Subcutaneous Mycoses Flashcards

1
Q

Chromoblastomycosis

A

Chronic fungal infection acquired via traumatic inoculation of slow-growing dematiaceous fungi
Primarily located in lower extremities

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2
Q

Principle Agents of Chromoblastomycosis

A

Fonsecaea pedrosi
Fonsecaea compacta
Phialophora verrucosum
Cladophialophora carrionii

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3
Q

Chromoblastomycosis Characterized Infection

A

Development of papule at site of trauma
Slowly spreads to form warty or tumor-like lesions
“cauliflower-like”

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4
Q

Types of sporulation

A

Phialophora
Rhinocladiella
Cladosporium

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5
Q

Phialophora type sporulation

A

Conidiophores are vase or flask-shaped

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6
Q

Rhinocladiella-type Sporulation

A

Conidiophores are swollen, knotted, or club-shaped
Terminally or laterally on hyphae
Bearing elongated conidia along upper portion and tips

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7
Q

Cladosporium-type Sporulation

A

Conidiophores vary in length, treelike branching
Bearing ovoid conidia branching chain
Hila spots seen

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8
Q

Sclerotic bodies

A

Muriform cells
Thick cross walls
Mature cells have intersecting cross walls
Younger stages - no septa

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9
Q

Fonsecaea pedrosi General Info

A

Resistant to most anti-fungal agents
Slow growing (2-3 wks)

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10
Q

Fonsecaea pedrosi Colony Morph

A

Brown to black, delicate velvety mycelium
Reverse: Black
Convex, cone-shaped protrusion
Slightly embeds agar

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11
Q

Fonsecaea pedrosi Microscopic Morph

A

Septate hyphae
Conidia arise from short denticles with sympodically
Primary conidia appear as rhinocladiella-type
Sclerotic bodies seen

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12
Q

Fonsecaea compacta General Information

A

Slow growing (28 days)

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13
Q

Fonsecaea compacta Morphology

A

Same as F. pedrosi

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14
Q

Fonsecaea compacta Microscopic

A

Hyphae are branched
Predominately cladosporium-type sporulation seen
Sclerotic bodies seen

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15
Q

Phialophora verrucosum General Info

A

Second most common cause of chromoblastomycosis
Slow growing (14 days)

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16
Q

Phialophora verrucosum Colony Morphology

A

Olive green to brown to black
May be heaped and granular
Embeds in medium
Reverse: Black

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17
Q

Phialophora verrucosum Microscopic

A

Hyphae are septate and branched
Phialophora-type sporulation, vase-shaped conidiophores either lateral or terminal
Sclerotic bodies seen

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18
Q

Other Names for Sclerotic Bodies

A

Muriform cells
Copper pennies
Meddler bodies

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19
Q

Mycetoma definition

A

Localized, chronic, granulomatous infection involving cutaneous and subcutaneous tissues
Usually found on feet or hands but may be on other parts of the body

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20
Q

Organisms that cause Mycetoma

A

Actinomyces
Nocardia
Streptomyces

21
Q

Development of Mycetomas

A

Traumatic injury by contaminated:
Thorns
Splinters from plants
Fish scales or fins
Snake bites
Insect Bites
Farm Implements
Knives
Sharp objects used by field workers

22
Q

Mycetomas Location

A

Primarily in tropical and hot temperate zones
- Africa, Asia, South and Central America

23
Q

Mycetoma lesions

A

Contain granulomas and abscesses that suppurate and drain through sinus tracts

24
Q

Causative Agents of Eumycotic Mycetomas

A

Exophiala jeanselmei
Pseudallescheria boydii/Scedosporium apiospermum
Madurella mycetomatis

25
Exophiala jeanselmei General Info
India, Malaya, Thailand, Argentina, and United States Infections secondary to trauma involving contaminated wood products Growth rate - 2 weeks
26
Exophiala jeanselmei Colony Morphology
Yeast like and green to black At 2 wks, grey to olive grey aerial mycelium Reverse: Black
27
Exophiala jeanselmei Microscopic
Septate, branched hyphae Conidiophores may be branched with tapered ends borne at obtuse or right angles from hyphae Elliptical conidia aggregate in clusters at tips and sides of conidiophores
28
Exophilia jeanselmei other testing
Tyrosine - decomposes Casein - negative Xanthine - negative KNO3 assimilation - positive
29
Pseudallescheria boydii (sexual state) Scedosporium apiospermum (asexual state) General info
Growth rate 7 days
30
P. boydii/S. apiospermum Colony Morphology
Floccose and white at first Grey to dark brown with age Reverse: white at first, then grey or black with age
31
P. boydii/S. apiospermum Microscope
Septate hypha with simply long or short conidiophores bearing conidia singly or in small groups
32
Asexual stage of P. boydii/S. apiospermum
Conidia are unicellular, oval with larger end toward apex Truncated (cut off) appearance at base
33
Sexual stage of P. boydii/S. apiospermum
Large cleistothecia typically round Asci and Ascopores are formed and held until bursting
34
P. boydii/S. apiospermum additional testing
Produce white to yellowish white granules in tissue sections Soft to firm Composed of hyaline hyphae
35
Madurella mycetomatis General Info
Location: Western and Eastern Africa Growth rate - 10 days Better growth at 37 C
36
Madurella mycetomatis Colony Morphology
Varies greatly White then becoming olive, yellow, brown Flat or domed shape Velvety to glabrous Characteristic brown diffusible pigment
37
Madurella mycetomatis Microscopic
SAB: septate hyphae with chlamydoconidia-like cells CM: produce conidiophores (phialide type), round or oval conidia
38
Madurella mycetomatis Other tests
Reddish brown to black granules in tissue sections Firm to hard Compact Variable in size and shape Frequently multilobulated
39
Phaeohyphomycosis definition
Describes ANY subcutaneous infection caused by any number of dematiaceous organisms exclusive of chromoblastomycosis or mycetoma
40
Exophiala dermatitidis General Info
Slow growth rate Yeast like at 10 days Mold like within 21 days
41
Exophiala dermatitidis Colony morphology
Yeast like at first. Develop aerial mycelium with age. Olive to black color Reverse: dark
42
Exophialia dermatitidis Microscope
Young cultures: oval to round, budding yeast like cells Mature cultures: Septate hyphae and flask-shaped to cylindric phialides that lack a flared lip
43
Exophialia dermititidis Other tests
Tyrosine - decomposes Casein - negative Xanthine - negative Growth at 42 C KNO3 assimiliation - negative
44
Sporotrichosis
Chronic infection characterized by lymppocutaneous lesions of the cutaneous and subcutaneous tissues that suppurate, ulcerate, and drain
45
Sporotrichosis organisms
Sporothrix schenckii
46
Sporothrix schenckii General Info
Rapid growth - 4 days
47
Sporothrix schenckii Colony Morphology
25-30 C - first moist and yeast like, later becomes wrinkled, leathery or velvety and brown to black 35-37 C - cream or tan, smooth and yeast like
48
Sporothrix schenckii Microscopic
25-30 C septate hyphae with slender erect tapering conidiophores at right angles to hyphae. Pear-shaped conidia with dentricles - "rosette" or "daisy-head" conidia 35-37 C oval to round, fusiform budding yeast "cigar bodies" on BHI