Systemic Mycoses

Question 1

Histoplasmosis

Answer 1

Endemic location and Pathologic Features: Mississippi and Ohio River valleys. Causes pneumonia.
Macrophage filled with Histoplasma (smaller than RBC) A.
Notes: Histo hides (within macrophages). Bird or bat droppings.

Question 2

Blastomycosis

Answer 2

Endemic location and Pathologic Features: States east of Mississippi River and Central America. Causes inflammatory lung disease and can disseminate to skin and bone. Forms granulomatous nodules.
Broad-base budding (same size as RBC) B.
Notes: Blasto buds (broadly).

Question 3

Coccidioidomycosis

Answer 3

Endemic location and Pathologic Features: Southwestern United States, California. Causes pneumonia and meningitis; can disseminate to bone and skin. Case rate increased after earthquakes (spores in dus are thrown up in the air and become spherules in lungs).
Spherule filled with endospores (much larger than RBC) C.
Notes: Coccidio crowds.
San Joaquin Valley or desert (desert bumps) “valley fever”.

Question 4

Paracoccidioidomycosis

Answer 4

Endemic location and Pathologic Features: Latin America.
Budding yeast with “captain’s wheel” formation (much larger than RBC) D.
Notes: “Captain’s wheel” appearance.
Paracoccidio parasails with the captain’s wheel all the way to Latin America.