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SAM Exam 1 > Lecture 4-5 - Fungal dz (Walton) > Flashcards

Lecture 4-5 - Fungal dz (Walton) Flashcards

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1
Q

Dimorphic fungi; saprophytic mycelial from in the soil produces infection spores, at body temperature these fungi transform into __ form

A

yeast

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2
Q

EXAM: types of dimorphic fungi

A 
blastomyces dermatitidis 
histoplasma capsulatum
coccidiodes immitis 
sporothrix schenckii 
cryptococcus neoformans
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3
Q

pathologic form of blastomycosis

A

extra-cellular yeast

thick, refractile, double wall, broad-based budding

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4
Q

endemic to mississippi, missouri, and ohio river valleys and great lakes

A

blastomycosis

more prominent after heavy rainfall (spore release) in warm weather
found near water in acidic sandy soils

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5
Q

increased __ and __ precede highest incidents of infection for blastomycosis

A

rainfall, temperature

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6
Q

why don’t all animals contract blastomycosis?

A

resident soil microbes typically destroy blastomyces in soil

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7
Q

poster child for blastomycosis

A

labs

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8
Q

how is blastomycosis transmitted

A

inhalation of spores
contaminated wound

  • not considered contagious
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9
Q

predispositions to blastomyces infection

A 
dogs 
males > females 
sporting dogs (labs, coonhounds), dobies 
large breeds 
2-4 yo
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10
Q

infection involves inhalation of __ which transforms into a yeast in the __

A

conidia
lungs (asexual budding)

can be spread systemically (blood or lymph)

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11
Q

inflammatory response often seen with fungal infections

A

granulomatous to pyogranulomatous

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12
Q

how does blastomycosis avoid the host’s IS (virulence)

A

BAD1 (impairs complement, can’t phagocytize the yeast)

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13
Q

any systemic dz or fungal dz always do a __ examination

A

fundic!

anterior uveitis, endophtalmitis, optic neuritis

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14
Q

most common CS of blastomycosis

A 
fever
lyphadenopathy
harsh lung sounds 
skin lesions 
cough, dyspnea, exercise intolerance
anorexia, wt. loos

usually localized to lungs and LNs but severe dz can be disseminated systemically

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15
Q

definitive dx for blastomycosis is based on __

A

cytologic, histopath, or culture

don’t culture! NEVER; can infect lab staff.

easiest and safest way is cytology

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16
Q

ELISA (ag serum assay) is a sensative test for blasto using serum or urine, but it can cross react with __ making positive result not dx for blastomycosis

A

histoplasma

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17
Q

__ are abnormal in over 85% of cases with blastomycosis and histoplasma

A

CXR; diffuse miliary pattern of lungs

both can have lytic boney lesions with periosteal reaction

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18
Q

broad-based budding on cytology

A

blastomycosis

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19
Q

does itraconazole penetrate CNS

A

No!

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20
Q

tx for blasto

A

itraconazole

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21
Q

blastomycosis tx; tx for at least __ and continue for at least __ past resolution of CS/rads

A

2-3mo

1-2mo

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22
Q

the most common systemic fungal dz in cat

A

cryptococcus neoformans

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23
Q

extra-cellular, thin walled, narrow based budding yeast with thick capsule

A

cryptococcosis

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24
Q

crytpococcus has a world wide distribution but there are very high incidences of it in

A

the western US (CA) and E. australia

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25
found in bird excrement, rare in birds due to high BT, inhaled transmission, not contagious, common in cats and purebred dogs
cryptococcus
26
how does cryptococcus evade the host's IS
Polysaccaride capsule (prevents phagocytosis)
27
associated with FeLV/FIV in cats and chronic steroids in dogs
cryptococcus annimal on IS therapy more likely to get than FIV/FeLV animal
28
CS of cryptococcus in cat
sneezing, nasal d/c SC masses ocular lesions
29
CS of cryptococcus in dog
CNS signs (dull, blindness, hypermetria, CN defs), ocular lesions (chorioretinitis, retinal detach) skin lesions less common in dogs
30
best dx test for cryptococcus
skull rads/CT/MRI ; increased soft tissue in nasal cavity, lysis, deformity, contrast enhancing mass
31
EXAM: definitive dx for cryptococcus
latex agglutination for Ag in serum, aqueous humor, or CSF highly sensitive and specific, can quantify cytology
32
tx of cryptococcus
fluconazole preferred in cats (will penetrate CNS) itraconazole is good first choice for cases w/o CNS involvement very sick patient fluconazole + amphotericin B can monitor titers to assess tx
33
small INTRAcellular dimorphic fungus that has a halo and signet ring appearance with double ring, thick wall, and broad based budding
histoplasma capsulatum
34
subtrop/tropic climate, mississippi, missoouri, ohio river valley, CA, TX
histoplasma capsulatum | similar distribution to blastomycosis
35
primary reservoir organism for histoplasma
bat and decaying bird guano not found in fresh feces of birds!
36
more susceptible to histoplasma
cats, esp persians and cats coinfected with FeLV
37
histoplasma microconidias are inhaled and transform into yeast which binds to __
CD11-18 integrins on alveolar macs and are phagocytized replicate in macs, macs are destroyed, causes inflammation in lung can be spred systemically
38
subclinical infectious are common and most animals IS will effectively clear this infection
histoplasma
39
most common CS in dogs with histoplasma
large bowel diarrhea
40
most common CS in cats with histoplasma
profound wt. loss, fever, respiratory signs, GI dz (can dx off a rectal scrape)
41
best way to dx histoplasma
cytology! (can be confused with sporothrix ) - lung wash or rectal scrape best ag assay/ELISA (urine has higher sensitivity than serum). can cross react with blasto. AGAIN, NO CULTURE; Don't kill people
42
2 fungi that have common overlap in radiographic findings and geographic regions
blasto and histo
43
first choice tx for histoplasma
itraconazole
44
barrel shaped arthrospores in chains found in the soil, spherules with endospores in tissues
coccidiodes immitis
45
dry, warm climates, sandy soil, california, NM, arizona areas
coccidiodes immitis
46
on histopath of coccidiodes immitis what will you see
spherules surrounded by neuts/WBC
47
respiratory CS occur withing 3wk exposure and disseminated dz develops within __ exposure for coccidiodes
4mo
48
dog w fever, painful swollen bone lesions, and travel hx to Arizona
coccidiodes
49
most sensitive test for coccidiodes
ab serology (can't tell if active infection though, but if see on cytology then know it's an active infection) ag titer has very low sensitivity; not recommended
50
radiographic findings for coccidiodes
hilar lymphadenopathy on CXR | very proliferative bone lesions
51
tx for coccidiodes
amputation for severe osteomyelitis, enucleation, itraconazole
52
nasal aspergillosis causative agent? disseminated?
aspergillus fumigatus aspergillus terreus these are ubiquitous, opportunistic, saprophytic fungi
53
GSD are susceptible to aspergillosis bc of __ deficiency
IgA mucosal def
54
ag test for aspergillosis
aspergillus galactomannan ag (serum or urine) can have false positive w other mycotic infections (blasto, histo) or plasmalyte IVF
55
radiographic and AUS findings for aspergillus
diskospondylitis osteomyelitis thoracic lymphadenomegaly pelvic dilation in kidneys (AUS)
56
definitive dx for aspergillosis
culture and/or PCR
57
another fungus with similar CS to cryptococcus that occurs in cat nose
sporothrix schenckii
58
fungus that looks similar to histoplasmosis on cytology
sporothrix
59
potentially zoonotic fungus
sporothrix!
60
water molds that causes granulomatous and eosinophilic inflammation
pythium insidiosum and lagenidiosis sp.
61
large, infrequently septate hyphae with non parallel wall
pythium, lagenidiosis
62
how are oomycetes (water molds) different from fungi
cell wall lacks chitin and ergosterol (this is the target for most antifungal drugs!) diploid non-septate hyphae
63
eosinophilic pyogranulomatous inflammation
water molds! pythium and lagenidiosis
64
when ID a water mold it is important to do __ to determine prognosis and tx
PCR
65
Tx for water molds
aggressive sx excision | antifungals
66
insect killer fungi that are best dx on culture and tx with aggressive sx excision
basidiobolus and connidiobolus
67
patients on __ are predisposed to infections with these opportunistic fungi (phaeohyphomycosis, hyalohyphomycosis)
cyclosporine
68
__ is caused by pigmented fungi and __ is caused by nonpigmented fungi
phaeohyphomycosis (confined to skin and SC) | hyalohyphomycosis (local and systemic dz)
69
dark-walled, irregularly septate hyphae or yeast-like cells containing melanin
phaeohyphomycosis
70
non-pigmented, frequenly septate, branching hyphae that can cause disseminated dz
hyalohyphomycosis

SAM Exam 1 (15 decks)

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