(1) Systemic Mycoses

Question 1

Refers to fungal infection that involves any internal organ of the body – can involve bone, lymph node, subcutaneous tissues, skin, meninges, etc.

• two or more organ systems involved, it is referred to as systemic (mycoses)

Answer 1

Systemic Mycoses

Question 2

Enumerate the Systemic mycoses

Answer 2

1. Blastomyces dermatitidis
2. Paracoccidioides brasiliensis
3. Histoplasma capsulatum
4. Coccidioides immitis

Question 3

match the systemic mycoses and its infection

1. Blastomyces dermatitidis
2. Paracoccidioides brasiliensis
3. Histoplasma capsulatum
4. Coccidioides immitis

a. Paracocidioidosis
b. Coccidioidosis
c. Histoplasmosis
d. Blastomycosis

Answer 3

1. d
2. a
3. c
4. b

Question 4

Enumerate the characteristic of Systemic Mycoses

Answer 4

• Dimorphic
• Infectious = Inhalation of spore (mold form)
• Requires BSL 3 (BSC 2)
• Sputum (most common specimen)
• NO p-2-p contact
• Cottony white to brown colonies
• Exonatigen Test

Question 5

General Characterisitc

They can exist both in the mold form (in their natural habitat) and in the yeast form (in the tissues)

Answer 5

Dimorphic

Question 6

General Characterisitc

Infective stage or form of sysyemic mycoses

q

Answer 6

SPORE

through inhalation

Question 7

General Characterisitc

What are the protection measure applied for labs to contain the microbes

Answer 7

BLS 3 with BSC 2

Question 8

General Characterisitc

Most common specimen

Answer 8

Sputum

Question 9

General Characterisitc

TOF

It DOES involve a person to person contact spread

Answer 9

F

Question 10

General Characterisitc

Match the colony description

1. Mycelial or Mold Form
2. Yeast Form

a. Moist and creamy opaque to pasty colonie on the media
b. Cottony white to brown colonies

Answer 10

1. b
2. a

Question 11

General Characterisitc

• Diagnosis is usually made through this
• antigen protein immunodiffusion method

Answer 11

EXOANTIGEN TEST

Question 12

Causes
- North american blastomycosis
- Chicago disease
- Gilchrists disease
- PNEUMONIA and SKIN INFECTION

Answer 12

Blastomyces dermatitidis

Question 13

Blastomyces dermatitidis

How pneumonia and skin infection are acquired

Answer 13

Pneumonia - inhalation of mold

Skin infection - Direct inoculation of the skin

Question 14

Describe the tissue form of Blastomyces dermatitidis

Answer 14

SINGLE-BUDDING YEAST with BROAD based connection (double
contoured)

Question 15

Describe the mold form of Blastomyces dermatitidis

Answer 15

Lollipop in appearance

Question 16

Blastomyces dermatitidis should be culture in a medium with?

Answer 16

cycloheximide - an antifungal, to make the medium selective

Question 17

Blastomyces dermatitidis uses what % of KOH for the tissue

Answer 17

10% KOH

Question 18

Blastomyces dermatitidis uses and antifungal agent and is use as treatment

Answer 18

Amphotericin B

Question 19

• Causes South American Blastomycosis
• Causes Lutz Splendore – Almeida Disease
• Organs attacked: Spleen, liver, lymph node, skin, lung

Answer 19

Paracoccidioides brasiliensis

Question 20

Enumerate the route of spread of P. brasiliensis?

Answer 20

NONE

Question 21

Describe the tissue form of Paracoccidioides brasiliensis

Answer 21

MULTIPLE BUDDING YEAST

“pinched-off” appearance or Mariners Wheel

Question 22

Describe the mold form of Paracoccidioides brasiliensis

Answer 22

Lollipop in appearance (conidia)

Similar to B. dermatitidis

The conidia are usually found at the TIP of conidiophore

Question 23

Paracoccidioides brasiliensis uses what % of KOH?

Answer 23

10% KOH: Yeast cell with multiple buds

Question 23

Paracoccidioides brasiliensis uses what medication for treatment

Answer 23

• Itraconazole
• Ketoconazole

Question 23

- Infection cause HISTOPLASMOSIS - RES (RETICULOENDOTHELIAL SYSTEM) parasite

Answer 23

Histoplasma capsulatum

Question 24

Histoplasma capsulatum is a RES parasite, what does this mean?

Answer 24

infects the RETICULOENDOTHELIAL SYSTEM and it refers to the **MACROPHAGES**

Question 25

Histoplasma capsulatum can cause what disease

Answer 25

DARLING’S disease

Question 26

Histoplasma capsulatum can be demonstrated in the blood by??

Answer 26

Blood smear stained with **Giemsa**

Question 27

Describe the tisuse form of Histoplasma capsulatum

Answer 27

YEAST CELLS INTRACELLULAR IN MACROPHAGES | SINGLE BUDDING yeast with a THIN BASE

Question 28

Describe the mold form of Histoplasma capsulatum

Answer 28

TUBERCULATE MACROCONIDIA (rough external surface, rope like hyphae if they are together) | looks acanthocyte sa hema

Question 29

it is the ENDEMIC DIMORPHIC fungus in the USA?

Answer 29

Histoplasma capsulatum

Question 30

TOF Histoplasma capsulatum is an extracellular mycoses of the RES

Answer 30

F Intracellular

Question 31

Histoplasma capsulatum uses what specimen

Answer 31

BONE MARROW, sputum, tissue - Stain with **Giemsa**: bone marrow, sputum - Stain with **PAS** and **H&E**: tissue

Question 32

Histoplasma capsulatum use this test to know if it is and ACTIVE or EARLY infection

Answer 32

DOUBLE DIFFUSION TEST

Question 33

# DOUBLE DIFFUSION TEST how many wells for the serum with antibody and antigen

Answer 33

- 2 well for serum w/ antibody - 1 well contain antigen

Question 34

# DOUBLE DIFFUSION TEST the wells will diffuse together and will form what?

Answer 34

PRECIPITATION LINE

Question 35

# DOUBLE DIFFUSION TEST H or M line - **Closer** to the serum wells - Seen during **ACTIVE** INFECTION - Disappears with the RESOLUTION of the disease but may persist up to 2 YEARS AFTER RECOVERY

Answer 35

H line

Question 36

# DOUBLE DIFFUSION TEST H or M line - Near the **Ag**-containing well - Present during **EARLY** INFECTION (More Ag than Ab) - Present in among those who have **RECOVERED** from the disease - Signifies presence of **EARLY INFECTION or CONVALESCENCE/RECOVERY**

Answer 36

M line

Question 37

Causes: - COCCIDIOIDOMYCOSIS - San Joaquin Valley Fever -

Answer 37

Coccidioides immitis

Question 38

Describe the tissue Coccidioides immitis

Answer 38

Spherule with endospores

Question 39

Describe the mold Coccidioides immitis

Answer 39

- **Barrel-Shaped** Arhtroconidia (INFECTIOUS FORM) - sac-like | Alternating barrel-shaped arthroconidia because they have a **space**

Question 40

Enumerate the Diagnosis for systemic mycoses

Answer 40

1. Direct Exam 2. Cultures 3. Immunological test

Question 41

Stains used for HISTOPLASMA | to demonstrate yeast form

Answer 41

WRIGHT OR GIEMSA *Demonstrated using blood smear*

Question 42

what stains and reagents are used for Blastomyces, Paracoccidioides, Coccidioides

Answer 42

- 10 % KOH - Periodic Acid-Schiff stain - H&E (Hematoxylin and eosin) for tissue section

Question 43

Cultures used for Diagnostic systemic mycoses

Answer 43

- Sabouraud Dextrose Agar (RT) - Blood Heart Infusion Agar + BLOOD (37°C)

Question 44

what Immunological Tests are used and which specific infection

Answer 44

**SKIN TEST** – coccidioidin, histoplasmin

Question 45

Match the Tissue form to genus and SPP 1. SINGLE-BUDDING YEAST with BROAD based connection (double contoured) 2. MULTIPLE BUDDING YEAST 3. YEAST CELLS INTRACELLULAR IN MACROPHAGES 4. SPHERULE WITH ENDOSPORES a. Paracoccidioides brasiliensis b. Coccidioides immitis c. Histoplasma capsulatum d. Blastomyces dermatitidis

Answer 45

1. d 2. a 3. c 4. b

Question 46

Match the MOLD form to genus and SPP 1. Lollipop in appearance 2. TUBERCULATE MACROCONIDIA 3. BARREL-SHAPED ARTHROCONIDIA a. Paracoccidioides brasiliensis b. Coccidioides immitis c. Histoplasma capsulatum d. Blastomyces dermatitidis

Answer 46

1. a & d 2. c 3. b