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I3 Fungi-Yeasts, Molds, Dimorphics > Fungi-Yeasts, Molds, Dimorphics > Flashcards

Fungi-Yeasts, Molds, Dimorphics Flashcards

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1
Q
  • Can cause superficial, localized or systemic infections.
  • Are free-living in nature and are usually acquired from the environment
  • Cause damage by eliciting inflammation or by direct invasion of tissue
A

Pathogenic Fungi

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2
Q

Where do pathogenic fungi live?

(exogenous)

A
  • Decaying Vegetation - Aspergillus
  • Pigeon Droppings - Crytococcus neoformans
  • Soil wih Bird and Bat Excreta - Histoplamsa capsulatum
  • Rose and Barberry Thorn - sporothrix Schenckii
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3
Q

Where do pathogenic fungi live?

(endogenous)

A
  • Skin and GI tract - Candida
  • Human skin rich in sebaceous glands - Malassezia
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4
Q

Primary Pathogenic Fungi Include…

A
  1. Blastomyces dematitidis
  2. Coccidioides Immitis
  3. Histoplamsa Capsulatum
  4. Spopthrix Schenckii
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5
Q

Opportunistic pathogenic fungi include…

A
  1. Aspergillus species
  2. Candida species
  3. Pneumocystis jirovecii
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6
Q

Compromised host defense that results in defective or low number of neutrophil may experience fungal invasion. What fungi are most likely responsible in this case?

A

Candida

Aspergillus

Mucor

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7
Q

Descibe superficial mycoses.

A

Limited to the outermost layers of the hair or skin. Mild infections with no or minimal inflammation.

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8
Q

What are some examples of Superficial Mycoses?

A
  • Black Piedra
  • White Piedra
  • Tinea Nigra
  • Tinea or pityriasis versicolor
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9
Q

What is this and how would you treat it?

A

This is an image of white piedra, a superficial mycosest, that causes white granules on hair shafts of genital and beard areas due to TRICHOSPORON BEIGELII

TX = shaving all hair; does not recur

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10
Q

How would you diagnose a superficial mycoses infection?

A

Wet monut of hair or skin with 10% KOH

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11
Q

What is this and how would you treat it?

A

Black Piedra, mild infection with no/minimal inflammation, superficial mycoses, that produces hard,gritty brown-black concentration on sclap hair due to PIEDRAIA HORTAE

TX= Shaving all hair; don’t recur

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12
Q

What is this and how would you treat it?

A

Tinea Nigra- a mild infection with no/minimal inflammation, superficial mycoses, that produces brown-black macules on palms>soles due to EXOPHIALA WERNECKII

TX = topical keratolytic agent or azole

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13
Q

What is this and how would you treat it?

A

Tinea or pityriasis versicolor, superficial mycoses, a mild infection with no/minimal inflammation that produces hyper- and hypo-pigmented confluent scaly macules on torso due to MALASSEZIA FURFUR

TX= Selenium sulfide sulfide 2.5% solution

Other keatolytic agents

Topical azole

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14
Q

How would you diagnose Cutaneous mycoses ?

A

Wet mount using 10% KOH with skin hair or nail scraping

Culture in media with cycloheximide and cloramphenicol to inhibit overgrowth of saprobic fungi and bacteria

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15
Q

Describe cutaneous mycoses.

A

Infect the keratinized tissues (epidermis, hair and nails) may elicit a cellular immune respons.

Consist of dermatophytes belonging to 3 genera:

  1. Microsporum
  2. Trichophyton
  3. Epidermophyton
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16
Q

What is this and how would you treat it?

A

Tinea Capitis, cutaneous mycoses

an infection of the keratinized tissue that may elicit a cellular immune response.

TX= oral terbinafine

itraconazole

ketoconazole & griseofulvin (rarely used)

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17
Q

What is this and how would you treat it?

A

Tinea Corporis, cutaneous mycoses

An infection of the keratinized tissues that may elicit a cellular immune response.

TX= topical terbinafine

naftifine

topical azoles

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18
Q

What is this and how would you treat it?

A

“Jock Itch” Tinea cruris, cutaneous mycoses

An infection of the keratinized tissues that may elicit a cellular immune response.

TX= topical terbinafine

naftifine

topical azoles

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19
Q

What is this and how would you treat it ?

A

Tinea Unguium (nails), cutaneous mycoses

An infection of the keratinized tissues that may elicit a cellular immune response.

TX= topical terbinafine

naftifine

topical azoles

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20
Q

What is this and how would you treat it?

A

Tinea Barbae, cutaneous mycoses

An infection of the keratinized tissues that may elicit a cellular immune response.

TX= topical terbinafine

naftifine

topical azoles

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21
Q

What is this ?

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A

Trichophyton mentagrophytes

Dermatophyte of the Trichophyton genre of cutaneous mycoses

22
Q

What is this

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A

Microsporum Gypseum in hair shaft

Dermatophyte of the Microsporum genre of cutaneous mycoses

23
Q

Describe Subcutaneous Mycoses.

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A

Involves the dermis and subcutaneous tissue. Usually involves trauma for entry

Some infection may not respond to antifungal therapy and my need surgery.

Includes the following disease:

  1. Lymphocutaneous sporotrichosis
  2. Chromoblastomycosis
  3. Phaeohyphomycosis
  4. Eumycetoma mycetoma
24
Q

What is this?

Study These Flashcards
A

DSZ= Lymphocutaneous Sporotrichosis

Causitve agent= Sporothrix Scheneckii (Dimorphic fungus)

Entry= implanted into skin by trauma

Clinical Manifestation= Nodule at site of entry ulcerates and form other nodules along lymphatic drainage channels

25
A patient who presents like this. what would you do to diagnose and treat the patient? What would you see?
This patient ahs Lymphocutaneous sporotrichosis caused by the dimorphic fungus sporothrix schenckii. Diagnose = culuture, You will see white mould that will darken to brown black with prolonged incubationat 25C and cigar shaped yeasts on biopsy TX= Saturated solution of KI (potassium iodide) Itraconazole Amphotericin B
26
What is this ?
Chromoblastomycosis, a subcutaneous mycoses Causitive agent = Fonsecaea or Cladosporium A warty, vegatative, caulifower like lesion.
27
How would you diagnose and treat Chromoblastomycosis?
Diagnosis = histophathology with epithelil cell hyperplasia and copper colored spherical fungi, sclerotic or Medlar bodies Treatment = surgical excision or cryosurgery, intraconazole, terbinafine
28
What is this ?
Eumycotic mycetoma, subcutaneous mycoses Causative agent = Pseudallescheria boydii and Madurall grisea (and also actinomyctes and bacteria) Purulent drainae from sinus tracts
29
A patient has eumycotic mycetoma. How would you diagnose and treat this?
Diagnosis = histopathology of grains from sinus tracts show fungal elements; culture Treatment = surgical excision or amputation for extensive dsz with wide margins to prevent recurrence \* limited success with itraconazole and ketoconazole
30
Describe Deep Tissue Fungal Infections
These infections are acquired from endogenous or environmental sources. May invade the organs of the entire body. Enter the bloodstream and disseminate. This group of infections includes: 1. Blastomyces dermatitidis 2. Aspergillus species 3. Coccidioides immitis 4. Histoplasms capsulatum 5. Candida species 6. Cryptococcus neoformans
31
Describe Primary Fungal Pathogens.
Infection that can affect a healthy host. Often have geographic prdilection Are inhaled and may cause chronic lung infection similar to TB May cuase system or disseminated disease in the immunocompromised host Include: 1. Blastomyces dermatitidis 2. Coccidioides immitis 3. Histoplasma capsulatum 4. Paracoccidioides brasiliensis
32
Blastomyces dermatitidis
Dimorphic fungus Entry = inhaled spores enter the lund Dogs may develop similar diseases Clinical manifestations = Primary lung infection amy be unapparent Chronic pneumonia and cavity Disseminate to skin, bone, and urogential tract
33
What is this and how would you treat it?
Blastomyces dermatitidis ( a primary fungal pathogen) TX= itraconazole better then fluconazole for lung infection; ketoconazole rarely used Amphotericin B for azole failures and disseminated infection
34
These lab findings would confirm diagnosis of what primary fungal infection.
Blastomyces dermatitis
35
These histological findings would suggest what primary fungal infection?
Balstomyces Dermititdis
36
Coccidioidomycosis
Dimorphic fungus Entry = inhaled spores enter lung Clincial manifestations: Symptomatic lung infection in 40% Chronic infection may result in lung cavity Disseminates to CNS, Bone, Skin Predispositions for dissemination: AIDS, Dark skinned individuals, pregnancy
37
Coccidioides Immitis Diagnosis would include:
Diagnosis: ## Footnote Culture Biopsy Complement fixation antibody: for disseminated disease and relapse
38
Describe Coccidioides immitis pathology.
endospores (2-5micron) within spherules seen in pyogenic and granulomatous reaction
39
How would you treat Coccidioides immitis?
Fluconazole better than itraconzale for lung infection; ketoconazole rarely used Amphotericin B for azole failures and disseminated inection
40
How would you treat this ?
This is coccidioides immitis. Fluconazole better than intraconazole for lung infection: ketoconazole. Amphotericin B for azole failures and disseminated infection
41
Histoplasma capsulatum
Dimorphic fungus Found in soil contaminated by bird or bat excreta Entry = inhaled spores lung Clinical manifestations =Primary lung infection may be symptomatic in 5% Lung lesion heals with calcification and fibrosis Chronic pneumonia and lung cavity Disseminate via bloodstream to all organs, esp in immunocompromised host
42
Describe the pathology of Histoplasma capsulatum.
phasocytosed ovoid yeast found within monocytes and histiocyte; granulomatous reaction
43
How would you treat this patient?
This patient has disseminated histoplasmosis. TX = itraconazole better than fluconazole for lung infection; ketoconazole rarely used.
44
Histoplasma capsulatum
45
Histoplasma capsulatum
46
Histoplasma capsultum
47
"yeast like vessicle like mariner's wheel"
Paracoccidioides brasiliensis
48
Disseminated Blastomyces
49
Disseminated Coccidioidomycosis
50
Dimorphic fungus Found in soil contaminated by bird or bat excreta Entry: inhaled spores lung Clinical manifestations: » Primary lung infection may be symptomatic in 5% » Lung lesion heals with calcification and fibrosis » Chronic pneumonia and lung cavity » Disseminate via bloodstream to all organs, especially in immunocompromised host
Histoplasma capsulatum
51
Pulmonary Histoplasmosis
52
Disseminated Histoplasmosis

I3 Fungi-Yeasts, Molds, Dimorphics (1 decks)

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