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Histoplasma, Blastomyces, Coccidioides

Terms in this set (26)

Histoplasma capsulatum.
-Only sepcies recognized to infect humans.
-Worldwide affect yet endemic to Ohio and Mississippi river valleys.
-Grows in soil, especially in areas with bird and bat droppings.
Blastomyces dermatitidis
-Disease occurs worldwide and is endemic in the Ohio, Mississippi, Missouri and Arkansas River valleys, especially the upper Midwest states of Minnesota and Wisconsin.
-The fungus grows in soil, especially in areas enriched with organic matter.
Coccidioides immitis
Disease is endemic in the hot, arid Sonora desert region of the southwestern U.S. (California, Arizona, New Mexico, Texas) and parts of Mexico.
-The fungus grows in soil, almost exclusively in areas with fine sand and silt.
Penicillium marneffei
-Grows in southeast Asia and problem for AIDS patients.
Histoplasma, Blastomyces, Coccidioides: Growth and reproduction.
-Thermally dimorphic.
-Grow as filamentous molds at room temp, switch to yeasts in human body.
Histoplasma, Blastomyces, Coccidioides: Habitat.
-Soil
Histoplasma, Blastomyces, Coccidioides: Transmission.
-Inhalation of the spores/conidia.
-Germinate in the lung and turn into yeast form.
Histoplasmosis: General features.
-Very common in US
-Somewhat resemble TB since they replicate within macrophages and for granulomatous lesions.
-Cell mediated immunity is key to recovery.
Histoplasmosis: Clinical manifestations: Asymptomatic infection.
-90% of people infected do not show signs of the dz.
-Happens in healthy immun-compotent people.
-Can have a recurrence later.
Histoplasmosis: Clinical manifestations: Flu-like syndrome
-Presents with flu-like symptoms.
-Most self limited and resolve w/o treatment.
-Many times go undiagnosed.
-Can have recurrence later.
Histoplasmosis: Clinical manifestations: Acute pulmonary histoplasmosis.
-Diffuse or localized pneumonitis is granulomatous lesions.
-Several weeks after exposure.
-Presents with fever, chills, cough, chest pain, and difficulty breathing.
-May have to be vented.
-In immunosupressed patients, it's just one sign of a large dissemination.
Histoplasmosis: Clinical manifestations: Chronic pulmonary histoplasmosis.
-Usually in patients with COPD.
-Re-activation of latent infection.
-Development of large cavities in upper lobes of lung.
Histoplasmosis: Clinical manifestations: Disseminated histoplasmosis.
-Hematogenous spread and replication in immunosuppressed patients and young children.
-Fatal if untreated.
Blastomycosis: Clinical manifestations: General features.
-Also resembles TB.
-Can infect normal and immunocompromised alike.
-Skin presentation in one major difference between it and other diseases like it.
Blastomycosis: Clinical manifestations: Asymptomatic infection.
-50% people infected show no sign.
Blastomycosis: Clinical manifestations: Mild flu-like syndrome.
-Mild flu symptoms
-May resolve on its own.
Blastomycosis: Clinical manifestations: Acute pulmonary blastomycosis.
-Acute illness resembling bacterial pneumonia.
-Symptoms include high fever, chills, productive cough, and pleuritic chest pain. Sputum is purulent or mucopurulent.
Blastomycosis: Clinical manifestations: Chronic pulmonary blastomycosis.
-Chronic illness with low-grade fever, productive cough, night sweats, and weight loss.
-Sputum is purulent or mucopurulent and hemoptysis may be present.
Blastomycosis: Clinical manifestations: Disseminated blastomycosis.
-Hematogenous spread and replication is typical of blastmycosis.
-Skin is most common site of extrapulmonary infection
-20-40% of all cases.
-Others include bone, GI tract, and CNS.
Coccidiomycosis: Clinical manifestations: General features.
-95% of cases seen from CA to AZ.
-Many normal individuals infected.
-The sperules remain extracellular and resist killing due to their size.
Coccidiomycosis: Clinical manifestations: Asymptomatic infection.
-No signs of dz.
-Duh.
-Why did I make this slide?
-Boobs, that is all.
Coccidiomycosis: Clinical manifestations: Mild flu-like syndrome.
-Flu-like symptoms that resolve in 6 months w/o treatment.
-60% of infection falls into this or asymptomatic category.
Coccidiomycosis: Clinical manifestations: Moderate respiratory disease.
-Acute illness resembling bacterial pneumonia.
-Symptoms include high fever, chills, cough, fatigue, shortness of breath, night sweats and sputum production.
-A small percentage of these patients develop nodules or cavities in the lungs.
Coccidiomycosis: Clinical manifestations: Disseminated coccidiomycosis.
-1-2% of patients develop this.
-Most common site of dissemination is the skin.
-Also, meningitis is more serious and lethal complication.
Histoplasma, Blastomyces, Coccidioides: Diagnosis.
-Imaging (xray, CT)
-Sampling of lung or disseminated sites.
-Observation of yeasts (Histoplasma and blastomyces) or spherules (Coccidiodes).
-Culture (slow)
-Antigen detection in urine (Histo)
-Serology- IgM titers important of C. immitis infections.
Histoplasma, Blastomyces, Coccidioides: Treatment
-Asymptmatic to mild cases require no treatment.
-Long term therapy is otherwise required (months to years)
-No vaccines
-Anti-fungal prophylaxis in AIDS patients.
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