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MSK Week 1 > Superficial and Cutaneous Mycoses > Flashcards

Superficial and Cutaneous Mycoses Flashcards

1
Q

What causes mycoses

A

Yeasts for the most part

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2
Q

What causes Pityriasis Versicolor

A

Malassezia Furfur

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3
Q

What does Pityriasis Versicolor look like

A

Hypo or hyper pigmented macules on chest, neck, back

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4
Q

What immune responses do we typically see to Superficial Mycoses?

A

Little to no immune response

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5
Q

Where do superficial mycoses colonize?

A

Outer keratinized surface of skin, hair, or nails

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6
Q

What causes dandruff?

A

Malessezia Globosa

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7
Q

How do we diagnose a superficial mycosis?

A

Direct visualization of yeast-like cells and short branched pseudohyphae.

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8
Q

Treatment for superficial mycosis?

A

Topical therapy, olive oil, single dose oral azole if widespread

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9
Q

What makes a cutaneous mycosis different from a superficial one BASICALLY?

A

Cutaneous involves invasion of the epidermis with an inflammatory response. They break down keratin after invading the stratum corneum.

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10
Q

What primarily causes cutaneous mycoses?

A

Mold dermatophytes such as trichophyton, epidermophyton, and microsporum

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11
Q

What does microsporum typically cause?

A

Athlete’s foot, jock itch, ringworm

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12
Q

Tinea infections

A

Latin for “worm”

Caused by dermatophytes. Result in inflammatory scaling often in the pattern of an expanding circle or ring with frequent hair loss

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13
Q

Tinea capitis

A

Tinea infection of the head

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14
Q

Tinea Coporis

A

Trunk of the body

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15
Q

Tinea Barbae

A

Tinea of the face

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16
Q

Tinea Cruris

A

Tinea inguinally

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17
Q

Tinea pedis

A

Tinea of the foot

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18
Q

Normal treatment for tinea?

A

Topical anti-fungal treatment. When hair or nails are involved, oral antifungal treatment is usually necessary.

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19
Q

How do we diagnose Tinea?

A

Microscopy/culture

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20
Q

Subcutaneous Mycoses

A

Invade the subcutaneous fat. This is rare, usually induced by trauma and often has a slow progression requiring surgery.

21
Q

Spreading pattern of subcutaneous Mycosis

A

Laterally, not to distant organs

22
Q

Sprotrichosis is caused by what

A

sporothrix schenckii transmission. This is a dimorphic fungi found in soil and vegetation. Penetrated epidermis will permit growth via a yeast form of this.

23
Q

Symptoms of a sprotrichosis mycosis infection

A

Usually starts as a small nodule that ulcerates and becomes painful. 2-3 weeks later secondary lesions along lymphatics progress proximally (sporotrichoid spread- other diseases exhibit a similar “spread”).

24
Q

Diagnosis of Sprotrichosis mycosis

A

Biopsy. Can establish genus and species from culture

25
Q

Treatment of Sprotrichosis Mycosis

A

Intraconazole orally - can take several weeks

26
Q

How do we typically get Sprotrichosis mycoses?

A

Inhalation typically

27
Q

Chromomycosis

A

Found in the tropics, this is an opportunistic fungus

28
Q

What is a granulomatous infection?

A

Result of an opportunistic subcutaneous fungal infection. They emerge out from the subcutaenous tissue and emerge outward. They form medlar bodies

29
Q

How do we treat subcutaneous mycoses?

A

Very difficult, usually try azoles long term

30
Q

Eumycotic mycetoma

A

Caused by a variety of fungi in the soil entering wounds. Causes a deep subcutaneous fungal infection that results in gross localized swelling with underlying sinus tracts. Granulomas can develop with granule formation and pus

31
Q

Fungi that can cause Eumycotic mycetoma

A 
Madurella (most common)
Fusarium
Acremonium
Exophiala
Scedosporium
32
Q

What eumycotic mycetoma do we find in trench warfare?

A

Madurella

33
Q

How do we diagnose Eumycotic mycetoma

A

Detection of granules by gross visualization or microscopy

34
Q

How do we treat Eumycotic mycetoma

A

Antifungal agents and local surgery. Treatment is usually not effective. Frequent cure is amputation

35
Q

Discuss microscopy as it is used to diagnose fungal infections: 10% KOH Tests

A

10% KOH tests are typically done on skin scraping. If you think cutaneous fungal infection, you may do this. KOH dissolves away keratinocytes and you may see fungal elements

36
Q

Discuss microscopy as it is used to diagnose fungal infections: Calcofluor white

A

Calcofluor white (generally a go to stain) is a fluorescent dye which binds to fungal walls

37
Q

Discuss microscopy as it is used to diagnose fungal infections: India Ink

A

o India ink (not as popular) used on CSF to look for Cryptococcus (has a large suger capsule. It shows as a halo under india ink

38
Q

Discuss microscopy as it is used to diagnose fungal infections: Methenamine Silver

A

There are a number of silver stains. This is fairly popular.

39
Q

Why is culture is considered the gold standard for detecting fungi

A
  1. More sensitive than microscopy
  2. Allows for ID via mycelium appearance or presence of asexual spores (genus and species)
  3. Usually grown on Sabouraud’s agar – designed to inhibit bacterial growth
  4. Most fungi can grow in standard blood culture bottles
40
Q

What is mycology

A

Study of fungi

41
Q

What type of organism is a fungus?

A

Fungi are eukaryotic, uni or multicellular, non-photosynthetic, and have chitin and glucan cell walls.

42
Q

What is a good medicinal target structurally on the fungus?

A

Fungal membrane contains ergosterol (mammal cell walls contain cholesterol so ergosterol is a good medicinal target

43
Q

Different types of general fungi?

A

They consist of yeasts (unicellular), molds (multicellular), or can be both (dimorphic).

44
Q

Are fungi aerobic or anaerobic?

A

Aerobic typically

45
Q

How do yeast multiply

A

Binary Fission

Budding (typically the route they take)

46
Q

What are hyphae and where do we find them?

A

Molds grow apically and branch via hypae (branches). At the hyphae, molds can grow spores.

47
Q

What are septa and where do we find them?

A

Hyphae have septa that have pores that allow communication and nutients vs. discrete cells.

48
Q

How do fungal spores reproduce?

A

Most fungal spores reproduce through mitosis (asexual) although some are sexual and reproduce via meiosis.

49
Q

Can Neutrophils combat fungi? If so how?

A

Neutrophils fight extracellular molds such as aspergillus and release defensins to fight them

MSK Week 1 (14 decks)

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