32 terms

Trif Fungi

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What are the yeasts
candidasis and cryptococcosis
What are the molds?
Aspergillosis and Zygomycosis
What are the dimorphic fungi?
coccidiomycosis, North American Blastomycosis and South American blastomycosis
Candidasis
candida albicans, most common pathogen. commendal on skin and oral cavity (immunocompetent: superficial infections....immunodeficient= deep).
predisposing conditions :
abx, immune suppresive therapy, DM, malnutrition, AIDS
Candida lesions
white memnrane on a red and moist surface.....oral caity= thrush, pharynx, vagina: from pregnancy and OC.
cutaneous candidiasis
onchymycosis, npronychia, folliculitis, moist intertrignious skin (armpits/webs of fingers and toes) and penis (balanitis)....Diaper rash= perineum of infacts from wet diapers.
Disseminated candida
renal abscess, myocardial abscess/endocarditis, brain, enophthalmitis, hepatic abscess and Candida pneumonia with bilateral nodular infiltrates.
Microscopy for Candida:
membrane of mycelia with filaments penetrating into underlying tissues and inflammatory cell reaction
diagnosis for candida
....diagnose with NON BRANCHING HYPHAE AND BUDDING YEAST with Periodic Acid Schiff stain
Cryptococcus neoformans- Cryptococcosis
round to oval yeast, unequal budding, no hyphae or mycelia....PIDGEON DROPPINGS!
normal individuals get
meningoencephalitis...aids patients get opportunistic infections.....normal people get chronic granulomatous reaction of macrophages, lymphocyes, giant cells (granulomatous arteritis)
Pathogenesis of Crypto:
mild/asymptomatic pulmonary infectin but fungus spreads hematogenously to CNS
Morphology:
lung lesion= SOLITARY PULMONARY GRANULOMA like a coin lesion...bainlesion
Immune suppressdd crypto
no inflammatory rxn, gelatinous mass of fungi in the meninges or encephalitis.......cysts in gray matter are EXPANDED PERIVASCULAR VIRCHOW-ROBIN SPACES: "soap bubble lesions"....diagnose with mucicarmine stain that is red
Aspergillus mold
A. fumigatus; septate hyphae branching at 45 degree angles....inhalation of spores....allergies (brewer's lung) and sinusitis/pneumonia
Immunocompromised aspergillosis
opportunistic infections and fungemia
Allergic form of aspergillosis
inhale spores and allergic response.....germination of spores= aggravation...bronchial asthma, allergic alveolitis
Colonizing form Aspergilloma= fungus ball
pre-existent TB cavities; round mass of proliferating tangling fungal hyphae in a wall cavity. hyphae do not invade adjacent pulmonary parenchyma
Invasive Aspergillos
primary lesion in lung is spread to heart, lung, kidney and there is a tendenacy to invade Blood vessels causing hemorrage
Zygomycosis / Mucormycosis
phycomycosis too....bread mold fungi....irregularly broad non septate hyphae with wide angle branching........decaying vegetable matter...seen in patients with potentially fatal diseases (severe noscomial and opportunistic infections)
Clinical forms of Zygomycosis
1. subQ
2. rhino cerebral: sinuss to brain causing meningoencephalitis and cerebral infarctions and thrombosis
3. Pulmonary: neutropenic patients-vascular invasion and septic infarction
Diagnosis of Zygomycosis
non septate hyphae in tissue
Cocciodes immitis- Coccidiomycosis
dimorphic fungus that is large, thick walled spherule with non budding (reproduces by endospores called arthroconidia). ....valley fever (dry windy weather brings inhalation of spores.)
Morphology of coccidiomycoses:
foci of consildation and granulomas resembling tubercles...."resemblance of tubercleS"....dissemination in immunocompromised people. Diagnosis: demonstration of organism in the sputum or serologic tests: latex agglutination, complement fixing antibodies in CSG
blastomyces dermatidits
North American blasto....round or oval yeast with thick/double contoured wall.....mold in warm moist soil with decaying veg. matter.
paracocciddiodes brasiliensis
dimorphic EXTERNAL BUDS from soul....pulmonary chronic granulomatous infection, disseminate on skin, musosal, LN
Pneumocystitis jirovecii pneumonia
used to be protozoa, now its a yeast....transmission via inhalation. healthy people: asymptomatic. NEONATES/ malnurished kids, immunosuppresed: pneumonia.
Pathology for P. jirovecii:
alveoli filled with cell debris, parasites and inflammatory exudate.
Diagnosis: silver stain of trans-tracheal aspiration
Clinical forms of Zygomycosis
1. subQ
2. rhino cerebral: sinuss to brain causing meningoencephalitis and cerebral infarctions and thrombosis
3. Pulmonary: neutropenic patients-vascular invasion and septic infarction
Diagnosis of Zygomycosis
non septate hyphae in tissue
Clinical forms of Zygomycosis
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