Systemic Mycoses Flashcards
Which Sketchy image represents Histoplasma capsulatum?
Which Sketchy image represents Blastomyces dermatitidis?
Which Sketchy image represents Coccidioides immitis?
Which Sketchy image represents Paracoccidioides brasiliensis?
Identify as many of the marked points in this image as you can.
Note: this image represents Histoplasma capsulatum.
Identify as many of the marked points in this image as you can.
Note: this image represents Blastomyces dermatitidis.
Identify as many of the marked points in this image as you can.
Note: this image represents Coccidioides immitis.
Identify as many of the marked points in this image as you can.
Note: this image represents Paracoccidioides brasiliensis.
True/False.
Histoplasma capsulatum is a dimorphic fungus.
True.
Histoplasma capsulatum is a dimorphic fungus.
Histoplasma capsulatum is associated with droppings from what animals (so in what locations?)?
Bat droppings (caves) and bird droppings (chicken coops)
In what geographic areas are infections with Histoplasma capsulatum endemic?
The midwestern and east central United States near the Ohio and Mississippi River valleys
How is infection with Histoplasma capsulatum transmitted?
Inhalation of spores
How does infection with Histoplasma capsulatum manifest on microscopy?
Small oval yeast forms seen within macrophages
Histoplasma capsulatum antigen can be detected in what body fluids?
Serum and urine
What mnemonic can help you to remember when Histoplasma capsulatum is a mold and when it is a yeast?
‘Mold in the cold; yeast in the heat.’
What type of desposits are commonly seen in pulmonary infection with Histoplasma capsulatum?
Calcific deposits
(i.e. calcified lung tissue and mediastinal/hilar lymph nodes)
The signs and symptoms of chronic histoplasmosis (cough, fatigue, weight loss, cavitations in the upper lobes of the lungs) clinically resemble what?
Reactivation TB
What cutaneous lesions are associated with infection with Histoplasma capsulatum?
Erythema nodosum
(most commonly of the shins)
Disseminated histoplasmosis is most commonly seen in what demographic?
This presentation is associated with what clinical finding?
Immunocompromised patients;
hepatosplenomegaly
How should mild cases of histoplasmosis be treated?
And severe and/or disseminated cases?
Azoles (e.g. itraconazole);
amphotericin B
True/False.
Blastomyces dermatitidis is not a dimorphic fungus.
False.
Blastomyces dermatitidis is a dimorphic fungus.
Blastomyces dermatitidis is endemic to what geographic regions?
The eastern and central United States near the Ohio and Mississippi River valleys and the Great Lakes region
When is Blastomyces dermatitidis a mold?
When is it a yeast?
In the cold (25 - 30°C);
at body temperature (35 - 37°C)
How is Blastomyces dermatitidis transmitted?
Inhalation of mold spores
The yeast form of Blastomyces dermatitidis produces a single _____-_____ bud with a double refractile cell wall of approximately what size?
The yeast form of Blastomyces dermatitidis produces a single broad-based bud with a double refractile cell wall of approximately the same size as RBCs.
Chest X-ray findings of blastomycosis are highly variable, but most commonly include what?
Patchy opacities or densities
_______mycosis can lead to pulmonary granuloma formation.
Blastomycosis can lead to pulmonary granuloma formation.
What organ systems are often affected by disseminated blastomycoses?
Skin, bone, and genitourinary involvement
How do blastomycoses often affect the skin in immunocompromised patients?
Papules, pustules, ulcers, and verrucous lesions
How do blastomycoses often affect bones in immunocompromised patients?
Bone pain caused by lytic lesions
Blastomyces dermatitidis antigen can be detected where?
Body fluids
What medication is used to treat mild-to-moderate cases of blastomycoses?
And severe cases?
Azoles (itraconazole, fluconazole);
amphotericin B
Coccidioides immitis is a dimorphic fungus that causes ________________ fever.
Coccidioides immitis is a dimorphic fungus that causes San Joaquin Valley fever.
Coccidioides immitis is endemic to what geographic region(s)?
The southwestern United States and northern Mexico
How is Coccidioides immitis transmitted?
Inhalation of mold spores
Mold spores of Coccidioides immitis are found in _____ and can become airborne when the ______ is disturbed.
Mold spores of Coccidioides immitis are found in soil and can become airborne when the ground is disturbed (i.e. earthquakes, dust storms, farming).
Coccidioides immitis is a dimorphic fungus (grows as mold at __-__°C and forms yeast-like spherules at __-__°C.
Coccidioides immitis is a dimorphic fungus (grows as mold at 25-30°C and forms yeast-like spherules at 35-37°C (body temperature).
How does Coccidioides immitis in infected tissue appear on mcroscopy?
How large are they?
Large, yeast-like spherules containing endospores;
larger than RBCs
Describe the common manifestations of coccidioidomycosis.
Pneumoniaandarthralgia
Chest radiography in primary coccidioidomycosis may show ___lateral infiltrates, ___lateral hilar adenopathy, or pulmonary _______ formation, though it is unremarkable in up to half of patients.
Chest radiography in primary coccidioidomycosis may show unilateral infiltrates, ipsilateral hilar adenopathy, or pulmonary nodule formation, though it is unremarkable in up to half of patients.
In addition to pneumonia and arthralgias, what cutaneous manifestations are sometimes seen in coccidioidomycoses?
Erythema nodosum
(often of the shins)
Extrapulmonary coccidioidomycosis occurs in _____________ patients and commonly involves _____, _____, _____, and the _____.
Extrapulmonary coccidioidomycosis occurs in immunocompromised patients and commonly involves skin, bones, joints, and the CNS.
True/False.
Coccidioidomycoses causes meningitis in immunocompetent patients.
False.
Coccidioidomycoses causes meningitis in immunocompromised patients.
How are mild-to-moderate cases of coccidioidomycosis treated?
And severe cases?
Azoles (itraconazole, fluconazole);
amphotericin B
Paracoccidioides brasiliensis is a dimorphic fungus that is a _____ in the cold and a _____ in the heat.
Paracoccidioides brasiliensis is a dimorphic fungus that is a mold in the cold and a yeast in the heat.
Paracoccidioides brasiliensis is endemic to what geographic regions?
Central and South America
The ________ budding yeast form of Paracoccidioides brasiliensis is said to resemble a __________.
The multipolar budding yeast form of Paracoccidioides brasiliensis is said to resemble a captain’s wheel.
The multipolar budding yeast form of Paracoccidioides brasiliensis is typically what size in relation to RBCs?
Larger than RBCs
How is Paracoccidioides brasiliensis transmitted?
Inhalation of mold spores
Paracoccidioidomycosis can lead to formation of pulmonary __________.
Paracoccidioidomycosis can lead to formation of pulmonary granulomas.
Disseminated paracoccidioidomycosis can commonly cause _______ lymphadenopathy.
Chronic paracoccidioidomycosis often presents with ______ ragged ______ and spots of hemorrhage.
Disseminated paracoccidioidomycosis can commonly cause cervical lymphadenopathy.
Chronic paracoccidioidomycosis often presents with oral ragged ulcers and spots of hemorrhage.
How is mild-to-moderate paracoccidioidomycosis treated?
And severe cases?
Azoles (itraconazole);
amphotericin B
