Terms in this set (79)
Systemic mycosis is seen mostly in what type of patients?
Fungal infection of internal organs
What is primarily involved in systemic mycosis?
What is the primary mechanism of systemic mycosis?
Inhalation of air-borne conidia
95% of systemic mycosis is?
5% of systemic mycosis is?
-Disseminate by hematogenous route
99% of systemic mycosis is due to what type of fungi?
Systemic mycosis is common in what area?
What are the known systemic mycotic infections?
Intracellular infection of the Reticuloendothelial system caused by the inhalation of conidia from the fungus.
Histoplasmosis is caused by?
Histoplasmosis is also known as?
Histoplasma capsulatum is present where in the environment?
-Feces of chicken, bats, & birds
What is the pathogenesis of Histoplasmosis?
-Inhalation of conidia or mycelial fragments and affect lower lobe of lung (usually right)
-Converts into yeast in alveolar macrophages (damages alveoli and cavitization)
-Localized granulomatous inflammation
-Granuloma with or without ceseation & assist in dissemination to RES
-Can enter blood stream and spread throughout body
In Histoplasmosis what can be seen in all phagocytic cells of RES?
Cytoplasm studded with fungal cells
Histoplasmosis usually affects what part of the body?
The right side of the body
Histoplasmosis is seen where?
Mississippi/ Ohio river area
Histoplasmosis is seen in patients with a CD4 count of_____?
Less than 100 cells/mL
Disseminated histoplasmosis is commonly seen in...?
-Children below 2 yrs and adolescents
An x-ray of the lungs of a patient with histoplasmosis presents?
What type of staining is used for patients with histoplasmosis?
-Methamine Silver Stain
What can be seen in the staining of histoplasmosis?
Small oval shaped yeast form with narrow-neck budding
Patients with histoplasmosis presents with?
-Signs of Influenza
-Calcified lesions in the lungs
Histoplasmosis can be cultured on?
What test are used to diagnose histoplasmosis?
-Skin histoplasmin test (inject histoplasmin, rash=positive)
-Lactophenol cotton blue test (LPCB)
Lactophenol cotton blue test on histoplasmosis presents?
-White cottony mycelia with large, thick walled, spherical spores with tubercles of finger-like projections (Tuberculate Macroconidia)
Treatment & Prevention for Histoplasmosis?
-Amphotericin B (AMB)
-Regular cleaning of farm buildings, chicken houses
Hisotoplasmosis is similar to what other infectious organism?
-both resemble TB
-both caused by fungi that grow as spores producing hyphae in environment, but are yeast in body
Blastomycosis is also known as?
Blastomycosis is caused by?
Inhalation of the spores of Blastomyces dermatitidis
A chronic granulomatous and suppurative disease having a primary pulmonary stage that is frequently followed by dissemination to other body sites (mainly skin & bone)
Blastomycosis is commonly seen in what type of people?
Males around the age of 30-50
Blastomycosis dermatitidis is what type of fungi?
dimorphic & asexual
What is the shape of the conidia of blastomycosis dermatitidis?
Primary infection of Blastomycosis resembles?
TB or histoplasmosis
Blastomycosis commonly affects what part of the body?
-Face, neck & hands
Disseminated form of blastomycosis causes..?
Multiple abscesses in different parts like bone, genitourinary system, breasts, etc...
What type of mount can be is used to diagnose blastomycosis?
For Blastomycosis, what can be seen on the Cauliflower White mount
Double contoured, thick walled, multinucleate giant yeast cells with broad base budding daughter cells
What type of testing can be used to diagnose Blastomycosis?
How does the hyphae of blastomycosis look like?
Fine, branched spetate hyphae with conidia located on short terminal or lateral branches
Treatment for Blastomycosis?
-Oral ketoconazole & Intraconazole (initial phase)
-AMB (life threatening infection)
-Diamorphic fungal Infection of the respiratory system caused by coccidioides immitis
-The most virulent of all fungal pathogens but NOT contagious
Which fungi pathogen is the most virulent?
Where does Coccidioides Immitis be found in the environment?
Coccidioidomycosis occurs by...?
-Inalation of arthroconidia
-Reaction of latent infection (in immunocompromised patients)
Coccidioidomycosis is mostly seen where?
-Mainly in California and Arizon
-Western side of US
Secondary infection of coccidioidomycosis causes..?
-Reactivation in lungs
-Dissemination and spreading (Brain,bones, skin, joints, etc)
CD4 count in a patient with coccidioidomycosis is?
Less than 100 cells/mm
What people are commonly affected by coccidioidomycosis?
What are 3 forms of coccidiomycosis?
Acute self-limiting coccidioidomycosis
-Similar to that of histoplasmosis except that erythema nodosum or multiform is more likely to be present
Red rash of skin
Does not self-resolve
Similar to that of histoplasmosis with spreading of infection to the meninges and mucous membranes occuring in many AIDs patients in the endemic region.
Who are more susceptible to disseminated coccidioidomycosis?
-Pregnant women in the 3rd trimester
Patients with coccidiomycosis presents with?
-Vessicle-like lesions of the face (complete distortion of face)
-Enlarged hilar lymph nodes
-Wedge-shaped lesions in left lung
-Cyst-like destructive lesions of the bone (in progressive cases) (osteomyelitis)
-Fever (Valley Fever/ Desert Rheumatism)
-Meningitis (disseminated disease)
Will coccidioides immitis be seen in erythyema nodosum (skin lesions)?
No (not a sign of disseminated disease)
What type of HSR does Coccidioides Immitis cause?
How does coccidioides Immitis present under a microscope?
Doubly refractile thick walled globular spherules filled with endospores
What type of staining can be used to diagnose Coccidioides?
What type of culture can be used to grow coccidioides Immitis?
On LPCB culture, Coccidioides hyphae appears..?
Branching septate hypha & chains of thick walled rectangular arthroconidia
What type of test can be done to diagnose Coccidioidomycosis?
-ID skin test (>5mm in 24-48hrs= positive test)
-Serology testing for Abs
Treatment for Coccidioidomycosis?
-AMB (rapidly progressive disease)
What is the side effect of Amphoterisin B?
-Magnesium & Potassium waisting
Acute or chronci granulomatous infection primarily of lungs & can disseminate to skin, mucosa, lymphnodes & other internal organs
Paracoccidioidomycosis is caused by?
Where is paracoccidioidomycosis seen?
South America & Central America
The yeast form of paracoccidiomycosis looks like?
Oval/globose cells 2-30 microns in diameter with small buds attached by a narrow neck encircling the parent cells
What type of manifestations of paracoccidioidomycosis can be seen?
-Ulceration, granulomatous infection of oral nasal mucosa
-involvement of the lymphatic system, spleen, intestines, liver
What type of mount can be used to diagnose paracoccidioidomycosis?
What can be seen in Cauliflower White examination of paracoccidioidomycosis
Round refractile yeast cells, single or in chains
What type of staining can be used to diagnose paracoccidioidomycoses?
A LPCB mount of Paracoccidioidomycosis shows?
Spherical mother cell surrounded by multiple thin-necked daughter cells (Mariner's Wheel)
Marner's Wheel is seen in what fungi infection?
Treatment for Paracoccidiomycosis?
-AMB with sulfonamides
Name all the dimorphic fungi