnosed?

A

Serology: Complement Fixation Test using histoplasmin and inactivated whole yeast phase; Direct histopathologic examination of infected tissue; Culture: Blood, urine, sputum

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11
Q

What is the treatment for Histoplasma capsulatum infection?

A

Amphotericin B

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12
Q

What is another name for Blastomyces dermatidis?

A

Ajellomyces dermatidis

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13
Q

What are the clinical manifestations of Blastomyces dermatidis infection?

A

Progressive exertional dyspnea, fever, nonproductive cough, chest discomfort

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14
Q

What is the morphology of the yeast phase of Blastomyces dermatidis?

A

Budding yeast, wide-based attachment between mother and daughter cells

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15
Q

What is the morphology of the mold phase of Blastomyces dermatidis?

A

Branching septate hyphae with pyriform microconidia

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16
Q

What is the epidemiological distribution of Blastomyces dermatidis?

A

Mainly limited to North America

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17
Q

How is Blastomyces dermatidis diagnosed?

A

Culture: Readily grown on conventional media; Histopathologic examination shows spherules in tissue; Serodiagnosis: Tube precipitin and Complement fixation tests

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18
Q

What is the treatment for Blastomyces dermatidis infection?

A

Amphotericin B

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19
Q

What is another name for Paracoccidioidomycosis?

A

Lutz-Splendore-Almeida’s disease

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20
Q

What is the morphology of the yeast phase of Paracoccidioidomycosis?

A

Budding yeast, ship’s wheel appearance

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21
Q

What is the morphology of the mold phase of Paracoccidioidomycosis?

A

Branching septate hyphae with no typical pattern of sporulation

22
Q

What is the epidemiology of Paracoccidioidomycosis?

A

Mainly restricted to Central and South America

23
Q

What is the clinical syndrome associated with Paracoccidioidomycosis?

A

Frequently asymptomatic but can become progressive; oral and nasal lesions

24
Q

How is Paracoccidioidomycosis diagnosed?

A

KOH preparations, culture, serodiagnosis

25
Q

What is the treatment for Paracoccidioidomycosis?

A

Long-term therapy with Amphotericin B; Ketoconazole is also effective

26
Q

What is another name for Coccidioidomycosis?

A

San Joaquin Valley fever

27
Q

What is the morphology of the mold phase of Coccidioidomycosis?

A

Branching septate hyphae with alternate cell developing into arthroconidia

28
Q

What is the morphology of the yeast phase of Coccidioidomycosis?

A

Large spherical structures called spherules filled with endospores

29
Q

What is the epidemiology of Coccidioidomycosis?

A

North, Central, and South America

30
Q

What are the clinical manifestations of Coccidioidomycosis?

A

Mild febrile to moderately severe pulmonary disease

31
Q

How is Coccidioidomycosis diagnosed?

A

Culture, histopathologic examination, serodiagnosis

32
Q

What is the treatment for Coccidioidomycosis?

A

Long-term therapy with Amphotericin B; Ketoconazole is a useful alternative

33
Q

What is another name for Cryptococcosis?

A

Acidic mucopolysaccharide capsule

34
Q

What is the morphology of Cryptococcus neoformans?

A

Pigeon roosts, survives well in dry, alkaline, nitrogen-rich environments

35
Q

What is the distinctive feature of Cryptococcus neoformans?

A

Solitary pulmonary nodule; meningitis in immunocompromised

36
Q

What is the epidemiology of Cryptococcosis?

A

Inhalation of dessicated yeast cells and small basidiospores into lungs

37
Q

What are the clinical manifestations of Cryptococcosis?

A

Definitive diagnosis: Culture, India ink preparation, serodiagnosis

38
Q

How does Cryptococcus neoformans cause infection?

A

Pulmonary lesions usually self-limited; Amphotericin B for disseminated disease

39
Q

How is Cryptococcosis diagnosed?

A

Nearly all infected in infancy

40
Q

What is the treatment for Cryptococcosis?

A

Trophic and cystic forms

41
Q

What are the two distinct forms of Pneumocystis?

A

Progressive exertional dyspnea, fever, nonproductive cough, chest discomfort

42
Q

What are the clinical manifestations of Pneumocystis jirovecii pneumonia (PCP)?

A

Clinical presentation, blood tests, radiographs suggestive but not diagnostic

43
Q

How is PCP diagnosed?

A

Induced sputum, bronchoscopy with bronchoalveolar lavage, transbronchial biopsy

44
Q

What is the preferred primary prophylaxis for PCP?

A

Trimethoprim-sulfamethoxazole (TMP-SMX)

45
Q

What are the alternative options for primary prophylaxis for PCP?

A

Dapsone, aerosolized pentamidine, atovaquone

46
Q

What is an adjunctive treatment for PCP?

A

Corticosteroids

47
Q

What staining methods are used for the microscopy of Pneumocystis?

A

Giemsa staining, GMS, Florescence microscopy, Toluidine Blue O, Diff quik

48
Q

What is shown in lung biopsy using silver stain for Pneumocystis?

A

Lung biopsy using silver stain to demonstrate Pneumocystis organisms in tissue

49
Q

What are the risk factors for PCP?

A

CD4 count <200 cells/µL, prior PCP, oral thrush, recurrent bacterial pneumonia

50
Q

What has led to a decline in the incidence of PCP in the United States and Western Europe?

A

Prophylaxis and effective ART, decline in incidence in the United States and Western Europe