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MYCOLOGY AND VIROLOGY > SYSTEMIC AND OPPORTUNISTIC MYCOSES > Flashcards

SYSTEMIC AND OPPORTUNISTIC MYCOSES Flashcards

1
Q

SYSTEMIC MYCOSES

A

● Blastomyces dermatitidis
● Paracoccidioides brasiliensis
● Coccidioides immitis
● Histoplasma capsulatum

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2
Q

Opportunistic Mycoses

A

a. Aspergillus spp
b. Fusarium spp.
c. Yeast (clinically significant)
i. Candida spp.
ii. Cryptococcus spp.
iii. Geotrichum spp

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3
Q

Causes North American Blastomycosis

A

Blastomyces dermatitidis

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4
Q

Human infection is initiated in the
lungs. Inhalation of the conidia or hyphal
fragments.

A

Blastomyces dermatitidis

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5
Q

Blastomyces dermatitidis specimens

A

sputum
pus
exudates
urine
biopsies from lesions

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6
Q

Delicate, septate hyphae with round or pyriform conidia borne slightly or directly on hyphae; resembling lollipops

A

Mold phase Blastomyces dermatitidis

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7
Q

Thick- walled, large yeast cells with single bud on broad-base; broad isthmus at constriction

A

Yeast phase Blastomyces dermatitidis

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8
Q

Microscopic Examination
Wet mounts of specimens
■ Show broadly attached buds on thick-walled yeast cells

A

Blastomyces dermatitidis

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9
Q

Blastomyces dermatitidis culture

A

Sabouraud’s agar or enriched blood agar at 30°C

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10
Q

Blastomyces dermatitidis treatment

A

amphotericin B.

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11
Q

Causes South American Blastomycosis. Inhaled, and initial lesions occur in the lung

A

Paracoccidioides brasiliensis

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12
Q

Most patients are 30-60 years of age, and over 90% are men.

A

Paracoccidioides brasiliensis

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13
Q

Paracoccidioides brasiliensis specimens

A

sputum, exudates, biopsies or other material from lesions

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14
Q

Small septate, branched hyphae with intercalary and terminal chlamydoconidia; few pyriform microconidia

A

Mold phase Paracoccidioides brasiliensis

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14
Q

Large, round to oval, thick-walled yeast cells with multiple cuds which attach to mother cell by narrow constrictions resembles a ship wheel or pilot wheel or mariner’s wheel

A

Yeast phase Paracoccidioides brasiliensis

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15
Q

Paracoccidioides brasiliensis
● Microscopic Examination

A

KOH or calcofluor white
■ Yeasts are often apparent

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16
Q

Paracoccidioides brasiliensis

A

Sabouraud’s agar or yeast extract agar

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17
Q

Paracoccidioides brasiliensis Most useful for diagnosis

A

Serologic Testing

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18
Q

Paracoccidioides brasiliensis treatment

A

Severe cases are treated with amphotericin B.

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19
Q

San Joaquin Valley Fever

A

Coccidioides immitis

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20
Q

Inhalation of arthroconidia leads to a primary infection. Major biologic hazard among laboratory personnel

A

Coccidioides immitis

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21
Q

Coccidioides immitis Specimens

A

sputum, exudate from cutaneous lesions, spinal fluid, blood, urine and tissue biopsies.

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22
Q

Coarse, septate, branched hyphae that produce thick-walled, barrel-shaped, rectangular arthroconidia that alternate with empty disjunctor cells.

A

Mold phase Coccidioides immitis

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23
Q

Large, round, thick-walled spherules with
endospores observed in tissue and direct
examination.

A

Yeast phase Coccidioides immitis

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24
Q

Coccidioides immitis
● Microscopic Examination

A

KOH or calcofluor white stain: spherules and endospores

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25
Q

Coccidioides immitis Culture

A

Inhibitory mold agar, Sabouraud’s agar, or blood agar slants

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26
Q

TRUE OR FALSE
Coccidioides immitis Since arthroconidia are highly infectious, suspicious cultures are examined only in a biosafety cabinet.

A

TRUE

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27
Q

Identification must be confirmed by detection of C. immitis

A

specific antigen, animal inoculation or use of a
specific DNA probe.

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28
Q

Darling’s disease/Spelunker’s disease

A

Histoplasma capsulatum

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29
Q

primary and begins in the lung and eventually
invades the reticuloendothelial system.

A

Histoplasma capsulatum

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29
Q

most prevalent pulmonary infection in
humans and animals

A

Histoplasma capsulatum

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30
Q

Initiated by inhalation of the conidia

A

Histoplasma capsulatum

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31
Q

Histoplasma capsulatum Specimens

A

sputum, urine, scrapings from superficial
lesions, bone marrow aspirates and buffy coat blood cells.

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32
Q

Septate hyphae with round to pyriform
microconidia on short branches or directly on
hyphal stalk; later lage, round, thick-walled
knobby, tuberculated macroconidia forms

A

Mold phase Histoplasma capsulatum

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33
Q

Small, budding, round to oval yeast cells;
intracellular to mononuclear cells

A

Yeast phase Histoplasma capsulatum

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34
Q

Observe for small ovoid cells within macrophages

A

Histoplasma capsulatum

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35
Q

Histoplasma capsulatum culture:

A

glucose-cysteine blood agar at 37°C and on Sabouraud’s agar or inhibitory mold agar at 25–30°C

36
Q

Fungal stains Histoplasma capsulatum

A
  1. Fungal stains: Gomori methenamine silver, periodic acid-Schiff or calcofluor white stain
  2. Giemsa-stained smears of bone marrow or blood
36
Q

Clinically Significant YEASTS

A

● Candida spp.
● Cryptococcus spp.
● Geotrichum spp.

37
Q

Most important group of opportunistic fungi pathogens

A

Candida spp.

38
Q

Normal flora of the skin, mucous membranes and gastrointestinal tract. Capable of causing Candidiasis

A

Candida spp.

39
Q

species exist as oval, yeastlike forms that produce buds or blastoconidia

A

Candida

40
Q

Produce pseudohyphae and true hyphae except C. glabrata

A

Candida spp.

41
Q

Candida spp. specimens

A

Swabs and scraping from superficial lesions, blood, spinal fluid, tissue biopsies, urine, exudates, and material from removed intravenous catheters.

42
Q

Gram-stained smears or histopathological slides for tissue biopsies, centrifuged spinal fluid, and other specimens
■ Pseudohyphae and budding cells

A

Candida spp.

43
Q

Skin or nail scrapings are first placed in a drop of 10% KOH and calcofluor white

A

Candida spp.

44
Q

All specimens are cultured on fungal or bacteriologic media at room temperature or at 37°C. Special agar for Candida is CHROM Agar

A

Candida spp.

45
Q

Candida spp. in CHROM Agar Light green colonies

A

C. albicans

46
Q

Dark-violet / dark mauve colonies

A

C. glabrata

47
Q

Dark green colonies

A

C. dubliniensis

48
Q

Pink , purple. May exhibit multiple color

A

C. auris

49
Q

Fuzzy pale pink

A

C. krusei

50
Q

Metallic/ dull-blue/ grayish blue

A

C. tropicalis

51
Q

Pink to purple colonies/ Pink-lavender colonies

A

C. kefyr

52
Q

Most isolated species from clinical material

A

Candida albicans

53
Q

Can be saprophytic in oral cavities, Gi or vaginal tract. Causes candidiasis or moniliasis infection

A

Candida albicans

54
Q

Oral moniliasis. Oral Thrush (white stuff/white cottage-cheese like patches on the mouth)

A

Candida albicans

55
Q

Vaginal moniliasis
Vulvovaginitis, Onychomycosis (nail infections) and Paronychomycosis (cuticle infections)

A

Candida albicans

56
Q

hyphae-like extensions of young yeast cells showing parallel sides, aseptate and will not constrict at their point of origin

A

Germ-tube Candida albicans

57
Q

look like germ tubes but are aseptate and constricted at their point of origin.

A

Pseudohyphae Candida albicans

58
Q

This usually causes meningitis in patients with AIDS

A

Cryptococcus neoformans

59
Q

Encapsulated yeast cell in bird and bat droppings; “pigeon droppings”

A

Cryptococcus neoformans

60
Q

Torulosis/Torulopsis or European Blastomycosis

A

Cryptococcus neoformans

61
Q

Specimens include cerebrospinal fluid, tissue, exudates, sputum, blood, cutaneous scrapings, and urine.

A

Cryptococcus neoformans

62
Q

Specimens are often examined in wet mounts, both directly and after mixing with India ink.

A

Cryptococcus neoformans

63
Q

Alternatively, on an appropriate diphenolic substrate, the phenol oxidase of C. neoformans produces melanin in the cell walls and colonies develop a

A

brown pigment.

64
Q

Often initially appears as a white to cream-colored, yeastlike colony; some isolates may appear as white, powdery molds.

A

Geotrichum candidum

65
Q

Hyphae are septate and produce numerous rectangular to cylindrical to barrel-shaped arthroconidia.

A

Geotrichum candidum

66
Q

Clinically Significant OPPORTUNISTIC MYCOSES

A

● Aspergillus spp.
● Fusarium spp.

67
Q

Can cause disease by ingestion of mycotoxins, traumatic inoculation, or inhalation.

A

Aspergillus spp.

68
Q

Also capable of causing disseminated infection in immunocompromised patients, pulmonary or sinus fungus ball, allergic bronchopulmonary aspergillosis, external otomycosis, mycotic keratitis, onychomycosis, sinusitis, endocarditis and central nervous system infection.

A

Aspergillus spp.

69
Q

The species are identified according to morphologic differences in their structures.

A

Aspergillus spp.

70
Q

Aspergillus spp. specimens

A

sputum, other respiratory tract specimens and lung biopsy tissue.

71
Q

Rapidly growing mold that produces a fluffy to granular, white to blue-green colony.

A

Aspergillus fumigatus

72
Q

Characterized by the presence of septate hyphae and short or long conidiophores with a characteristic “foot cell” at their base.

A

Aspergillus fumigatus

73
Q

Cultures of A. fumigatus are thermotolerant___and able to withstand temperatures ___

A

thermotolerant
up to 45°C

74
Q

Somewhat more rapidly growing species that produces yellow-green colony.

A

Aspergillus flavus

75
Q

conidiophore is coarsely roughened near the
vesicle.

A

A. flavus

76
Q

Produces darkly pigmented, roughened spores
macroscopically, but microscopically its hyphae are hyaline and septate.

A

Aspergillus niger

77
Q

Produces colonies within 2 to 6 days. Growth begins initially as yellow colony

A

Aspergillus niger

78
Q

With age, the colony becomes jet black and powdery, but the reverse remains buff or cream colores.

A

Aspergillus niger

79
Q

Less commonly seen in the clinical laboratory

A

Aspergillus terreus

80
Q

Produces tan colonies that resembles cinnamon.

A

Aspergillus terreus

81
Q

Produces larger cells, aleurioconidia, which are found on submerged hyphae.

A

Aspergillus terreus

82
Q

Most commonly isolated organisms within this group are within the Fusarium solani species complex.

A

Fusarium spp.

83
Q

Long been known to cause mycotic keratitis.

A

Fusarium spp.

83
Q

Oftentimes infections are associated with the consumption of grains contaminated with trichothecene mycotoxins produced by F. sporotrichiodes or F. poae.

A

Fusarium spp.

84
Q

Capable of causing sinusitis, wound (burn) infection, allergic fungal sinusitis, endopthalmitis, and disseminated fusariosis.

A

Fusarium spp.

85
Q

Colonies grow rapidly, within 2 to 5 days, and are fluffy to cottony and may be pink, purple, yellow, green or other colors, depending on the species.

A

Fusarium spp.

86
Q

Most common medium used to induce sporulation is of Fusarium spp.

A

corneal agar.

87
Q

Fusarium spp. keys to identification are based on growth on

A

potato dextrose agar.

MYCOLOGY AND VIROLOGY (10 decks)

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