FUNGAL INFECTIONS OF THE LUNGS Flashcards by Iseoluwa Ojo

AGENTS OF SYSTEMIC MYCOSIS

•_____________
•________________
•________________
•___________________
•_______________

Histoplasma capsulatum

Coccidides immitis

Blastomyces dermatidis

Paracoccidiodes Brasilensis

Cryptococcus neoformans

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AGENTS OF SYSTEMIC MYCOSIS
Yeast or mold

•Histoplasma capsulatum
• Coccidides immitis
• Aspergillus fumigatus
• Cryptococcus neoformans
•Blastomyces dermatidis
•Paracoccidiodes brasillensis

Dimorphic

Mold

Yeast

Dimorphic

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The primary focus of infection for all five agents is the ________.

lungs

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Infections of systemic mycosis

• Most cases are (asymptomatic or symptomatic?) or (mild or severe?) of very (short or long?) duration,

asymptomatic

Mild

Short

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Infections of systemic mycosis

resolve without therapy

accompanied by a high degree of specific resistance to reinfection.

T/F

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General characteristics of systemic mycosis infections

(Primary or Secondary ?) spread usually brings the patient to hospital.

All grow on _____________ Agar though ____ phases may be inhibited by _______

Secondary

Sabaurauds Dextrose

yeast; cycloheximide

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Histoplasma capsulatum

______ disease, _______ disease, ________ disease or reticuloendothelial cytomycosis.

Cave; Darlings

spelunkers

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Histoplasma capsulatum

• Occurs by a ______ of the ______

Inhalation

conidia

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Histoplasma capsulatum

• Worldwide distribution but is most common in the ———.

• African variant is H. ________ (H. capsulatum var. ________)

USA

duboisii; duboisii

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Histoplasma capsulatum

• Over _____ cases reported in Africa and ______ of them are from Nigeria

• a natural reservoir is the _____ cave in Ogbunike in _________ State

250; Half

bat; Anambra

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Morphology of Histoplasma capsulatum

The parasitic phase is a (small or large?) budding ______ found almost exclusively in ____________.

•_______has both _____ and _____ conidia

Small

yeast; macrophages

Mould

micro and macro

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Histoplasma capsulatum

Mold phase: Note characteristic (small or large?), (rounded or flattened?) , _____-celled, tuberculate _____conidia formed on (short or long?) , _______, (differentiated or undifferentiated?) conidiophores

Large

Rounded

Single

Macro

Short

Hyaline

Undifferentiated

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EPIDEMIOLOGY of histoplasma capsulatum

•Habitat is ______ especially in area contaminated with ________________. E.g. ________,___________

Soil

bat and bird droppings

caves, chicken coops barn attics

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EPIDEMIOLOGY of histoplasma capsulatum

•Birds are not affected

bats are not affected.

T/F

T
F

Birds not affected though bats may be affected.

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histoplasma capsulatum

•Has been known to occur in epidemics

T/F

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CLINICAL SYNDROME of Histoplasma capsulatum

•________ is portal of entry

•Depends on degree of __________

Lung

immunocompetence

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CLINICAL SYNDROME of Histoplasma capsulatum

In Immunocompetent host
•________ or ________-like illness (normal exposure)

•_________ histoplasmosis – heavy exposure

•Complications are (common or rare?) e.g. pericarditis, mediastinal fibrosis

Asymptomatic or mild flu

Acute pulmonary

Rare

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CLINICAL SYNDROME of Histoplasma capsulatum

In Immunocompromised host

_________ histoplasmosis – immune defect e.g. in AIDS, leukemia, chronic steroid therapy

___________ histoplasmosis- structure defect (chronic obstructer pulmonary diseases) e.g. cavity

Disseminated

Chronic pulmonary

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In Africa – H. duboisii , has a predilection for _______ and ________ tissues.

bone and subcutaneous

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TREATMENT of histoplasmosis

•______________

•RELAPSE OCCURS OFTEN IN _______ .

AMPHOTERICIN B

AIDS

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ASPERGILLOSIS
• Caused by _____________

•__________ in environment

Aspergillus fumigatus

Ubiquitous

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ASPERGILLOSIS

• Molds or yeasts?

• Requires _________ for growth but _______ because of sporolation

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Molds

4-5 days

1-3 weeks

ASPERGILLOSIS

• Hyphae are (branching or non -branching?) and (septate or aspetate?)

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Branching

Septate

Clinical Syndrome of ASPERGILLOSIS

• Most often route of transmission is by __________

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inhalation

ASPERGILLOSIS Causes infections in only both immunosuppressed patients T/F

F ASPERGILLOSIS Causes infections in both immunocompetent and immunosuppressed.

Clinical Syndromes of aspergillosis 3 types • _______ •___________/________ •__________ pulmonary aspergillosis

Allergic Aggressive/acute Invasive Chronic

Clinical Syndromes •Allergic : Aspergillus ________ aspergillosis. Leads to _________ with Fungal Sensitivity •Aggressive/acute Invasive: _______ pulmonary aspergillosis •Chronic pulmonary aspergillosis – a ____ of disease ranging from ____________ to ________

Brochopulmonary; Severe Asthma Invasive spectrum aspergilloma (fungal ball) to chronic necrotising aspergillosis

TREATMENT of ABPA (Allergic Bronchopulmonary Aspergillosis) •______________ •Recurrent or Acute; __________

Oral Glucocorticoids Itraconazole

TREATMENT of Chronic Pulmonary Aspergillosis Aspergilloma •_________ or ___________ •Surgical _______ e.g _______

Itraconazole or voriconazole resection; lobectomy

TREATMENT of Invasive Aspergillosis •________ •__________ may be used in combination therapy

Voriconazole Caspofungin

COCCIDIODOMYCOSIS Aka _________ disease, ________ fever, _________

Posada’s San Joaquin Valley Desert rheumatism

COCCIDIODOMYCOSIS •Agent: ________________ •A ________mycete.

Coccidiodes immitis Deutero

MORPHOLOGY of Coccidiodes immitis • Mold phase: (Branching or non-branching?) (septate or aseptate?) hyphae with alternate cell developing into __________. • Yeast Phase: (Small or Large?) _______ structures. they are ______ that are filled with ————-.

Branching; septate arthroconidia Large; spherical spherules; endospores

Culture of Coccidioides immitis on Sabouraud's dextrose agar showing a _____-like to downy, _______ colony with a __________ reverse.

suede greyish white tan to brown

Epidemiology of Coccidiodes immitis •Geographically restricted to _____,______, and _______ •Has been known to spread extensively following __________

North, Central and South America dust storms

Disease of New world is ???

COCCIDIODOMYCOSIS

Clinical Syndrome of Coccidiodes immitis •_____ is the Portal of Entry • (Mildly or Highly?) pathogenic

Lung Highly

Clinical Syndrome of Coccidiodes immitis • Unlike ________, Inhalation of conidia (Spores) leads a (lesser or greater?) number of people to develop a mild febrile to moderately severe pulmonary disease

histoplasma Greater

Clinical Syndrome of Coccidiodes immitis • About _____% of individuals develop symptomatic infection following exposure. • Disseminated infection most commonly affects the _______ and/or ______

40 meninges skin

Clinical Syndrome of Coccidiodes immitis Most primary infections are not self-limited

F Most primary infections are self-limited, may progress in some patients

Coccidiodes immitis Can be grown easily on conventional media but it must be carefully handled because ????

C. immitis is the leading cause of laboratory-acquired fungal infection

__________ is the leading cause of laboratory-acquired fungal infection

C. immitis

Treatment of Coccidiodes immitis •Long term therapy with __________ •_____________ is a useful alternative

Amphotericin B Ketoconazole

Cryptococcosis Agent:____________________ •Class ________

Cryptococcus neoformans Basidiomycete

Cryptococcosis •_______________’s Disease, Torulosis or _______________________

Busse-Buschke European Blastomycosis.

MORPHOLOGY of cryptococcus neoformans •Budding (yeast or mold?) •Most distinctive feature is ______________________

Yeast an acidic mucopolysaccharide capsule

acidic mucopolysaccharide capsule is Required for pathogenicity by cryptococcus neoformans T/F

Visualisation of capsule of cryptococcus neoformans is in _____________

India ink preparation

Epidemiology of cryptococcus neoformans • World wide distribution • Recovered in large numbers from excreta and debris of __________ • True prevalence unknown due to _________________________

pigeon roosts a lack of reliable skin or serological tests

Clinical Syndrome of cryptococcus neoformans • _______ is the Portal of Entry •Primary pulmonary infection frequently (asymptomatic or symptomatic?) but can become progressive •Most common picture is that of a ____________

Lung; asymptomatic solitary pulmonary nodule

Clinical Syndrome of cryptococcus neoformans Symptomatic infection is mainly _______ and is usually but not always __________. •Other disseminated disease include ______ lesions and __________ lesions

meningitis opportunistic skin ; osteolytic bone

Pathogenesis of cryptococcus neoformans • Inhalation of _______ cells & small _______ into lungs • Migrate to ____ where they cause __________ • Major clinical manifestation may resemble brain tumour brain abscess, degenerative CNS disease or T.B /fungal meningitis • May have lesions in _____,_______ and other organs

dessicated yeast; basidiospore CNS; meningoencephalitis skin (orofacial) , lungs

Cryptococcus neoformans produces urease T/F

Treatment of cryptococcus neoformans • Pulmonary lesions usually ____—- • Disseminated disease is usually ____ if untreated • ________________ • Add _____________ in meningitis for better CSF penetration

self-limited fatal Amphotericin B 5-fluocytosine

FUNGAL INFECTIONS OF THE LUNGS Flashcards

(54 cards)