South american blastomycosis

Question 1

mucocutaneous inv also known as a

Answer 1

Paracoccidiomycosis - almost always a sign of disseminated dx. primarily in the lungs

Question 2

Mucocutaneous type usually begins in

Answer 2

mouth whwre small papules and ulcerations appear. gingival lesions are most common. ff by lesions on tongue and lips. in time adjacent tissues are affected and extensige ulceratiojs eventually destroy the nose, lips, and face.

Question 3

skin lesions may show

Answer 3

ulcerations, paeudoepitheliomatous hyperplasia, microabscess.

lymphatic type manifests as enlargment of the regional ln soon after appearance of initial lesions about the moutg. adenopatgy (supraclavicuoar and axially regions- may spread) Nodes may ulcerate.

Question 4

etio

Answer 4

paracoccidiodes brasiliensis.

Question 5

biopsy

Answer 5

pseudoepitheliomatous huperplasia, abscess, ulceration.
granulomatous inflamm infiltrate is freq present consisting of lymphocytes, epitheloid cells and langerhans giant cells.

chronic granulomatous disease endemic in brazil. argentina. valenzuela.

Question 6

15x more in

Answer 6

men

Question 7

immuno

Answer 7

complement fixation tests are positive in 97% of severe dx.

immunodiffusion teats are often used for dx and posttx ff up. Test is highly specific but only about 90% sensitive.

Question 8

tx

Answer 8

Itraconazole 200mg/day for 6-9 months for mild dx.
12-18 mos for moderate disease.
severe- amphotericin B and itraconazole.
ketoconazole and tmp smx are alternative tx.

HIV px infected- long term tx w tmp smx.