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MYCOVIRO > 7.1-SYSTEMIC MYCOSIS + COCCIDIOIDOMYCOSIS > Flashcards

7.1-SYSTEMIC MYCOSIS + COCCIDIOIDOMYCOSIS Flashcards

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1
Q

What are the four primary systemic mycoses?

A

Histoplasmosis, Blastomycosis, Coccidioidomycosis, Paracoccidioidomycosis

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2
Q

What is the mode of transmission (MOT) for systemic mycoses?

A

Inhalation of conidia

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3
Q

What fungal structure is associated with virulence in systemic mycoses?

A

α-glucan in the cell wall

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4
Q

Are systemic mycoses transmissible from person to person?

A

No

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5
Q

What is the defining characteristic of the fungi that cause systemic mycoses?

A

Thermally dimorphic

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6
Q

Which systemic mycosis-causing fungi have clearly defined habitats?

A

Coccidioides (dry soil), Histoplasma (soil mixed with guano)

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7
Q

Which systemic mycosis-causing fungi have poorly defined habitats?

A

Blastomyces, Paracoccidioides

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8
Q

What are the typical outcomes of systemic mycoses in immunocompetent individuals?

A

Asymptomatic or self-limiting infection

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9
Q

What are the two causative agents of Coccidioidomycosis?

A

Coccidioides immitis & Coccidioides posadasii

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10
Q

What are the alternative names for Coccidioidomycosis?

A

San Joaquin Valley Fever / Desert Rheumatism

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11
Q

Where is Coccidioides immitis primarily found?

A

California

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12
Q

Where is Coccidioides posadasii primarily found?

A

Arizona, Texas, South America

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13
Q

What is the tissue form of Coccidioides?

A

Spherules with endospores (not true yeast)

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14
Q

What does the mycelial phase of Coccidioides look like?

A

Moist, gray membrane → white cottony aerial mycelium → tan to brown with age

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15
Q

How fast does Coccidioides grow?

A

5-14 days (arthroconidia in 1-2 weeks)

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16
Q

What is the structure of Coccidioides mycelial phase?

A

Coarse, septate, branched hyphae with thick-walled barrel-shaped arthroconidia

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17
Q

What alternates between arthroconidia in Coccidioides?

A

Empty disjunctor cells

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18
Q

What is the structure of Coccidioides yeast phase?

A

Large, round, thick-walled spherules with endospores

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19
Q

What are the two clinically useful antigens of Coccidioides?

A

Coccidioidin & Spherulin

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20
Q

What is Coccidioidin derived from?

A

Liquid mycelial culture filtrate

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21
Q

What is Spherulin derived from?

A

Broth culture of spherules

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22
Q

What is the most common initial manifestation of Coccidioidomycosis?

A

Self-limited influenza-like illness

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23
Q

What are the hypersensitivity reactions associated with Coccidioidomycosis?

A

Rash, erythema nodosum, erythema multiforme

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24
Q

What are risk factors for systemic Coccidioidomycosis?

A

Heredity, sex (males > females), age, immunosuppression

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25
Which hormones stimulate the growth of Coccidioides?
Estradiol & progesterone
26
How is Coccidioidomycosis diagnosed histologically?
Granulomas with giant cells & interspersed suppuration
27
What samples are used to diagnose Coccidioidomycosis?
Sputum, exudates, CSF, blood, urine, tissue biopsy
28
What is the preferred stain for detecting spherules & endospores?
KOH or calcofluor white stain
29
What media are used to culture Coccidioides?
Inhibitory mold agar, Sabouraud’s agar, blood agar
30
Why must cultures be handled in a biosafety cabinet?
Highly infectious arthroconidia
31
What are confirmatory tests for Coccidioides immitis?
Antigen detection, animal inoculation, DNA probe
32
What test detects IgM antibodies for Coccidioides?
Latex agglutination test
33
What tests detect IgG antibodies for Coccidioides?
Immunodiffusion (ID) & Complement Fixation (CF)
34
What CF antibody titer suggests dissemination?
≥1:32
35
Why are serologic tests often negative in AIDS patients with Coccidioidomycosis?
Impaired antibody production
36
What is a positive Coccidioidin skin test?
≥5 mm induration in 24-48 hours
37
What is the more sensitive alternative to Coccidioidin?
Spherulin
38
What is the general treatment for self-limited Coccidioidomycosis?
Supportive care
39
What is the first-line treatment for severe Coccidioidomycosis?
IV amphotericin B → oral itraconazole
40
What is the treatment for Coccidioidal meningitis?
Oral fluconazole
41
When is surgical resection necessary?
For pulmonary cavities
42
Is Coccidioidomycosis communicable from person to person?
No
43
Do infected rodents contribute to Coccidioides spread?
No evidence
44
What are control measures to reduce environmental exposure?
Paving roads, planting grass, using oil sprays, reducing dust
45
What is the mode of transmission (MOT) for systemic mycoses?
Inhalation of conidia
46
What type of fungi cause systemic mycoses?
Thermally dimorphic fungi
47
What cell wall component is associated with virulence in systemic mycoses?
α-glucan
48
Why is Coccidioides sometimes considered not dimorphic?
Unlike Histoplasma, Blastomyces, and Paracoccidioides, which form yeast in tissue, Coccidioides forms spherules instead of yeast.
49
What are the etiologic agents of coccidioidomycosis?
Coccidioides posadasii Coccidioides immitis
50
Where is Coccidioides posadasii primarily found?
Arizona, Texas, and South America.
51
What is the colonial appearance of Coccidioides?
Moist, gray membranous colony that develops white, cottony aerial mycelium; turns tan to brown with age.
52
How fast does Coccidioides grow?
Growth rate: 5-14 days. Arthroconidia may need 1-2 weeks to form.
53
How is coccidioidomycosis acquired?
Inhalation of arthroconidia
54
What is the only evidence of infection in many cases?
Development of serum precipitins and conversion to a positive skin test within 2-4 weeks.
55
What factors increase the risk of systemic coccidioidomycosis?
Heredity, sex (males more susceptible), age, and compromised cell-mediated immunity Elevated estradiol and progesterone levels stimulate fungal growth
56
What diagnostic finding confirms coccidioidomycosis?
Presence of spherules with endospores
57
What specimens are collected for culture?
Sputum, exudate from cutaneous lesions, spinal fluid, blood, urine, and tissue biopsies
58
What stains help visualize spherules?
KOH stain Calcofluor white stain Histologic preparations
59
What precautions must be taken with suspected Coccidioides cultures?
Must be examined only in a biosafety cabinet
60
What culture media are used for Coccidioides?
Inhibitory mold agar Sabouraud’s agar Blood agar slants (with or without antibiotics and cycloheximide)
61
What tests confirm the identification of Coccidioides?
Detection of C. immitis-specific antigen Animal inoculation Specific DNA probe
62
What serologic tests detect IgG antibodies?
Immunodiffusion (ID) test Complement fixation (CF) test
63
Why are serologic tests often negative in AIDS patients?
Due to impaired antibody response.
64
What is the treatment for severe coccidioidomycosis?
Intravenous amphotericin B followed by oral itraconazole for months.
65
What is the drug of choice for coccidioidal meningitis?
Oral fluconazole
66
What is the etiologic agent of histoplasmosis
Histoplasma capsulatum
67
Where is Histoplasma capsulatum found in nature?
Avian and bat habitats (guano) Alkaline soil
68
What is the geographic distribution of histoplasmosis?
Global Endemic in: Ohio, Missouri, and Mississippi River valleys Central Africa (var. duboisii)
69
What is the microscopic morphology of Histoplasma capsulatum?
Oval yeasts (2 × 4 µm), intracellular in macrophages
70
What are the etiologic agents of coccidioidomycosis?
Coccidioides posadasii Coccidioides immitis
71
Where is Coccidioides found in nature?
Soil, rodents
72
What is the geographic distribution of coccidioidomycosis?
Semiarid regions of: Southwestern United States Mexico Central and South America
73
What is the microscopic morphology of Coccidioides?
Spherules (10–80 µm) containing endospores (2–4 µm)
74
What is the etiologic agent of blastomycosis?
Blastomyces dermatitidis
75
Where is Blastomyces dermatitidis found in nature?
Unknown (riverbanks?)
76
What is the geographic distribution of blastomycosis?
Mississippi, Ohio, and St. Lawrence River valleys Southeastern United States
77
What is the microscopic morphology of Blastomyces dermatitidis?
Thick-walled yeasts with broad-based, usually single, buds (8–15 µm)
78
What is the etiologic agent of paracoccidioidomycosis?
Paracoccidioides brasiliensis
79
Where is Paracoccidioides brasiliensis found in nature?
Unknown (soil?)
80
What is the geographic distribution of paracoccidioidomycosis?
Central and South America
81
What is the microscopic morphology of Paracoccidioides brasiliensis?
Large, multiply budding yeasts (15–30 µm)

MYCOVIRO (27 decks)

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