Fungal Dz Cards

Question 1

Blasto- stages/infective form

Answer 1

Dimorphic: different form in soil (saprophytic mycelial), produces infective spores, transforms to (extracellular) yeast at body temp

Question 2

Blasto- appearance/size

Answer 2

5-20 um, double refractile wall

Question 3

Blasto- type of budding

Answer 3

Broad-based

Question 4

Blasto- environment/location/distribution

Answer 4

River valleys, mid-atlantic and beyond map; humid with acidic, sandy soils near water (FL alkaline) ; pockets, not diffuse

Question 5

Blasto- transmission/infection

Answer 5

inhalation > puncture/sore contamination with spores; most transform to yeast in lungs (but skin wounds’ infection local until hematogenous spread); lymphatic spread potential but uncommon

Question 6

Blasto- zoonosis?

Answer 6

No, but common exposure likely; WARN THE LAB! becomes infectious mold at room temp

Question 7

Blasto- signalment

Answer 7

Dog: young, sporting, male large breed (lifestyle) Cat: young male

Question 8

Blasto- body response

Answer 8

Cell mediated immunity, pyogranulomatous, phagocytosis ineffective

Question 9

Blasto- definitive diagnosis

Answer 9

find org on cyto, histo, culture

Question 10

In blastomycoses, what CS do cats sometimes have that arent mentioned in dogs

Answer 10

GI signs, urinary tract disease, pleural/abdominal effusion.

Question 11

Endophthalmitis in a young male sporting dog- top ddx

Answer 11

Blasto

Question 12

Blasto- other dx

Answer 12

serology unreliable (FN common), antigen testing (serum/urine) more effective, x-reaction possible

Question 13

Blasto- rads

Answer 13

Abnormal in 85%, discrete, round nodular pulm pattern; bone lesions lytic with periosteal rxn and ST swelling around- looks like cancer

Question 14

Blasto- tx type/duration

Answer 14

Itraconazole (not generic); 2nd- Amphoteracin B; If eye/CNS- fluconazole (may enucleate); min 2-3 m, at least 1-2 m past resolution

Question 15

Why are false negatives common in blasto serology

Answer 15

Not all patients develop Ab’s

Question 16

T/F subclinical infections of blasto are common

Answer 16

False

Question 17

When should you culture for blasto

Answer 17

When infection suspected but cytology negative OR refractory to Tx

Question 18

Best and worst Px for blasto

Answer 18

Poor- CNS
Guarded- severe pulmonary
Good- just coughing

Question 19

Tx blasto relapse

Answer 19

2nd full course, resistance uncommon

Question 20

Crypto- pathologic form

Answer 20

extra-cellular, thin walled, narrow budding (3-5 um) yeast; Smaller than all blasto but with large capsule (up to 30 um),

Question 21

Crypto- location

Answer 21

Ubiquitous (esp. S. CA), bird excrement

Question 22

Crypto- zoonosis

Answer 22

Not contagious, cmmon exposure

Question 23

Crypto- transmission, type of infection

Answer 23

inhalation- nasal/pulm infection most common

Question 24

What is the most common fungal dz in cats

Answer 24

Cryptococcus

Question 25

T/F- underlying immunosuppression common in dogs/cats with crypto

Answer 25

F

Question 26

Crypto- immunity

Answer 26

cell mediated; ineffective phagocytosis bc capsule

Question 27

How does crypto get into CNS, other extra-pulm sites

Answer 27

Direct extension/local spread through cribiform plate; hematogenous spread via macrophages eat then exocytose

Question 28

Crypto- cat main 2 CS

Answer 28

nasal d/c and sneezing; ulcerative cutaneous masses (Less common: inflammatory ocular (> primary lesion)

Question 29

Sneezing cat with bump on nose- dx

Answer 29

Cryptococcus

Question 30

Crypto- dog CS

Answer 30

Nasal, CNS, ocular most common (skin, kidney, general CS possible)

Question 31

If rads abnormal in crypto, what signs are seen

Answer 31

Hilar lymphadenopathy, diffuse-miliary pattern

Question 32

Skull imaging findings - crypto

Answer 32

granuloma filling nose, nasal bone lysis/deformity

Question 33

Best dx for crypto

Answer 33

Serology- latex agglutination for Agin serum, aq humor, CSF

Question 34

T/F resistance to antifungals is relatively common in Crypto

Answer 34

T

Question 35

Nasal or skin crypto- Tx type and duration

Answer 35

Itraconazole; ~8months (1-2 m past CS and negative titers)

Question 36

CNS or ocular crypto- Tx

Answer 36

Amphoteracin B + flucytosine first, then itra/fluconazole once controlled

Question 37

Crypto- Px

Answer 37

Skin/nose: fair to good but slow; eye/brain: guarded to grave

Question 38

Histoplasmosis- fungus type, pathologic form

Answer 38

dimorphic (infective spores in soil, yeast at body temp)

Question 39

Crypto- fungus type

Answer 39

Dimorphic, fungal form not seen- only yeast;

Question 40

Histo- pathologic form

Answer 40

Intracellular small (2-4 um) yeast at body temp, thick double wall, broad based budding; smaller than blasto

Question 41

Histo- transmission

Answer 41

Inhalation (or ingestion)

Question 42

Histo- zoonosis

Answer 42

No

Question 43

Histo- signalment

Answer 43

young male sporting, young male cats

Question 44

Histo- immunity

Answer 44

Cell-mediated, in most system will clear! Dz in high dose or imm-compromised

Question 45

T/F- subclinical infections with histo are uncommon

Answer 45

F

Question 46

Histo- CS dogs

Answer 46

Respiratory and GI (LI diarrhea)

Question 47

Histo- CS cats

Answer 47

profound weight loss, respiratory, SI diarrhea

Question 48

Dx histo

Answer 48

Intracellular organisms on CBC