Systemic Mycoses

Question 1

Blastomycoses dermatitidis “North American”

Answer 1

Disease: Blastomycosis/Gilchrist disease/North American
Manifestation: Chronic granulomatoud lesions and suppurative infection. Pneumonia (start of infection), then to Skin and Bones.

Mold Form: “LOLLIPOP APPEARANCE” - Old culture
Septate Hyphae
Pear shaped conidia

Yeast Form: ONE BROAD-BASED BUDDING; LARGE
Budding in broad based, Thick walled
Hyaline, Large cells
Double contoured

Question 2

Paracoccodioides brasiliensis “South American”

Answer 2

Disease: Paracoccidioidomycosis/South American blastomycosis
Manifestation: Granulomatous disease in the Lungs (primary), skin, Lymph nodes

Macroscopic: MULTIPLE BUDS - SHIPS WHEEL APPEARANCE

Mold Form: Septate, Branched Hyphae with intercalary and terminal chlamydoconidia
Yeast Form: Multiple buds in Ship’s wheel appearance

Question 3

Histoplasma Capslatum

Answer 3

Disease: Histoplasmosis/Darling’s Disease
Manifestation: Benign Pulmonary Disease and disseminate in the reticulo-endothelial system

Microscopic: TUBERCULATE KNOBBY MACROCOINIDIA (Old culture)

Mold Form: Small round budding cells
Yeast Form: Round to Pear-shaped microconidia and INTRACELLULAR, inside macrophages

Culture: White Cottony

Diagnosis: Exoantigen Test

Question 4

Coccidioides immitis

Answer 4

Disease: Coccidioidomycosis
Manifestation: Mild Flu-like symptoms

Microscopic:
Yeast Form: SPHERULES CONTAINING ENDOSCPOSES (inside spherules)
Mold Form: Barrel-shaped Arthroconidia alternating with EMPTY CELLS

Question 5

Fungal-Like Bateria

Answer 5

Actinonomyces israeili, Actinomyces bovis

Nocardia asteriods, Nocardia brasiliensis

Question 6

Clinical Manifestations of Actinomyces spp.

Answer 6

Actinomyces israeili - ACTINOMYCOSIS

Actinomyces bovis - LUMP JAW IN CATTLE

Question 7

Actinomyces spp.

Answer 7

Microscopic:
Gram Positive Bacilli
Fragile Branching Filaments
Non-acid fast

Culture: Anaerobic
Biochemical:
Neg - Catalase, Gelatinase
Pos - Litmus Milk, Glucose

Question 8

True or False.
N. asteriodes - Lymphocutaneous
N. brasiliensis - Pulmonary Infection

Answer 8

False.
N. brasiliensis - Lymphocutaneous
N. asteriods - Pulmonary Infection

Question 9

True or False. N. asteriodes grows at 46C, while N. brasiliensis does not.

Answer 9

True

Question 10

Maturation of Candida spp.

Answer 10

3 days

Question 11

Most common yeast isolate

Answer 11

C. albicans

Question 12

1 C. albicans

Answer 12

Microscopic:
Forms Pseudohyphae with some true hyphae
Budding yeast with Blastoconidia and chlamydospores
Germ tube formation

Culture: Creamy, Pasty, Smooth colonies

Question 13

2 C. tropicalis

Answer 13

Microscopic:
Spherical budding yeast-like cells
Blastoconidia appear singly or clusters

Question 14

C. pseudotropicalis

Answer 14

Microscopic: “LOGS IN STREAM” APPEARANCE

Elongated blastoconidia in parallel

Question 15

C. parapsilosis

Answer 15

Microscopic:
GIANT CELL “large hyphal structure”
Crooked/Curved appearance

Question 16

Agent in Oral Candidiasis or Thrush

Answer 16

C. albicans

Question 17

Geotrichum candidium

Answer 17

Rectangular characteristic with “Hockey Stick” germ tube appearance

Question 18

C. neoformans

Answer 18

Disease: Cryptococcosis/Busse Buschke disease
Manifestation: Crytococcal meningitis
Transmission: Inhalation of cells, and pigeon dropping

Microscopic: 
Globose-Ovoid budding yeast like cells
Encapsulated yeast (+ India Ink)

Macroscopic:
Bird seed - Creamy, Mucoid dark brown color

Diagnosis: 
CRAG (+)
Germ Tube (+)
India Ink (+)
Urease (+)