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House Microbiology > FUNGAL INFECTIONS OF THE LUNGS > Flashcards

FUNGAL INFECTIONS OF THE LUNGS Flashcards

1
Q

AGENTS OF SYSTEMIC MYCOSIS

•_____________
•________________
•________________
•___________________

A

Histoplasma capsulatum

Coccidides immitis

Aspergillus fumigatus

Cryptococcus neoformans

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2
Q

AGENTS OF SYSTEMIC MYCOSIS
Yeast or mold

•Histoplasma capsulatum
• Coccidides immitis
• Aspergillus fumigatus
• Cryptococcus neoformans

A

Dimorphic

Dimorphic

Mold

Yeast

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3
Q

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

A

lungs

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4
Q

Infections of systemic mycosis

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

A

asymptomatic

Mild

Short

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5
Q

Infections of systemic mycosis

resolve without therapy

accompanied by a high degree of specific resistance to reinfection.

T/F

A

T

T

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6
Q

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 _______

A

Secondary

Sabaurauds Dextrose

yeast; cycloheximide

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7
Q

Histoplasma capsulatum

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

A

Cave; Darlings

spelunkers

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8
Q

Histoplasma capsulatum

• Occurs by a ______ of the ______

A

Inhalation

conidia

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9
Q

Histoplasma capsulatum

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

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

A

USA

duboisii; duboisii

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10
Q

Histoplasma capsulatum

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

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

A

250; Half

bat; Anambra

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11
Q

Morphology of Histoplasma capsulatum

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

•_______has both _____ and _____ conidia

A

Small

yeast; macrophages

Mould

micro and macro

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12
Q

Histoplasma capsulatum

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

A

Large

Rounded

Single

Macro

Short

Hyaline

Undifferentiated

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13
Q

EPIDEMIOLOGY of histoplasma capsulatum

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

A

Soil

bat and bird droppings

caves, chicken coops barn attics

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14
Q

EPIDEMIOLOGY of histoplasma capsulatum

•Birds are not affected

bats are not affected.

T/F

A

T
F

Birds not affected though bats may be affected.

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15
Q

histoplasma capsulatum

•Has been known to occur in epidemics

T/F

A

T

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16
Q

CLINICAL SYNDROME of Histoplasma capsulatum

•________ is portal of entry

•Depends on degree of __________

A

Lung

immunocompetence

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17
Q

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

A

Asymptomatic or mild flu

Acute pulmonary

Rare

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18
Q

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

A

Disseminated

Chronic pulmonary

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19
Q

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

A

bone and subcutaneous

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20
Q

TREATMENT of histoplasmosis

•______________

•RELAPSE OCCURS OFTEN IN _______ .

A

AMPHOTERICIN B

AIDS

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21
Q

ASPERGILLOSIS
• Caused by _____________

•__________ in environment

A

Aspergillus fumigatus

Ubiquitous

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22
Q

ASPERGILLOSIS

• Molds or yeasts?

• Requires _________ for growth but _______ because of sporolation

A

Molds

4-5 days

1-3 weeks

23
Q

ASPERGILLOSIS

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

A

Branching

Septate

24
Q

Clinical Syndrome of ASPERGILLOSIS

• Most often route of transmission is by __________

A

inhalation

25
Q

ASPERGILLOSIS Causes infections in only both immunosuppressed patients

T/F

A

F

ASPERGILLOSIS Causes infections in both immunocompetent and immunosuppressed.

26
Q

Clinical Syndromes of aspergillosis

3 types

• _______
•___________/________
•__________ pulmonary aspergillosis

A

Allergic

Aggressive/acute Invasive

Chronic

27
Q

Clinical Syndromes

•Allergic : Aspergillus ________ aspergillosis. Leads to _________ with Fungal Sensitivity

•Aggressive/acute Invasive: _______ pulmonary aspergillosis

•Chronic pulmonary aspergillosis – a ____ of disease ranging from ____________ to ________

A

Brochopulmonary; Severe Asthma

Invasive

spectrum

aspergilloma (fungal ball) to chronic necrotising aspergillosis

28
Q

TREATMENT of ABPA (Allergic Bronchopulmonary Aspergillosis)

•______________
•Recurrent or Acute; __________

A

Oral Glucocorticoids

Itraconazole

29
Q

TREATMENT of Chronic Pulmonary Aspergillosis

Aspergilloma
•_________ or ___________
•Surgical _______ e.g _______

A

Itraconazole or voriconazole

resection; lobectomy

30
Q

TREATMENT of Invasive Aspergillosis

•________
•__________ may be used in combination therapy

A

Voriconazole

Caspofungin

31
Q

COCCIDIODOMYCOSIS

Aka

_________ disease, ________ fever, _________

A

Posada’s

San Joaquin Valley

Desert rheumatism

32
Q

COCCIDIODOMYCOSIS

•Agent: ________________

•A ________mycete.

A

Coccidiodes immitis

Deutero

33
Q

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 ————-.

A

Branching; septate

arthroconidia

Large; spherical

spherules; endospores

34
Q

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

A

suede

greyish white

tan to brown

35
Q

Epidemiology of Coccidiodes immitis

•Geographically restricted to _____,______, and _______

•Has been known to spread extensively following __________

A

North, Central and South America

dust storms

36
Q

Disease of New world is ???

A

COCCIDIODOMYCOSIS

37
Q

Clinical Syndrome of Coccidiodes immitis

•_____ is the Portal of Entry

• (Mildly or Highly?) pathogenic

A

Lung

Highly

38
Q

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

A

histoplasma

Greater

39
Q

Clinical Syndrome of Coccidiodes immitis

• About _____% of individuals develop symptomatic infection following exposure.

• Disseminated infection most commonly affects the _______ and/or ______

A

40

meninges

skin

40
Q

Clinical Syndrome of Coccidiodes immitis

Most primary infections are not self-limited

A

F

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

41
Q

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

A

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

42
Q

__________ is the leading cause of laboratory-acquired fungal infection

A

C. immitis

43
Q

Treatment of Coccidiodes immitis

•Long term therapy with __________

•_____________ is a useful alternative

A

Amphotericin B

Ketoconazole

44
Q

Cryptococcosis

Agent:____________________

•Class ________

A

Cryptococcus neoformans

Basidiomycete

45
Q

Cryptococcosis

•_______________’s Disease, Torulosis
or _______________________

A

Busse-Buschke

European Blastomycosis.

46
Q

MORPHOLOGY of cryptococcus neoformans

•Budding (yeast or mold?)

•Most distinctive feature is ______________________

A

Yeast

an acidic mucopolysaccharide capsule

47
Q

acidic mucopolysaccharide capsule is Required for pathogenicity by cryptococcus neoformans

T/F

A

T

48
Q

Visualisation of capsule of cryptococcus neoformans is in _____________

A

India ink preparation

49
Q

Epidemiology of cryptococcus neoformans

• World wide distribution

• Recovered in large numbers from excreta and debris of __________

• True prevalence unknown due to _________________________

A

pigeon roosts

a lack of reliable skin or serological tests

50
Q

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 ____________

A

Lung; asymptomatic

solitary pulmonary nodule

51
Q

Clinical Syndrome of cryptococcus neoformans

Symptomatic infection is mainly _______ and is usually but not always __________.

•Other disseminated disease include ______ lesions and __________ lesions

A

meningitis

opportunistic

skin ; osteolytic bone

52
Q

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

A

dessicated yeast; basidiospore

CNS; meningoencephalitis

skin (orofacial) , lungs

53
Q

Cryptococcus neoformans produces urease

T/F

A

T

54
Q

Treatment of cryptococcus neoformans

• Pulmonary lesions usually ____—-

• Disseminated disease is usually ____ if untreated
• ________________
• Add _____________ in meningitis for better CSF penetration

A

self-limited

fatal

Amphotericin B

5-fluocytosine

House Microbiology (93 decks)

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