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Mycology > Systemic Mycoses > Flashcards

Systemic Mycoses Flashcards

1
Q

What are the types of opportunistic pathogens that cause systemic mycoses?

A

1) Candida–>most common (yeast)
2) Cryptococcus neoformans (yeast)
3) Aspergillus (mold)
4) Pneumocystis jiroveci

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2
Q

What type of pathogen can become an opportunistic pathogen?

A

Zygomycetes

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3
Q

What are the species of Candida?

A

1) Candida albicans
2) C.tropicalis
3) C. parapsilosis
4) C. glabrata (cannot form pseudohyphae or true hyphae)

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4
Q

Which species of Candida cannot form pseudohyphae or true hyphae?

A

C. glabrata

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5
Q

What is used to differentiate C. albicans from all other yeasts?

A

Germ tubes that are formed at normal body temp (37 celcius)

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6
Q

What medium is used to identify Candida species?

A

Chrome agar

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7
Q

Candida Epidemiology

A
  • Grows everywhere
  • Major source of nosocomial infections
  • Grows very well on plastics
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8
Q

Candida Risk Factors

A
  • Hematological malignancy
  • Neutropenia
  • GI surgery
  • Extremes of age
  • Exposures
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9
Q

Candida Pathogenesis

A

Use adhesins like Fibronectin to attach to the cell surface and then use proteases that sit on hyphae and germ tubes to burrow inside

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10
Q

Immunity to Candida

A

Neutrophils and a working Th1 response is critical

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11
Q

What are some clinical manifestations of Candida?

A
  • Diaper Rash
  • Oropharyngeal Infection (Thrush)
  • Vulvovaginitis (Yeast infection)
  • Cutaneous disease…can affect scrotum, nails, in between digits
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12
Q

How would you treat a mucosal or cutaneous Candida infection?

A

Topical nystatin or oral azoles

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13
Q

How would you treat a deep-seated Candida infection?

A

Oral or IV azoles or Echinocandin

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14
Q

How would you treat C. galbrata?

A

Amphotericin B plus Echinocandin

-It is resistant to Azoles

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15
Q

What are the species of Aspergillus?

A

1) Flavus
2) Niger
3) Terreus

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16
Q

What kind of patients are highly susceptible to Aspergillus infections?

A

Patients with previous lung problems.

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17
Q

What are the species of Zygomyces?

A

1) Rhizopus

2) Mucor

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18
Q

Zygomyces Morphology

A

Asexual conidia found within sporangium
Sparsely septated hyphae
-Rhizoids are present

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19
Q

Which species of Rhizopus is the most common cause of human disease?

A

Rhizopus arrhizus

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20
Q

What are the zygomycoses mentioned in class?

A

Rhinocerebral zygomycoses, Pulmonary zygomycoses, cutaneous zygomycoses

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21
Q

What is the major organism that causes Pneumocystosis?

A

Pneumocystis jiroveci

22
Q

What can Pneumocystis jiroveci cause?

A
  • Pneumocystis jiroveci pneumonia (PJP)
  • Penumocystis carinii pneumonia (PCP)
  • Interstitial pneumonitis
23
Q

How is Pneumocystosis diagnosed?

A

“Crushed Ping-Pong balls”

24
Q

How is Pneumocystosis treated?

A

Trimethoprim-Sulfamethoxazole (Anti-biotic)

Pentamidine (anti-parasitic)

25
Q

Morphology of Cryptococcus neoformans

A

Budding from a narrow/thin base

26
Q

Cryptococcus neoformans is associated with…

A

Soil contaminated by pigeons

27
Q

Cryptococcus gatti is found…

A

In the Pacific Northwest, associated with trees

28
Q

In immunocompromised patients, C. neoformans and C. gatti cause what disease?

A

Meningo-encephalitis. Results in increased intracranial pressure. Will be a chronic infection, and symptoms may wax and wane.

29
Q

Endemic fungi are of what morphology?

A

Dimorphic

30
Q

Endemic fungi are often found in…

A

soil and bat feces

31
Q

What is the morphology of Histoplasma capsulatum

A

Thermally dimorphic
Room temp: Mold with thick-walled macroconidia and oval microcinidia
Body temp (37 C): Intracellular thin-walled yeast

32
Q

Pathology of Histoplasma capsulatum

A

Microconidia are phagocytosed by macrophages and it germinates into yeast

33
Q

What regions is Histoplasma capsulatum endemic to?

A

Ohio and Mississippi river valleys, Mexico, Central and South America

34
Q

Symptoms of Histoplasmosis

A

Light antigen load–> no symptoms
Heavy antigen load–> Flu-like symptoms
Rare complications: ARDS, mediastinal fibrosis, pericarditis, arthritis

35
Q

1/100,000 people infected with Histoplasma capsulatum get?

A

Chronic pulmonary disease

36
Q

1/2,000 people infected with Histoplasma capsulatum get?

A

Disseminated infection.
Chronic: weight loss, fatigue, oral ulcers, hepatosplenomegaly
Subacute: Same as chronic but with fever, CNS probs, adrenals and heart valves
Acute: Septic shock-like syndrome, oral&GI bleeding, meningitis, endocarditis

37
Q

Diagnosis of Histoplasma capsulatum

A

Serological test for histoplasmin antigen in serum or urine

38
Q

Treatment of Histoplasma capsulatum

A

Oral azoles and Amphotericin B..especially for chronic disseminated disease

39
Q

What is the morphology of Blastomyces Dermatitidis?

A

Room temp: White to tan mold with oval conidia found on terminal hyphae branches
Body temp: Non-encapsulated yeast

40
Q

What is the distinctive feature of Blastomyces?

A

Broad-based budding

41
Q

Where is Blastomyces Dermatitidis found?

A

MS and Ohio River Valleys and Bogalusa, Louisiana

Conidia breathed in when soil and leaves are disturbed

42
Q

What are the symptoms of Pulmonary Blastomyces?

A

Acute: Spectrum of symptoms
Chronic: Resembles cancer or TB

43
Q

What are the symptoms of Cutaneous Blastomyces?

A

Painless lesions that can resemble a squamous cell carcinoma in the skin and bones

44
Q

How do you diagnose Blastomyces Dermatitidis?

A

Broad-based budding in the tissue

Immunological test to look for antibodies

45
Q

Treatment for Blastomyces

A

Amphotericin B, Itraconazole, Fluconazole

46
Q

What is the morphology of Coccidiomycosis?

A

Room Temp: Barrel shaped arthrocondida

Body Temp: Anthrocondida become rounded spherules

47
Q

What is the epidemiology of Coccidiomycosis?

A

Endemic to SW USA, Northern Mexico, and South America

-Referred to as Valley Fever or San Joaquin Fever

48
Q

What kinds of infections do people with Coccidiomycoses get?

A

Primary infection: Asymptomatic pulmonary disease. 10% develop macular rash.
Secondary infection: Symptomatic after 6 wks. Nodular cavitary disease in the lungs. Resembles military TB or disseminated TB.

49
Q

What are the risk factors for Coccidiomycoses?

A

HIV+ men of Filipino, African-American, Native American, or HIspanic origen
-Mortality is 90% without treatment

50
Q

Diagnosis for Coccidiomycoses

A

Endosporulating spherules in sputum, exudates, or tissue

Most commonly made via biopsy

51
Q

Treatment of Coccidiomycoses

A

Amphotericin B, Itraconazole, Ketoconazole

Mycology (5 decks)

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