Test 3 Wk11: 11 Respiratory Fungal Infections - Shah Flashcards

1
Q

North American Blastomycosis Causative Agent:

A

B.dermatitidis

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2
Q

B.dermatitidis is — in nature

A

dimorphic

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3
Q

B.dermatitidis location

A

Ohio & Mississippi River
valleys, the Great Lakes,
and in the southeast

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4
Q

Clinical Presentation

Blastomycosis : B.Dermatitidis

A

Flu like symptoms

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5
Q

B.Dermatitidis Acute pulmonary

A

Acute pulmonary: lobar
segmental consolidation,

Mimics bacterial pneumonia .

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6
Q

B.Dermatitidis Chronic pulmonary

A

Chronic pulmonary lobar infiltrates

Mimics tuberculosis or lung
cancer

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7
Q

— Can disseminate to skin & bone in immunocompromised patients

A

B.Dermatitidis

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8
Q

B.Dermatitidis is acquired by

A

acquired by inhaling spores:
dissemination Suppurative
granulomatous;

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9
Q

— often misdiagnosed are carcinoma

A

B.Dermatitidis

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10
Q

Diagnosis & Treatment :

B.Dermatitidis

A

KOH preparation:

Sputum, BAL, lung tissue, skin biopsy,

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11
Q

B.Dermatitidis Yeast form is

A

Yeast form is large (8-12 um), round, thick walled and

hyaline

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12
Q

Histoplasmosis:

A

H. capsulatum

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13
Q

H. capsulatum location

A

Ohio and Mississippi

river valleys in the USA.

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14
Q

H. capsulatum elicits — similar to —

A

Elicits granulomas; TB

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15
Q

H. capsulatum animals

A

birds and bats

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16
Q

H. capsulatum comes from soil that is

A

high N content

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17
Q

H. capsulatum forms — in the body

A

histocytes

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18
Q

H. capsulatum is

A

dimorphic

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19
Q

Histoplasmosis

clinical presentation

A

variable

asx in healthy; can dissiminate in immunosuppressed

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20
Q

Histoplasmosis

clinical presentation rare cases

A

Acute Respiratory Distress Syndrome

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21
Q

Acute respiratory distress syndrome in Histoplasmosis

A

10% inflammatory sequelae, such as persistent
lymphadenopathy with bronchial obstruction,
arthritis, arthralgias , or pericarditis,

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22
Q

Mediastinal fibrosis: ARDS Histoplasmosis

A

Persistent host response to
the organism may result in massive fibrosis and
constriction of mediastinal structures, including
the heart and great vessels.

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23
Q

H. capsulatum

Diagnosis & Treatment

A

Direct microscopy

Culture of blood, bone, marrow or other material

enzyme immunoassay

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24
Q

The yeast phase of H. capsulatum organism can be detected in:

A

Sputum, BAL, fluid,
peripheral blood films, bone
marrow, and tissue stained

25
Q

H. capsulatum found can be seen in tissue stained with

A

with Giemsa, GMS, or PAS

stains

26
Q

H. capsulatum PAS stain

appears

A

appears as a small yeast about 5-6 microns in diameter

27
Q

Coccidioidomycosis

A

C. Immitis & C.posadasii

28
Q

Coccidioidomycosis located in

A

southwest

29
Q

Coccidioidomycosis also known as

A

San Joaquin Valley Fever

30
Q

Coccidioidomycosis environment

A

Arid, alkaline soils, hot

summers.

31
Q

Coccidioidomycosis outbreaks

A

dust storm and earthquakes

32
Q

which Coccidioidomycosis accounts for the majority of infections outside of California

A

C. posadasii

33
Q

Coccidioidomycosis are

A

dimorphic

34
Q

Coccidioidomycosis forms — at 37C

A

Spherules

35
Q

Coccidioidomycosis spherules can be mistaken as

A

toxoplasma gondii tissue cysts

36
Q

Coccidioidomycosis forms — in the environment

A

Arthroconidia

37
Q

Coccidioidomycosis Clinical presentation

A

Variable; usually self limited; can be life threatening;

38
Q

Coccidioidomycosis is known as the great imitator and mimics

A

syphilis, typhoid,

39
Q

Coccidioidomycosis sx

A

fever, cough, chills, pleurisy, arthralgia

40
Q

Coccidioidomycosis extrapulmonary sites of infection

A
skin
soft tissue
bones
joints
meninges
41
Q

Coccidioidomycosis risk factors

A

Filipino, African American, Native American, Hispanic

Male

Women in 3rd trimester

Depressed cell mediated immunity

42
Q

Coccidioidomycosis pathology

A

Necrotizing granulomatous inflammation

pneumonitis

huge (20 60 µm) round thick walled spherule under microscope full of smaller endospores

43
Q

Diagnosis: Coccidioides immitis

A
sputum
pus from skin lesions
gastric washings
CSF
biopsy
44
Q

Coccidioides immitus stain

A

Calcofluor white stain

45
Q

Paracoccidiodes brasiliensis is

A

dimorphic

46
Q

Paracoccidiodes brasiliensis forms — at 37C

A

“pilots wheel” multipolar arrangement

47
Q

Paracoccidioidomycosis

Clinical Presentation

A

Granulomatous disease of
mucous membranes, skin, and
pulmonary system.

48
Q

25% patients exhibit, pulmonary manifestations of Paracoccidioidomycosis can

A

which can disseminate to

extrapulmonary sites w/out tx

49
Q

Paracoccidioidomycosis Diagnosis

A

Examination of sputum

BAL

scrapings or biopsy

pus draining from lymph nodes

CSF

tissue

50
Q

Paracoccidioidomycosis Histopathology

A

multiple buds forming a “Captain’s wheel.“ “Pilot’s wheel”

51
Q

C. Neoformans

A

Capsule

52
Q

Aspergillilus hyphae

A

Mold with septate

53
Q

Pneumocystis jirovecii

A

Cup shaped fungus

54
Q

Histoplasma capsulatum , a dimorphic fungus, is found in
soil heavily contaminated with bird droppings. Which of
the following statements best describes the presence of
the organism in tissue biopsies?

A

Oval Budding yeast inside macrophages

55
Q

Histoplasma is prevalence in which part of the USA?

A

Ohio and Mississippi

river valleys in the USA.

56
Q

Coccidioides immitis

A

A dimorphic fungus, which produces “Spherule” in its tissue phase.

57
Q

Blastomyces dermatitidis

A

A dimorphic fungus most commonly found in soils of Northeastern
USA which is also an important veterinary problem

58
Q

Cryptococcus neoformans

A

A yeast acquired by inhalation that causes respiratory infection
primarily in immunocompromised patients