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Flashcards in fungus 5 Deck (25)
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1

inhalation of what dust borne spores causes histoplasmosis

histoplasma capsulatum

2

where is histoplasmosis most common in the US

the Ohio and Mississippi River valleys

3

what accelerates sporulation of histoplasma in soils

avian or bat guano contamination

4

what are risk factors for histoplasmosis

1. spelunking
2. demolishing chicken coops or barns
3. exposure to forests with large bird roosts
4. farming
5. excavation

5

what ingest and sequester histoplasma within the human immune system

macrophages

6

how long after exposure to histoplasma does cellular immunity develop

10-14 days

7

what do macrophages develop histoplasma into in an immunocompetent host

granulomas

8

how does primary histoplasmosis infection occur

when granuloma formation fails or is overcome by massive inoculum

9

how does reactivation of histoplasmosis infection occur

occurs when immune system wanes and granulomas dissipate

10

what are the two clinical presentations of histoplasmosis

1. asymptomatic prirmary infection
2. acute pulmonary histoplasmosis
3. chronic pulmonary histoplasmosis
4. disseminated histoplasmosis

11

how long does it take for an asymptomatic primary infection to resolve?

1 month without any therapy

12

mediastinal granulomas, pericarditis and rheumatologic syndromes are possible with what type of histoplasmosis

acute pulmonary histoplasmosis

13

what is the treatment for mild to moderate acute pulmonary histoplasmosis

less than 4 weeks = no therapy
longer than 4 weeks = itraconazole

14

what is the treatment for moderately severe or severe acute pulmonary histoplasmosis

liposomal amphotericin B
followed by itrasconazole
and methylprednisolone (with inflammation)

15

what is the treatment of chronic cavitary pulmonary histoplasmosis

itraconazole for 1 year (longer if immunocompromised)

16

what is the treatment for mild to moderate disseminated histoplasmosis

itraconazole

17

what is the treatment for moderately severe or severe disseminated histoplasmosis

liposomal amphotericin B (or any other form)
followed by itraconazole

18

what is the treatment for dissimenated histoplasmosis in the CNS

liposomal amphotericin B
followed by itraconazole (for a year)

19

what other fungus is very similar to histoplasmosis pathogenically

blastomycosis

20

what are the different clinical presentations of bastomycosis

1. acute pulmonary blastomycosis
2. chronic pulmonary blastomycosis
3. disseminated/ extrapulmonary blastomycosis

21

what does chronic pulmonary blastomycosis mimic?

TB

22

what is the least common but most fatal form of blastomycosis

in the CNS

23

how are the signs of cryptococcosis different from histoplasmosis and blastomycosis

cryptococcosis symptoms are generally in the CNS; not in the lungs

24

skin lesions are often seen with what two fungi

histoplasmosis and blastomycosis

25

True/False severe histoplasmosis and blastomycosis are both treated with liposomal amphotericin followed by itraconazole

true