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Terms in this set (24)
What are cryptococci known for?
Being heavily encapsulated (thick mummy sarcophagus)
What is the capsule of cryptococci made of?
Repeating polysaccharide capsular antigens (painted on surface of sarcophagus)
Why is the repeating polysaccharide capsule important?
Because it is the main virulence factor making it anti-phagocytic and it is the basis for one of the diagnostic tests
Where is cryptococci found?
Normal in soil and often in pigeon droppings (pigeon and droppings)
How is cryptococci transmitted?
It is inhaled and settles in lung as a primary focus and from there it will disseminate elsewhere (archaeologist opened sarcophagus and is now coughing)
What is unique about cryptococci?
It is urease positive (Holding NH3 spray bottle)
What population do you typically see symptoms in for cryptococci infections?
Immunocompromised patients especially those with HIV, have malignancies, and on high dose steroid therapy -- cryptococci is an opportunistic infection (mummy is holding favorite cane)
What three general symptoms does cryptococci infection cause?
Fever (man sweating), pneumonia, and meningitis
What kind of lung symptoms are seen with cryptococci infections?
Cough, dyspnea, and other serious lung infections (man coughing) -- unlikely that the infection will be caught at this stage and it is likely to progress to more serious symptoms
What are some serious symptoms of cryptococci infection?
It can spread to the CSF and cause meningitis (neck brace on archaeologist)
What is the #1 cause of fungal meningitis?
Why is cryptococci infection bad?
At best, patients have a very long treatment course, can have permanent neuro deficits, and it can be lethal
What can be used to diagnose cryptococcal infection?
Bronchopulmonary washings (cleaning soap bubbles on mummy's chest)
What can tissue samples be stained with?
With mucicarmine (red) or methanamine silver stains to visualize cryptococci (other sarcophagus is painted red and silver)
How do you diagnose cryptococcal meningitis?
Have to do a lumbar puncture, look at CSF
What do you stain the CSF with after doing a lumbar puncture?
Stain with india ink (pot of tar with old mummy bones)
What will be seen under the microscope?
5-10 micrometers of yeast with wide capsular halos (pot of tar with halos) -- heavy capsule results in the halos
What is a better test than the india ink stain?
Latex agglutination test (man with latex gloves)
What does the latex agglutination test do?
Detects the repeating polysaccharide capsular antigen and causes agglutination
True or false: After invading the CSF, cryptococci produces gross pathology of the brain that can be seen on imaging.
What is the brain pathology referred to with respect to the gross brain pathology that is caused by cryptococcal meningitis?
Soap bubble lesions in the gray matter of the brain (soap on mummy's head)
What is different about the treatment for cryptococci compared to other fungal infections?
It is laborious and not like the typical fungal treatments. Poor prognosis many times.
What is the treatment for cryptococcal meningitis?
Amphotericin B along with flucytosine and then that is followed by a maintenance therapy of fluconazole (All are depicted on background wall as frogs, egyptian playing flute, and pine cone)