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Unit 4: Micro > Systemic Mycoses 1 > Flashcards

Systemic Mycoses 1 Flashcards

1
Q

Name the 4 systemic mycoses discussed

A

Coccidiodes, Histoplasma, Blastomyces, Paracoccidioides

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2
Q

Are they all thermally dimorphic?

A

Yes

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3
Q

Thermal dimorphism of coccidiodes

A

Mold/Spherule

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4
Q

Where is coccidiodes endemic to?

A

US Southwest

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5
Q

What is the mechanism of infection by arthrospores in coccidiodes?

A

Mold grows in warm weather–> infectious arthrospores released in dry–> spores are inhaled–>spores change form (to spherule)

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6
Q

Are most infections by coccidiodes mild? What are the symptoms? How are they contained?

A

Yes- 60% are mild. Either asymptomatic or flu-like. Innate immunity clears it or CMI contains it.

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7
Q

What is moderate illness by coccidiodes like?

A

Valley fever/desert rheumatism- pulmonary + EN

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8
Q

Severe infection by coccidiodes?

A

Major pneumonia or dissemination (bare or in macrophages)

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9
Q

Risk factors for coccidiodes infection

A

Age, race, pregnancy, immunocompromised, occupational exposure

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10
Q

How to diagnose coccidiodes

A

Exam, history, PPD, biopsy for spherules, culture for dimorphism, serology for dissemination

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11
Q

If predisposed to complications, treat coccidiodes with this

A

Oral azoles

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12
Q

If coccidiodes presents as meningitis treat with this

A

Fluconazole

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13
Q

If pregnant or coccidiodes has disseminated treat with this

A

Amphotericin B

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14
Q

Thermal dimorphism of histoplasma

A

Mold/yeast (yeast in tissue)

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15
Q

Where is histoplasma endemic to

A

Ohio, Missouri, Mississippi River Valley

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16
Q

Is histoplasma soil based?

A

Yes

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17
Q

Microconidia, the infectious spores of histoplasma, are exposed how?

A

Kicked up by construction projects

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18
Q

What kind of symptoms does histoplasma cause?

A

Pulmonary

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19
Q

If healthy, how does your body handle histoplasma?

A

Clears it or contains in granuloma

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20
Q

What does higher dose infection of histoplasma look like?

A

Tb

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21
Q

How does histoplasma disseminate in an CMI-deficient host?

A

Macrophages

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22
Q

Does histoplasma survive lysosomal fusion after being engulfed by macrophages?

A

Yes

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23
Q

If disseminated, histoplasma causes what symptoms?

A

Pancytopenia and ulcerated lesions on the tongue

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24
Q

How to diagnose histoplasma based on history

A

History (birds, bats, endemic area, immunocompromised, occupation)

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25
Q

How to diagnose histoplasma based on biopsy

A

yeast in macrophages

26
Q

How to diagnose histoplasma based on culture

A

Look for dimorphism- use two temperatures

27
Q

Can you use ELISA for histoplasma diagnosis?

A

Yes, look for the antigen

28
Q

If serious lung involvement with histoplasma, how do you treat?

A

Itraconazole

29
Q

If histoplasma causes meningitis, how do you treat?

A

Fluconazole

30
Q

If histoplasma is disseminated, how do you treat?

A

Amphotericin B

31
Q

Thermal dimorphism of blastomyces

A

mold/yeast

32
Q

Where is blastomyces endemic to?

A

Eastern US

33
Q

Does innate immunity usually clear blastomyces?

A

Yes

34
Q

What is inhaled to infect us with blastomyces?

A

Conidia

35
Q

Is conidia readily destroyed?

A

Yes, our immune system takes care of it

36
Q

Conidia is transformed into yeast- is yeast readily destroyed in blastomyces?

A

No, they are harder to kill- they produce BAD1

37
Q

How is most of the infection of blastomyces contained?

A

A granulomatous response

38
Q

What predisposes you to hematogenous spread of blastomyces?

A

Immunosuppression

39
Q

Moderate acute form of blastomyces

A

pneumonia with purulent sputum

40
Q

Moderate chronic form of blastomyces

A

mimics Tb

41
Q

Severe acute form of blastomyces

A

ARDS

42
Q

Which form of blastomyces may include ulcerating skin lesions or EN and bone/joint pain?

A

All forms!

43
Q

Diagnosis of blastomyces by sputum

A

Look for yeast

44
Q

Diagnosis of blastomyces by culture

A

Look for hyphae with pear-shaped conida

45
Q

Diagnosis of blastomyces by biopsy

A

Look for yeast with suppurating (non-caseating) granules

46
Q

How to treat most blastomyces

A

Itraconazole

47
Q

How to treat blastomyces if meningitis is present

A

Fluconazole

48
Q

How to treat severe blastomyces

A

Amphotericin B

49
Q

Thermal dimorphism of paracoccidioides

A

mold/ multibud yeast

50
Q

Where is paracoccidioides endemic to?

A

Latin America

51
Q

In what populations is paracoccidioides severe?

A

Kids or immunocompromised

52
Q

Is paracoccidioides severe in adults?

A

No it’s moderate and chronic

53
Q

Who gets the moderate, chronic form of paracoccidioides?

A

Men in agriculture or construction

54
Q

Does the adult form of paracoccidiodes have a long latency?

A

Yes!

55
Q

Where do we see lesions in the adult form of paracoccidioides?

A

Skin and mucous membranes

56
Q

Lymphadenopathy and hepatosplenomegaly are seen in which form of paracoccidioides?

A

Juvenile form

57
Q

You do a puss or tissue KOH mount to look for paracoccidioides. What’re you looking for?

A

Multiple buds on yeast cells

58
Q

Should you culture for paracoccidioides?

A

Yes

59
Q

How do you treat paracoccidioides?

A

Itraconazole

60
Q

How do you treat severe paracoccidioides?

A

Amphotericin B

61
Q

What else can you do to treat paracoccidioides besides using meds?

A

Improvement towards a healthier lifestyle

Unit 4: Micro (6 decks)

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