31: Fungal infections of the respiratory tract

Question 1

organisms and disease in sinuses

Answer 1

zygomycetes cause mucormycosis

Question 2

organism and disease in oral cavity

Answer 2

candida causes thrush and eposhpagitis

Question 3

histoplasma cuases

Answer 3

histoplasmosis

Question 4

blastomyces cause

Answer 4

blastomycosis

Question 5

paracoccidiodies cause

Answer 5

paracoccidioidomycosis

Question 6

coccidiodies cause

Answer 6

coccididioidomycosis

Question 7

cryptococcus causes

Answer 7

cryptococcosis

Question 8

pneumoctstis causes

Answer 8

PCP

-in immunosuppressed

Question 9

aspergilus causes

Answer 9

aspergillosis

- in immunosuppressed

Question 10

what are the three zygomycetes

Answer 10

rhizopus
absidia
mucor

Question 11

describe the zygomycetes group

Answer 11

non-septate hyphae

sporangia bearing sporangiospores

Question 12

rhinocerebral zygomycosis

Answer 12

• most common form of zygomycosis
• primarily in diabetic patients
• starts in sinuses and moves

Question 13

nasal congestion, blood tinged rhinorrhea, tender sinuses, headache and fever
-edema and visual disturbance

Answer 13

rhinocerebral zygomycosis

Question 14

zygomatic infection of the skin

Answer 14

traumatic inoculation

Question 15

zygomatic infection of the GI

Answer 15

neonates and premature infants

Question 16

broad aseptate hyphae observed in blood vessels branching at right angles

Answer 16

zygomycoses (mucormycosis)

Question 17

treatment for mucormycosis caused by zygomycoses

Answer 17

amphotericin B

Question 18

candida form as normal flora

Answer 18

yeast

Question 19

candida form within tissues

Answer 19

hyphal form

Question 20

• diffuse erythema and white patches on the surface of the buccal mucosa, throat, tongue and gums
• plaques scraped away revealing raw lesion

Answer 20

oral cadidiasis (thrush)

Question 21

what are some cuases of oral candidiasis in adults

Answer 21

steroids
antineoplastic drugs
antibiotics

Question 22

what are the white lesions of thrush composed of?

Answer 22

yeast and pseudohyphal forms of c. albicans

Question 23

treatment for thrush

Answer 23

mouth washes or lozenges of nystatin and azole compounds

Question 24

4 dimorphic systemic mycoses

Answer 24

• histoplasma capsulatum
• blastomyces dermatitidis
• paracoccidioides brasiliensis
• coccidioides immitis

Question 25

dimorphic fungi

Answer 25

molds in environment, yeast in tissues during infection

Question 26

non-dimorphic systemic mycoses

Answer 26

cryptoccus neoformans | - encapsulated yeast in environment and man

Question 27

where is histoplasmosis most prevalent

Answer 27

missippi and ohio river valleys

Question 28

darling's disease, cave dwellers disease or spelunkers disease

Answer 28

hisoplasmosis

Question 29

histoplasmosis is cuased by

Answer 29

histoplasma capsulatum

Question 30

clinical syndrome of histoplasmosis

Answer 30

inhaled spores are phagocytosed by pulmonary macrophages and converted to yeast form, replicate and spread

Question 31

- mild flu like illness with dry cough, fever and fatigue | - calcification of pulmonary lesions

Answer 31

pulmonary histoplasmosis

Question 32

- fever, night sweats, anorexia, weight loss, and fatigue in addition to repiratory sympotoms - hepato and splenomegaly and lymphadenopathy

Answer 32

chronic pulmonary and disseminated histoplasmosis

Question 33

histoplasmosis treatment

Answer 33

amphotericin B - AIDS and immunosuppressed require lifelong suppressive therapy with azoles

Question 34

endemic in ohio and missippi river valley and missouri and arkansas river basins

Answer 34

blastomycosis

Question 35

gilchrist's disease, chicago's disease

Answer 35

blastomycosis

Question 36

causative agent of blastomycosis

Answer 36

blastomyces dermatitidis

Question 37

how do you distinuish the yeast of b. dermatidis from the yeast of h. capulatum

Answer 37

dermatidis: larger size and very thick cell walls

Question 38

disseminated blatomycosis

Answer 38

skin lesion and bone necrosis, prostate infections

Question 39

treatment for blastomycosis

Answer 39

amphotericin B | -azole for umcomplicated pulmonary disease

Question 40

limited to tropical regions of south and central america

Answer 40

paracoccidiomycosis

Question 41

90% of clinical disease occurs in men

Answer 41

paracoccidioidomycosis

Question 42

causative agent of pparacoccidioidomycosis

Answer 42

paracoccidioides brasiliensis

Question 43

"ships wheel" | "mickey mouse ears"

Answer 43

paracoccidioidomycosis

Question 44

san joaquin valley of cali and in southern arizon

Answer 44

coccidioidomycosis

Question 45

following inhalation the fungus converts into a spherule

Answer 45

coccidiodidomycosis | - multinucleated structure produces hundreds of spores

Question 46

"desert rheumatism" | - fever, nodules, arthralgia

Answer 46

disseminated disease of coccidioidomycosis

Question 47

develops slowly with increasing headache, fever, stiff neck, and other neurological signs -fatal if untreated

Answer 47

coccidial or cryptococcosis meningitis

Question 48

coccidiodiomycosis treatment

Answer 48

azole and amphotericin B for meningitis and disseminated disease

Question 49

leading form of fungal meningitis

Answer 49

cryptococcal meningitis

Question 50

commonly found in soil with bird droppings

Answer 50

- cryptococus neoformas | - histoplasma capsulatum

Question 51

cryptococcosis diagnosis

Answer 51

india ink stain!

Question 52

treatment of cryptococosis meningitis

Answer 52

6-10 wks amphotericin b and 5-fluorcytosine or fluconazole

Question 53

pneumocystis jiroveci carinii pneumonia PCP

Answer 53

highly lethal form of pneumoia occuring primarily in the immuno-compromised

Question 54

etiology of PCP

Answer 54

pneumocystis carinii/jiroveci

Question 55

describe pneumocystis carinii/jiroveci

Answer 55

- single celled eukaryotic organism similar to fungi

Question 56

dyspnea, nonproductive cough, and fever - interstitial pneumoonitis with cellular infiltrate - weakness, tachypnea and cyanosis

Answer 56

PCP

Question 57

PCP organisms

Answer 57

trophozoite sporozoites cysts

Question 58

PCP treatment

Answer 58

trimethoprim-sulfamethoxazole | interferes with folate synthesis pathway of organism

Question 59

most common types of aspergillosis associated with disease

Answer 59

a. fumigatus and a. flavus mold in both environment and man

Question 60

"fungus balls"

Answer 60

colonization of pre-exiting lung lesions by aspergillomas -typically unilateral

Question 61

space occupying lesions that move as the patient changes position, hemoptysis

Answer 61

aspergillomnas

Question 62

septate hyphae with v-shaped branches at a 45 degree angle

Answer 62

aspergillosis

Question 63

aspergillosis treatment

Answer 63

- azole - echinocandin - amphotericin B - surgical removal of aspergillomas