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YL2-MICRO > SYSTEMIC OPPORTUNISTIC MYCOSES > Flashcards

SYSTEMIC OPPORTUNISTIC MYCOSES Flashcards

1
Q

Endogenous causes of systemic opportunistic mycoses

A

cancer & leukemia

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2
Q

Exogeneous causes of systemic opportunistic mycoses

A

immunosuppressive therapy & AIDS

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3
Q

HIGH RISK GROUPS FOR DEVELOPING SERIOUS FUNGAL INFECTIONS individuals undergoing

A

BSMI:
Blood and marrow transplant (BMT)
Solid organ transplantation
Major Surgery
Immunosuppressive therapy

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4
Q

HIGH RISK GROUPS FOR DEVELOPING SERIOUS
FUNGAL INFECTIONS individuals WITH:

A

ANAP:
Acquired Immunodeficiency Syndrome (AIDS)
Neoplastic disease
Advance Age
Premature birth

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5
Q

Most well known causes of opportunistic mycoses

A

Candida albicans, Cryptococcus neoformans, and
Aspergillus fumigatus.

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6
Q

Causative agents of Candidiasis

A

Candida albicans (80-90%)

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7
Q

Most important group of opportunistic fungal pathogens. 3rd most common cause of central line-associated bloodstream infections (BSI),

A

Candida species

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8
Q

Ovoid or oval yeastlike form; Produce buds or blastoconidia; Produces pseudohyphae and true hyphae (except ____________) in both culture and tissue. Most form smooth, white, creamy, domed colonies

A

Candida species; Candida glabrata

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9
Q

Forms germ tubes and terminal, thick-walled chlamydoconidia

A

C. albicans

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10
Q

Incapable of forming pseudohyphae, germ tubes, or
true hyphae

A

C. glabrata

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11
Q

Candida species stain poorly with __________?

A

hematoxylin & eosin (H&E)

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12
Q

Candida species stain well with:

A

Periodic acid-Schiff (PAS)
Gomori methenamine silver (GMS)
Gridley fungus stain

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13
Q

ability of C. albicans to survive in many different environmental microniches within the human host.

A

Phenotypic switching

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14
Q

Primary sites of Candida species

A

GI tract

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15
Q

iatrogenic, nosocomial infection. Due to impaired epithelial barrier functions

A

Candidiasis

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16
Q

Thrush, glossitis, stomatitis and angular cheilitis. Mucosal infections caused by Candida spp. Usually present as white cottage cheese-like patches on
the mucosal surface.

A

OROPHARYNGEAL CANDIDIASIS

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17
Q

Type of oropharyngeal candidiasis that reveals a raw bleeding surface when scraped

A

Pseudomembranous

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18
Q

Type of oropharyngeal candidiasis that flat, red, occasionally sore areas

A

Erythematous type

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19
Q

are non-removable white thickening of the epithelium caused by the Candida species

A

Candida leukoplakia

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20
Q

sore features at the corners of the mouth

A

Angular cheilitis

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21
Q

present as pruritic rash with erythematous vesiculopustular lesions in areas where the skin surface is occluded and moist, such as the groin, axilla, toe webs, and breast folds.

A

Cutaneous candidiasis

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22
Q

common in infants under unhygienic conditions of chronic moisture and local skin maceration associated with amniotic irritation due to irregularly change of unclean diapers.

A

Diaper candidiasis

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23
Q

A rare condition marked by deficiency in T-lymphocyte
responsiveness to Candida spp.

A

Chronic mucocutaneous candidiasis

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24
Q

severe localized form which may occur with or without endocrinopathy characterized by marked hyperkeratotic granulomatous tissues.

A

Candida granuloma

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25
Q

Vulvovaginal candidiasis is a common condition in
women. Often associated with_____________?

A

use of broad-spectrum antibiotics, 3rd trimester of pregnancy, low vaginal pH, and diabetes mellitus.

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26
Q

associated with oral candidiasis may be a presentation of HIV infection or AIDS. with symptoms: intense vulval pruritus, burning, erythema, and dyspareunia associated with a creamy white curd-like discharge

A

Chronic refractory vaginal candidiasis

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27
Q

principal predisposing conditions for systemic candidiasis in neonates.

A

Low birth weight and age, prolonged intravascular
catheterization, and the use of antibiotic drugs

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28
Q

3rd most common cause of late-onset sepsis in NICU (high risk)

A

neonatal candidiasis

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29
Q

Usually associated with AIDS and severe immunosuppression following treatment for leukemia or solid tumors with symptoms of burning pain on the substernal area, dysphagia, nausea, and vomiting

A

Esophageal and gastrointestinal candidiasis

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30
Q

Acquired either hematogenous dissemination causing a diffused pneumonia or by bronchial extensions in patients with oropharyngeal candidiasis.

A

Pulmonary Candidiasis

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31
Q

Transient asymptomatic candiduria may occur during
antibiotic or corticosteroid treatment which promotes the growth of Candida. Usually, a result of a local spread of yeast from gastrointestinal and genital tract

A

Urinary Tract Candidiasis

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32
Q

fever, rigors, lumbar pain and abdominal pain; is usually the result of either an ascending infection or more frequently, hematogenous dissemination from another organ

A

Renal candidiasis or pyelonephritis

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33
Q

Criteria of suggestive renal infection

A
  1. The isolation of yeast in urine specimens obtained by suprapubic aspiration.
  2. Positive blood cultures and a positive immunodiffusion precipitin test result (seroconversion) in a patient with iatrogenic predisposing factors and or underlying illness
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34
Q

Occurs in patients with severe neutropenia usually acute leukemia with symptoms of fever, hepatosplenomegaly and INC blood conc of alkaline phosphatase

A

HEPATIC AND HEPATOSPLENIC CANDIDIASIS

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35
Q

Histopathology of hepatosplenic candidiasis

A

Diffuse hepatic and splenic necrotic lesions or
abscesses containing small numbers of pseudohyphae

36
Q

presence of yeasts in the blood with or without visceral involvement. A characteristic presentation is antibiotic resistant fevers in neutropenic patients with tachycardia and dyspnea.

A

Candidemia

37
Q

most common form of cardiac candidiasis

A

Endocarditis

38
Q

most sensitive method for the isolation of Candida from the blood.

A

Lysis centrifugation

39
Q

globose to elongate yeast-like cells or blastoconidia

A

Candida albicans

40
Q

Candida albicans produce by__________?

A

multilateral budding

41
Q

T/F Colony pigmentation always present in Candida albicans

42
Q

Prophylaxis for Candida species has been shown to be efficacious when employed in specific high-risk groups such as bone marrow and liver transplant patients

A

Fluconazole

43
Q

Treatment for Mucosal and cutaneous candidiasis

A

topical creams, lotions, ointments, suppositories containing azole agents (e.g., imidazoles and triazoles)

44
Q

TX for Oral systemic therapy (candidiasis)

A

fluconazole or itraconazole

45
Q

TX for Bladder colonization or cystitis (candidiasis)

A

amphotericin B directly to the bladder or oral fluconazole

46
Q

A systemic mycoses caused by the encapsulated,
basidiomycetous, yeastlike fungi

A

Cryptococcosis

47
Q

worldwide in distribution and found as ubiquitous saprophyte of soil, especially soil enriched with pigeon
droppings

A

C. neoformans

48
Q

capsular serotypes A, D and AD

A

C. neoformans

49
Q

capsular serotypes B and C

50
Q

predominant clinical presentation of cryptococcosis in AIDS patients

A

Meningitis

51
Q

Large mass lesions in lung or brain are called as _________?

A

“cryptococcomas”

52
Q

affects immunocompromised hosts predominantly, and is the most common cause of fungal meningitis

A

C. neoformans

53
Q

Spherical to oval; Encapsulated basidiomycete yeastlike fungus; Germ tubes, hyphae, and pseudohyphae are usually ABSENT in clinical material

A

Cryptococcus Neoformans / Gatti

54
Q

C. neoformans & gatti replication via?

55
Q

Cryptococcus species stains with ______

A

Indian Ink

56
Q

Surrounded by optically clear, smoothly contoured, spherical zones, or “halos” that represent the extracellular polysaccharide capsule

A

Cryptococcus species

57
Q

The capsule of cryptococcus sp. is a distinctive marker that may have a diameter up to 5 times that of fungal cell and is easily detected with____________.

A

Mucin (Mayer mucicarmine)
PAS
GMS stains

58
Q

The cell wall of C. neoformans contain ___________, which is demonstrated by staining with the____________.

A

Melanin; Fontana- Masson stain

59
Q

Individuals with CD4+ lymphocyte counts of
_____________ are at high risk for CNS and
disseminated cryptococcosis

60
Q

worldwide in association with soil contaminated with avian excreta

A

C. neoformans var. neoformans and var. grubii:

61
Q

found in tropical and subtropical climates in association with eucalyptus tree

A

C. gattii:

62
Q

Conditions with asymptomatic colonization of
Cryptococcus:

A

Bronchitis
Bronchiectasis

63
Q

When present symptoms include cough, low-grade
fever, pleuritic chest pain

A

pulmonary cryptococcosis

64
Q

dissemination to the brain and meninges; Meningitis, meningoencephalitis or expanding cryptococcoma

A

CNS CRYPTOCOCCOSIS

65
Q

localized solid tumor-like masses usually found in the
cerebral hemispheres or cerebellum, more rarely in the
spinal cord

A

Cryptococcoma

66
Q

Lesions: lytic without periosteal reaction and symptoms of dull pain on movement are reported

A

CRYPTOCOCCOSIS OF THE BONE

67
Q

Primary isolation media of C. neoformans

A

Sabouraud’s dextrose agar

68
Q

Genus Cryptococcus:
ð Fermentation of sugar:______________
ð Assimilation of nitrate: ____________
ð Assimilation of inositol: _____________

A

Negative
Variable
Positive

69
Q

Induction therapy for cryptococcosis

A

Amphotericin B + flucytosine acutely for 2
weeks Followed by 8-week consolidation, with either oral fluconazole (preferred) or itraconazole

70
Q

TX for cryptococcosis for AIDS patients

A

Lifelong maintenance with either fluconazole
or itraconazole

71
Q

most common human pathogen among others Aspergillus

A

A. fumigatus

72
Q

Aspergillus spp. grow in culture as _________

A

Hyaline molds

73
Q

Grow as branched septate hyphae that produce conidial heads when exposed to air in culture and tissue. A conidial head consists of a conidiophore with a terminal vesicle on which are borne one or two layers
of phialides, or sterigmata

A

Aspergillus spp.

74
Q

In tissue: hyphae of Aspergillus spp. is stained poorly with H&E, but is well visualized by the _________

A

PAS, GMS and Gridley fungal stains

75
Q

branches of aspergillus spp are dichotomous and usually arise at what angle?

A

Acute angle (45 degree)

76
Q

most frequent and most important portal
of entry of Aspergillus

A

Respiratory Tract

77
Q

Indolent, slowly progressive, “semi-invasive” with Fever, cough, sputum production and positive serum antibody precipitin may also be detected

A

CHRONIC NECROTIZING ASPERGILLOSIS

78
Q

Saprophytic colonization of preformed cavities with symptoms of hemoptysis and many are asymptomatic; Positive immunodiffusion precipitin test to antibody to Aspergillus & Elevated specific IgE against Aspergillus

A

NON-INVASIVE ASPERGILLOSIS OR ASPERGILLOMA / Fungus ball

79
Q

Mimics acute bacterial pneumonia with serum antibody precipitins usually negative

A

Acute invasive pulmonary aspergillosis

80
Q

Primarily seen in immunocompetent individuals; Predisposing factors: history of chronic sinusitis
and poor draining sinuses with excessive mucus

A

Non-invasive “aspergilloma” form

81
Q

Usually seen in immunocompromised patients. Has similar clinical setting to that seen in rhinocerebral zygomycosis with a symptoms: fever, rhinitis and signs of invasion into the orbit

A

Invasive form aspergillosis of the paranasal sinuses

82
Q

Fast growing colonies with white, yellow, yellow brown, brown to black or green in color ;cultures show colonies with characteristic radiating chains of conidia.

A

A. fumigatus

83
Q

single palisade-like layer of phialides

A

Uniseriate

84
Q

layer of subtending cells

85
Q

Detects a wide variety of fungal pathogens:
Aspergillus, Candida, Fusarium, Trichosporon

A

(1-3) B-D-Glucan test

86
Q

Tx for aspergillosis : Amphotericin B (lipid formulation) but A. terreus is resistant to it. What is alternative treatment option that is more efficacious and less toxic than Ampo B

A

Voriconazole

YL2-MICRO (5 decks)

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