Fungal infections

Question 1

fungal infections epidemiology

Answer 1

• immune compromise
• geographic region (recent travel)

Question 2

Pneumocystic carinii (aka pneumocystis jirovecii) is diagnosed by (4)

Answer 2

1. BAL (bronchoalveolar lavage)
2. transbronchial biopsy
3. Tracheal aspirate
4. pleural fluid

Question 3

Pneumocystis jirovecii (or carinii) is identified by which lab tests (3)?

Answer 3

1. giemsa
2. methaenamine silver stain
3. fluorescent Ab

Question 4

Pneumocystis jirovecii (carinii) transmission

Answer 4

respiratory droplets

Question 5

Pneumocystis jirovecii (carinii) infective state? reproductive?

Answer 5

• cyst forms
• trophic forms (trophozoite & precyst)

precyst contains infectie spores

Question 6

Which fungi has chitin in its cell wall?

Answer 6

p. jirovicii

Question 7

which fungi is the most virulent?

Answer 7

c. immitus

Question 8

which 3 fungi that infect the lung are dimorphic?

Answer 8

1. c. immitus
2. h. capsulatum
3. blastomyces dermatitidis

Question 9

Coccidioides immitis are endemic to which geographical regions?

Answer 9

1. San Joaquin, CA
2. Maricopa, Pima Counties of AZ
3. Southwestern TX

low rainfall, airid climate

Question 10

C. immitus characteristics

Answer 10

1. mold form barrel-shaped arthroconidia
2. spherules with endospores

Question 11

Erythema multiforme, erythema nodosum and arthritis can be seen in allergic reaction to which fungi?

Answer 11

c. immitus

Question 12

C. immitus infects by which route?

Answer 12

inhaled, small enough to avoid immune cells in upper airway

Question 13

Histoplasma capsulatum is endemic to which 3 areas

Answer 13

1. ohio
2. mississippi
3. missouri

areas w/high nitrogen in soil

Question 14

why is histoplasmosis called cave disease?

Answer 14

bat and bird guano is abundant and people who go into caves are exposed to H. capsulatum

Question 15

H. capsulatum progession of disease

Answer 15

1. inhalation of microconidia in areas contaminated with bird and/or bat droppings
2. microconidia phagocytosed by macrophages in pulmonary parenchyma

Question 16

H. capsulatum key dx feature

Answer 16

1. macroconidia by latex agglutination
2. Enzyme immuno assay (EIA) in blood

Question 17

H. capsulatum infectious form

Answer 17

microconidia: infectious form

Question 18

Cryptococcus neoformans characteristics

Answer 18

Heavily encapsulated yeast

Question 19

Which fungi is found in soil and pigeon droppings?

Answer 19

Cryptococcus neoformans

Question 20

Cryptococcus neoformans is dx by which 2 lab tests ?

Answer 20

1. detection of capsule using India Ink stain
2. ELISA: serological tests to detect cryptococcal capsular antigen
3. cultures: sabouraud dextrose

Question 21

5 sx of cryptococcus infection

Answer 21

1. SOB
2. cough
3. fever
4. chest pain
5. fever

Question 22

cryptococcus neoformans complications

Answer 22

CNS infection

Question 23

2nd MC fungal infection after candida

Answer 23

aspergillus (4 species)

Question 24

infectious process of aspergillosis

Answer 24

conidia inhaled –> germinate –> hyphae growth –> dissemination

Question 25

asperginllosis xray finding

Answer 25

fungus ball

Question 26

aspergillosis sx

Answer 26

1. pneumonia like 1. allergic reactions

Question 27

Aspergillosis can spread to which organs (4)?

Answer 27

1. brain 1. liver 1. heart 1. bone

Question 28

blastomycosis: aka, Gilchrist disease, Chicago disease is endemic to which 2 regions?

Answer 28

Mississippi and Ohio River basins

Question 29

2 forms of blastomyces dermatitidis

Answer 29

mycelial: soil yeast: body

Question 30

blastomyces dermatitidis sx

Answer 30

1. flu-like symptoms 2. cough, weight loss, chest pain, fever 3. **-ulcerative skin and bone lesions (as it progresses)**

Question 31

blastomycosis is identified with which lab finding?

Answer 31

methenamine silver stain: budding yeast cells

Question 32

disseminated blastomycosis may cause which conditions?

Answer 32