Pictures

Question 1

What does this picture show?

Answer 1

a syncytia cell

a bunch of CD4 T helper cells that coalesced

eventually it will burst & release virions

**note all the nuclei!

Question 2

What does this picture show? What is it a sign of?

Answer 2

Kaposi Sarcoma

a sign of a person with AIDS

usu a benign skin cancer

its presence signals immunodeficiency

Question 3

What fungal cell morphology does this picture show?

Answer 3

blastoconidia formation. you see the budding formation!

Question 4

Which fungal cell morphology does this pictures show?

Answer 4

This shows fission formation.

Question 5

Which fungal cell morphology does this picture show?

Answer 5

pseudohyphae

elongation & then budding

see constriction, but not septum

Question 6

Which fungal cell morphology does this picture show?

Answer 6

coenocytic hyphae

hollow & multinucleated

Question 7

Which fungal cell morphology does this picture show?

Answer 7

septate hyphae

Question 8

What type of asexual spore does this picture show? What features do you notice?

Answer 8

mucorales

note the sporangiospores

Question 9

Which asexual spore does this picture show? Which features do you notice?

Answer 9

coccidioides immitis

note the arthroconidia

Question 10

Which asexual spore does this picture show? Which features do you note?

Answer 10

Penicillium spp.

Conidia are present-these are the infectious particles

Question 11

Which asexual spore does this picture show? Which features do you note?

Answer 11

aspergillus spp.

note the conidia

Question 12

The patient is a 46-year-old woman who recently received a hematopoietic stem cell transplant. Several days after the transplant, she developed cough, shortness of breath, and persistent fever despite antibacterial therapy. Culture of bronchoalveolar lavage fluid grew the fungus shown below. What is the term for the structure identified by the arrows?

A) Conidia

B) Arthroconidia

C) Sporangiospores

D) Pseudohyphae

E) Coenocytic hyphae

Answer 12

A. Conidia of Aspergillus Fumigatus

Question 13

What dose this picture show?

Answer 13

blastomyces dermatitidis

you can see the budding yeast surrounded by neutrophils

Question 14

What does this picture show? Which phase is this fungus in?

Answer 14

This pic shows histoplasma capsulatum in its saprobic phase. This shows a tuberculate macroconidia at 20 dC.

Question 15

What does this picture show? Which phase is this fungus in?

Answer 15

coccidioides immitis in the lung (tissue, parasitic phase)

note the endosporulating spherules

Question 16

What does this picture show? Which phase is this fungus in?

Answer 16

penicillium marneffei

in tissue (parasitic phase)

sausage-shaped yeast

Question 17

What does this picture show? Which phase is this fungus in?

Answer 17

paracoccidioides brasiliensis

in tissue (parasitic phase)

large, multiple budding yeast

Question 18

A 27-year-old man from Mexico with newly diagnosed AIDS presents to the clinic with 4 weeks of fever, chills, night sweats, myalgias, dry cough, nausea, vomiting, and diarrhea. He recently had a negative tuberculin skin test. He is initially treated for presumptive Pneumocystis pneumonia and atypical pneumonia. Two weeks later, however, fungal blood cultures show growth of hyphal elements shown in the figure. What is the diagnosis?

A) Disseminated blastomycosis

B) Disseminated histoplasmosis

C) Disseminated coccidoiodomycosis

D) Mycobacterium avium complex (MAC)

E) Disseminated Acinetobacter baumanii

Answer 18

B. Disseminated histoplamosis. The figure shows the tuberculate macroconidia of Histoplasma capsulatum when the fungus is grown at room temperature. Tissue or growth at 37°C would show small budding yeast. The fungus is endemic in the Ohio and Mississippi river valleys, Mexico and Central and Southern America.

Question 19

A 71-year-old Chinese male was admitted with complaint of chronic cough, malaise and transient low-grade fever. The patient received a procedure of right middle lobe and lower lobectomy. Histopathology and results of culture at room temperature are shown. It is likely that a travel history would show that the patient had visited the following region of the U.S.

A) New England

B) Florida

C) Ohio river valley

D) Desert southwest

E) Pacific northwest

Answer 19

The histopathology and culture show, respectively, the spherules and arthoconidia of Coccidioides immitis. C. immitis is endemic in Southwestern U.S., Mexico, and Central and South America.

Question 20

What does this picture show?

Answer 20

aspergillus fumigatus

with conidial heads

Question 21

What does this picture show?

Answer 21

this shows vaginal candidiasis

Yeast-like forms with buds, pseudo-hyphae and germ tubes

Question 22

What does this picture show?

Answer 22

cryptococcus neoformans

India ink negative stain of CSF

you see the large polysaccharide capsule

Question 23

What does this picture show?

Answer 23

this shows rhinocerebral mucormycosis

aseptate coenocytic hyphae

Question 24

What does this picture show?

Answer 24

pneumocystis jirovecii

cysts seen as empty, collapsed balls

Question 25

The patient is a 32-year-old male who presents with headache, fever, cranial nerve palsies, memory loss and lethargy over several weeks. A lumbar puncture was done. CSF analysis showed lymphocytic pleocytosis, decreased glucose and slightly elevated protein. A stain of CSF is shown. What is the most likely cause of this patient’s infection? A. Cryptococcus neoformans B. Mycobacterium tuberculosis B. Nocardia asteroides D. Staphylococcus aureus E. Listeria monocytogenes

Answer 25

A. This is an India ink negative stain that shows the capsule of Cryptococcus neoformans. The other microbes are bacteria that lack capsules and would not show the budding seen in the image.

Question 26

What condition does this picture show?

Answer 26

oral candidiasis

Question 27

What does this picture show?

Answer 27

this is KOH mount of oral candidiasis shows budding yeast & pseudohyphae

Question 28

What does this picture show?

Answer 28

gram stain of vaginal candidiasis shows budding yeasts, pseudohyphae epithelial cells gram negative rods

Question 29

What does this picture show?

Answer 29

candida esophagitis seen a lot in AIDS patients this is a methylamine silver stain

Question 30

What does this picture show?

Answer 30

this shows candida germ tubes they are grown in serum

Question 31

What does this picture show?

Answer 31

CHROMagar Candida note that different species of candida show up as different colors

Question 32

WHat does this picture show?

Answer 32

pulmonary aspergillosis

Question 33

What does this picture show?

Answer 33

aspergillum note the conidiophores & conidia

Question 34

What does this picture show?

Answer 34

periorbital mucormycosis may have begun as a sinus infection

Question 35

What does this pic show?

Answer 35

mucorales in tissue

Question 37

The patient is a 43-year-old woman who became severely neutropenic during the course of chemotherapy for treatment of breast cancer. She developed cough, chest pain, shortness of breath and had a persistent fever despite conventional antibiotic therapy. Results of a lung biopsy are shown below. What is the diagnosis? A)Pulmonary blastomycosis B)Chronic pulmonary histoplasmosis C)Pulmonary tuberculosis D)Invasive pulmonary aspergillosis E)Progressive pulmonary coccidioidomycosis

Answer 37

D. Invasive Pulmonary Aspergillosis. Note the branching septate hyphae

Question 38

A 12-year-old girl received aggressive chemotherapy for acute lymphoblastic leukemia. Four weeks after initiation of therapy, she presented with signs, symptoms and radiological evidence of brain abscess. A craniotomy and biopsy were done. Histopathology showed the presence of broad, largely aseptate hyphae. Culture grew the organism shown below. What is the best antifungal for treatment of this infection? A)Ketoconazole B)Fluconazole C)Caspofungin D)Amphotericin B E)Flucytosine

Answer 38

D. Amphotericin B. She has cerebral mucormycosis the pic shows sporangiospores characteristic of mucorales drug of choice for this is amphotericin B b/c the bug is intrinsically resistant to all other antifungals