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MT6322 MYCOVIRO > U6 LEC: OPPORTUNISTIC MYCOSES > Flashcards

U6 LEC: OPPORTUNISTIC MYCOSES Flashcards

1
Q

Infections in patients with immune deficiencies who would otherwise not be infected.

A

Opportunistic Mycoses

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2
Q

Opportunistic mycoses are seen in those people with impaired host defenses such as?

A
  • AIDS
  • Alteration of Normal Flora
  • Diabetes Mellitus
  • Immunosuppressive therapy
  • Malignancy
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3
Q

Part of a normal human flora

A

Endogenous

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4
Q

Examples of Endogenous Mycoses

A
  • Candida spp.
  • Pneumocystis jirovecii
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5
Q

Most common endogenous mycoses, indicator of weak immune system

A

thrush (Candida spp.)

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6
Q

Fungus does not normally live in/on human body

A

Exogenous

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7
Q

Examples of Exogenous Mycoses

A
  • Cryptococcus neoformans
  • Aspergillus (different species)
  • Zygomycetes
  • Many Other Fungi
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8
Q

Causative agent of Candidiasis or Moniliasis

A

Candida albicans and other Candida spp.

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9
Q

Candida albicans causes?

A

Candidiasis or Moniliasis

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10
Q

Candidiasis

oval, buddying yeast that produces?

A

pseudohyphae

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11
Q

T/F: Candida albicans causes the most frequent opportunistic fungal infections.

A

True

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12
Q

Candidiasis

harmless inhabitants of the?

A

skin and mucous membranes (RT, GIT, Female Genital Tract)

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13
Q

T/F: Normal immune system keeps Candida on body surfaces.

A

True

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14
Q

Other Candida species

A
  • C. tropicalis
  • C. krusei
  • C. parapsilosis
  • C. glabrata
  • C. gullermondii
  • C. lusitaniae
  • C. kefyr
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15
Q

Candidiasis

Main Defense Mechanisms

A
  • skin and mucous membranes integrity
  • presence of normal bacterial flora
  • phagocytosis
  • killing (most in PMNs, less in macrophages)
  • T cells (CD4)
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16
Q

Candidiasis

Important Risk Factors

A
  • Neutropenia
  • Diabetes mellitus
  • AIDS
  • SCID
  • Myeloperoxidase defects
  • Broad-spectrum antibiotics
  • Indwelling catheters
  • Major surgery
  • Organ transplantation
  • Neonates
  • Severity of an illness
  • Intravenous drug addicts
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17
Q

Candidiasis

Clinical Forms

A
  1. Cutaneous and Mucosal
  2. Invasive
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18
Q

Candidiasis

Manifestations under Cutaneous and Mucosal Candidiasis

A
  • Oral thrush
  • Oezophagitis
  • Vulvovaginal infection
  • Cutaneous candidiasis (skin trauma, burn patients)
  • Onchomycosis
  • Mucocutaneous candidiasis (SCID patients)
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19
Q

Invasive Candidiasis also refers to?

A

Systemic, Disseminated, Hematogenous Candidiasis

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20
Q

Invasive Candidiasis

begins with?

A

candidemia (only 50% can be proven)

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21
Q

Invasive Candidiasis

If phagocytic system is normal?

A

invasive infection stops here (destroyed by phagocytes)

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22
Q

Invasive Candidiasis

If phagocytic system is compromised?

A

infection spreads to many organs (causes focal infection)

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23
Q

Invasive Candidiasis

Mortality of candidemia

A

30-40%

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24
Q

Candidiasis

Specimen

A
  • Swabs or scrappings from lesions
  • Sputum
  • CSF
  • Exudates
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25
Q

Candidiasis

Microscopic

A

Gram (+) oval, budding yeast/elongated budding cells in chain (pseudohyphae)

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26
Q

Candidiasis

SDA

A

soft, cream-colored colonies with yeasty odor, surface growth consists of oval budding cells

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27
Q

Candidiasis

Ferments?

A

glucose and maltose producing acid and gas

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28
Q

Candidiasis

Serological test

A

Precipitation tests

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29
Q

This agar is used to differentiate Candida based on?

A

color

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30
Q

CHROM agar

Green

A

C. albicans

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31
Q

CHROM agar

Pink

A

C. krusei

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32
Q

CHROM agar

Metallic blue

A

C. tropicalis

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33
Q

CHROM agar

White to mauve

A

Other species

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34
Q

This is done for Candida albicans in presence of high protein content.

A

Germ tube

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35
Q

Germ Tube

specimen

A

plasma or serum

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36
Q

Germ Tube

(+) result

A

presence of germ tube

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37
Q

Germ Tube

What Candida spp. is present if there is (+) result?

A

Candida dubliniensis

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38
Q

Chlamydoconidia is present in?

A

C. albicans and C. dubliniensis

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39
Q

Candidiasis

Epidemiology

A
  • Endogenous
  • Cross infections (ICU patients)
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40
Q

Candidiasis

Treatment

A

Neutropenic patients: Amphotericin B

Non neutropenic patients:
Nystatin, Caspofungin

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41
Q

Candidiasis

This treatment suppresses intestinal and vaginal candidiasis

A

Nystatin

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42
Q

Causative agent of Pneumocystis Pneumonia

A

Pneumocystis jirovecii

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43
Q

Pneumocystis jirovecii causes?

A

Pneumocystis Pneumonia

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44
Q

Pneumocystis jirovecii is formerly called?

A

P. carinii

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45
Q

Pneumocystis

previously classified as?

A

protozoa

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46
Q

Pneumocystis

considered as fungus based on?

A

nucleic acid and biochemical analysis

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47
Q

Pneumocystis

Present in?

A

lung of many mammals

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48
Q

Pneumocystis

Infection in humans

A

persistent but harmless

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49
Q

Pneumocystis

Main Risk Factors

A
  • AIDS
  • Transplantation
  • Corticosteroid
  • Antineoplastic therapy
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50
Q

Pneumocystis

Main defense mechanism

A

T-cell mediated

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51
Q

Pneumocystis

Causes what in immunocompromised patients?

A

Interstitial pneumonitis

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52
Q

Pneumocystis

Specimens can be?

A

sputum, bronchoalveolar lavage

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53
Q

Pneumocystis

Treatment and Prevention

A

Co-trimoxazole or Pentamidine

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54
Q

Causative agent of Cryptococcosis or Torulosis

A

Cryptococcus neoformans

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55
Q

This causes Cryptococcosis

A

Cryptococcus neoformans

56
Q

Other term for Cryptococcosis

A

Torulosis

57
Q

Cryptococcosis

causes an acute or chronic infection that involves the brain, called?

A

meningitis

58
Q

Cryptococcosis

occurs worldwide in?

A

soil and in bird droppings

59
Q

Cryptococcosis

Prominent feature

A

thick polysaccharide capsule

60
Q

Cryptococcosis

Infection is via?

A

respiratory tract

61
Q

Cryptococcosis

Symptoms associated with?

A

nonspecific pulmonary signs and symptoms

62
Q

Cryptococcosis

May disseminate in other organs like?

A

brain (cryptococcal meningitis)

63
Q

Cryptococcosis

Clinical manifestation

A

slowly developing chronic meningitis that resembles a brain tumor, brain abscess, degenerative CNS disease

64
Q

Cryptococcosis

Specimen

A

CSF, Exudate, Sputum, Urine

65
Q

Cryptococcosis

Microscopic

A

round or ovoid, often budding with thick capsule

66
Q

Cryptococcosis

SDA

A

cream, shiny, mucoid colonies

67
Q

Cryptococcosis

Serological tests

A

Cryptococcal polysaccharide capsular antigen test, latex agglutination test

68
Q

Cryptococcosis

Treatment

A

Combination of chemotherapy of Amphotericin B and Flucytosine

69
Q

Cryptococcosis

Main Risk Factors

A
  • T cell deficiency (AIDS)
  • Corticosteroid therapy
  • Organ transplantation
  • Hematological malignancy
70
Q

Cryptococcosis

Main Defense Mechanism

A

T cells

71
Q

Cryptococcosis

Treatment

A

Amphotericin B +
- Flucytosine

72
Q

Cryptococcosis

Recurrence Prevention

A

Fluconazole

73
Q

Cryptococcosis

Epidemiology

A

Exogenous, not transmitted from human to human

74
Q

Cryptococcosis

This agar is used to detect the enzyme, phenol oxidase

A

Niger Seed Agar (Bird Seed Agar)

75
Q

Causative agent of Aspergillosis

A

Aspergillus spp.

76
Q

Aspergillus spp. causes?

A

Aspergillosis

77
Q

Aspergillosis

Worldwide occurring saprophytes, living in?

A

soil and plants (small conidia that form aerosols)

78
Q

Aspergillosis

Most common

A

Aspergillus fumigatus

79
Q

Aspergillosis

Other species

A
  • A. flavus
  • A. niger
  • A. terreus
  • A. nidulans
80
Q

Aspergillosis

Produces aflatoxins in food

A

A. flavus

81
Q

Aspergillosis

Specimen

A

Tissue biopsy

82
Q

Aspergillosis

Microscopic

A

hyphal fragments (using methenamine silver)

83
Q

Aspergillosis

Cultivation in SDA

A

gray to green colonies

84
Q

Aspergillosis

Main Defense Mechanisms

A

Phagocytosis

85
Q

Aspergillosis

Treatment

A
  • Amphotericin B
  • Itraconazole
  • Flucytosine
  • Surgery
86
Q

Aspergillosis

Prevention

A

Avoid exposure to conidia (new buildings)

87
Q

Aspergillosis

Main Risk Factors

A
  • Hematological malignancy
  • Bone marrow transplantation
  • Corticosteroid therapy
88
Q

Causative agent of Zygomycosis

A
  • Mucor
  • Rhizopus
  • Absidia
  • Rhizomucor
89
Q

Zygomycosis is also called as?

A

Mucormycosis
Phycomycosis

90
Q

Zygomycosis

invasive disease caused by?

A

Zygomycetes (Mucor, Rhizopus, Rhizomucor, Absidia)

91
Q

Zygomycosis

These fungi are?

A

ubiquitous thermotolerant saprophyte

92
Q

Zygomycosis

spores are present in?

A

air and dust

93
Q

Obsolete polyphyletic taxon, forms coenocytic hyphae and reproduce asexually by producing sporangiophores within which develops sporangiospores

A

Class Phycomycetes

94
Q

Rhizopus

Mycelium, 3 types of hyphae

A
  • Stolon
  • Rhizoid
  • Sporangiophores
95
Q

Mucor

Mycelium

A

1 type only: Sporangiophores

96
Q

Rhizoids

A

R: Present

M: not present

97
Q

Food

A

R: absorbed by rhizoids

M: absorbed by entire mycelial surface

98
Q

Sporangiophores

A

R: occurs in tufts from the stolons opposite the rhizoids

M: occur singly from any point on the mycelium

99
Q

Spores

A

R: easily disseminated by the wind

M: remain adhered to the columella, not easily disseminated

100
Q

Absidia

Difference from Rhizopus

A

Rhizoids in between Sporangiosphores

101
Q

Absidia

Difference from Mucor

A

Mucor have no rhizoids

102
Q

Rhizomucor

Difference from Mucor

A

have rhizoids and stolons, grow at 50-55C

103
Q

Rhizomucor

Difference from Absidia

A

have globose sporangia, sporangiophores are not swollen where they merge with the columella

104
Q

Zygomycosis

Risk Factors

A
  • Acidosis
  • Leukemias
  • Lymphoma
  • Corticosteroid treatment
  • Severe burns
  • Immunodeficiencies
105
Q

Zygomycosis

Clinical Manifestations

A
  • Rhinocerebral Mucormycosis
  • Thoracic Mucormycosis
  • Other sites of invasion
106
Q

This disease can progress rapidly with invasion of the sinuses, eyes, cranial bones and brain

A

Rhinocerebral Mucormycosis

107
Q

Rhinocerebral Mucormycosis

Results from germination of?

A

sporangiospores in nasal passages

108
Q

Rhinocerebral Mucormycosis

Invasion of?

A

hyphae into blood vessels

109
Q

Rhinocerebral Mucormycosis

Invasion of hyphae causes?

A
  • Thrombosis
  • Infarction
  • Necrosis
110
Q

Rhinocerebral Mucormycosis

Patients develop?

A
  • edema of involved facial area
  • bloody nasal exudate
  • orbital cellulitis
111
Q

Rhinocerebral Mucormycosis

Almost invariably associated with?

A
  • acute diabetes mellitus
  • debilitating disease (leukemia, lymphoma)
112
Q

Thoracic Mucormycosis

Follows inhalation of sporangiospores with?

A

invasion of lung parenchyma and vasculature

113
Q

Thoracic Mucormycosis

In both locations, this causes massive tissue destruction

A

ischemic necrosis

114
Q

Other Sites of Invasion

Skin infections following burns or surgery

A

Primary cutaneous infections

115
Q

Other Sites of Invasion

These are also reported

A

Subcutaneous zygomycosis

116
Q

Zygomycosis

Specimen

A

Nasal discharge, sputum, biopsy

117
Q

Zygomycosis

Microsopic (KOH)

A

broad and aseptate, branched mycelium, sometimes distorted hyphae, clearly stained by Methenamine silver stain

118
Q

Zygomycosis

SDA

A

Abundant and cottony

119
Q

Zygomycosis

Treatment

A

Amphotericin B

120
Q

Causative agent of Penicilliosis / Talaromycosis

A

Talaromyces marneffei

121
Q

Talaromyces marneffei causes?

A

Penicilliosis

122
Q

Other term for Penicilliosis

A

Talaromycosis

123
Q

Talaromyces marneffei is formerly known as?

A

Penicillium

124
Q

T/F: There are more than 100 Penicillium species.

A

False

more than 150

125
Q

Penicilliosis

Form

A

thermally dimorphic

126
Q

Penicilliosis

Present in?

A

environment (saprophytes), grow on various substrates (bread, jam, fruit, cheese)

127
Q

Penicilliosis

Important opportunistic pathogen in?

A

HIV infected

128
Q

Penicilliosis

Causes?

A

disseminated infection with multiple organ involvement

129
Q

Penicilliosis

Common in?

A

Southeast Asia

130
Q

Penicilliosis

Risk Factors

A
  • Adult-onset immunodeficiency syndrome
  • Cancer
  • HIV/AIDS
  • Organ transplant
131
Q

Penicilliosis

These can also get Talaromycosis.

A

Bamboo rats (no evidence of spread from rats to people)

132
Q

T/F: Penicilliosis has no person to person spread.

A

True

133
Q

Penicilliosis

Specimen

A

Bone marrow, blood, lung fluids, lymph nodes, skin

134
Q

Penicilliosis

Microscopic

A

yeast are small, oval, 2-4um in diameter

135
Q

Penicilliosis

SDA

A

yellow green colonies with characteristic soluble red pigment

136
Q

Penicilliosis

Molecular techniques

A

PCR

137
Q

Penicilliosis

Treatment

A

Amphotericin B, Oral Itraconazole

MT6322 MYCOVIRO (10 decks)

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