Sketchy: Aspergillis Flashcards
Where will aspergillomas be seen on an upright CXR?
at the bottom (they’re gravity dependent)
Aspergillus form ______ with fruiting bodies.
conidiophores
What kind of reaction is Allergic bronchopulmonary asperigillosis (ABPA)?
type I hypersensitivity
What does Aspergillus look like on microscopy?
its hyphae branch at acute angles and have septations
Name the fungi:
- its hyphae branch at acute angles and have septations
Aspergillus
Ddx?
- necrosis of paranasal sinuses and nose
- Mucor
- Aspergillosis
Angioinvasive aspergillosis invades _____ and disseminiates very quickly throughout the body.
blood vessels
Who is susceptible to developing aspergillomas?
those who already have lung cavities (TB, Klebsiella)
Cue:
- scarecrow with black dots where his kidneys, heart, and nose should be, and the top of his head has a black spot with a ring around it
- Disseminated Angioinvasive aspergillosis. Affects:
- kidney = kidney failure
- heart = endocarditis
- nose = necrosis when spread to paranasal sinuses
- head ring spot = ring-enhancing brain lesions
Cue:
- frogs
frogs = amphibians = Amphotericin B for tx of angioinvasive dz
Dx?
- a cat
catalase positive
What does angioinvasive aspergillosis look like on light microscopy?
acute angle septate hyphae invading blood vessels and the surrounding tissues
Cue:
- cow with a liver-shaped spot grazing next to a tractor with a crab on it
- liver spot = hepatocellular carcinoma
- crab = CA
How can Angioinvasive aspergillosis be distinguished from TB?
Aspergillosis will have ring-enhancing lesions on CT
What is Aspergillus fumigatus?
a fungi
What s/s does Allergic bronchopulmonary asperigillosis (ABPA) cause?
- wheezing
- fever
- migrating pulmonary infiltrates
Who gets angioinvasive aspergillosis?
immunocompromised pts (esp neutropenia from leukemia/lymphoma)
What is the tx for Aspergillis infections?
- -conazoles (esp VORIconazole) for less serious
- surgical debridement
- Amphotericin B for angioinvasive dz
Cue:
- Farm worker with a cane, sweaty and coughing up blood, is standing next to a sprinkler system with red hoses
- angioinvasive aspergillosis:
- cane = immunocompromised
- sweaty = fever
- coughing up blood = hemoptysis
- red hoses = blood vessels invaded by aspergillis
Cue:
- pinecones within a vortex
-conazoles (esp VORIconazole) = tx for less serious Aspergillis infections
How could the cause of necrosis of paranasal sinuses and nose be differentiated?
- Mucor = right angle branching
- Aspergillosis = acute angle branching
______ are extremely carcinogenic, esp. for the development of hepatocellular carcinoma.
Aflatoxins
ASpergillus
Acute Septate
Cue:
- sweaty farm worker carrying an inhaler labeled “IgE”, running underneath the airplane
- Allergic bronchopulmonary asperigillosis (ABPA):
- sweaty = fever
- inhaler = asthma, wheezing, CF pts
- IgE = increased IgE in Type I hypersensitivity rxn
- running = migratory (pulm infiltrate)
- airplane = labeled ABPA
Ddx?
- fever
- neuro deficits
- cough/PNA symptoms
- hx of TB
- TB
- Aspergillosis (will have ring-enhancing lesions on CT)
What are the 3 infections that Aspergillus causes?
- Allergic bronchopulmonary asperigillosis (ABPA)
- Aspergillomas
- Angioinvasive aspergillosis
Cue:
- peanut plant and a wheat field
peanuts and wheat –> aflatoxins –> also produced by Aspergillus FLAVIS –> hepatocellular carcinoma
Name 2 fungi that are catalase positive.
- Candida albicans
- Aspergillus fumigatus
Aflatoxins are extremely carcinogenic, esp. for the development of _______.
hepatocellular carcinoma
Dx?
- acute angle septate hyphae invading blood vessels and the surrounding tissues
Angioinvasive aspergillosis of Aspergillis
Cue:
- crop duster flying over an asparagus farm
Aspergillus fumigatus
Cue:
- farmworker coughing into a napkin next to a cactus with peanuts at the bottom of it
- coughing = aspergillomas (fungus balls w/i the lungs)
- cactus = TB cavities (pts with these are susceptible to aspergillomas)
- peanuts at bottom = aspergillomas are gravity dependent (will be on bottom of upright CXR)
How is Aspergillus transmitted?
conidiophores with fruiting bodies are inhaled
Cue:
- peanut plant with acute-angle branching and septae and yellow flowers
- Aspergillus hyphae branch at acute angles and have septations
- flowers look like conidiophores with fruiting bodies (their inhalation = transmission)
What immunoglobulin will be increased in Type I hypersensitivity reactions?
IgE
