What does this picture show?
a syncytia cell
a bunch of CD4 T helper cells that coalesced
eventually it will burst & release virions
**note all the nuclei!
What does this picture show? What is it a sign of?
Kaposi Sarcoma
a sign of a person with AIDS
usu a benign skin cancer
its presence signals immunodeficiency
What fungal cell morphology does this picture show?
blastoconidia formation. you see the budding formation!
Which fungal cell morphology does this pictures show?
This shows fission formation.
Which fungal cell morphology does this picture show?
pseudohyphae
elongation & then budding
see constriction, but not septum
Which fungal cell morphology does this picture show?
coenocytic hyphae
hollow & multinucleated
Which fungal cell morphology does this picture show?
septate hyphae
What type of asexual spore does this picture show? What features do you notice?
mucorales
note the sporangiospores
Which asexual spore does this picture show? Which features do you notice?
coccidioides immitis
note the arthroconidia
Which asexual spore does this picture show? Which features do you note?
Penicillium spp.
Conidia are present-these are the infectious particles
Which asexual spore does this picture show? Which features do you note?
aspergillus spp.
note the conidia
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
A. Conidia of Aspergillus Fumigatus
What dose this picture show?
blastomyces dermatitidis
you can see the budding yeast surrounded by neutrophils
What does this picture show? Which phase is this fungus in?
This pic shows histoplasma capsulatum in its saprobic phase. This shows a tuberculate macroconidia at 20 dC.
What does this picture show? Which phase is this fungus in?
coccidioides immitis in the lung (tissue, parasitic phase)
note the endosporulating spherules
What does this picture show? Which phase is this fungus in?
penicillium marneffei
in tissue (parasitic phase)
sausage-shaped yeast
What does this picture show? Which phase is this fungus in?
paracoccidioides brasiliensis
in tissue (parasitic phase)
large, multiple budding yeast
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
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.
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
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.
What does this picture show?
aspergillus fumigatus
with conidial heads
What does this picture show?
this shows vaginal candidiasis
Yeast-like forms with buds, pseudo-hyphae and germ tubes
What does this picture show?
cryptococcus neoformans
India ink negative stain of CSF
you see the large polysaccharide capsule
What does this picture show?
this shows rhinocerebral mucormycosis
aseptate coenocytic hyphae
What does this picture show?
pneumocystis jirovecii
cysts seen as empty, collapsed balls
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
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.
What condition does this picture show?
oral candidiasis
What does this picture show?
this is KOH mount of oral candidiasis
shows budding yeast & pseudohyphae
What does this picture show?
gram stain of vaginal candidiasis
shows budding yeasts, pseudohyphae
epithelial cells
gram negative rods
What does this picture show?
candida esophagitis
seen a lot in AIDS patients
this is a methylamine silver stain
What does this picture show?
this shows candida germ tubes
they are grown in serum
What does this picture show?
CHROMagar Candida
note that different species of candida show up as different colors
WHat does this picture show?
pulmonary aspergillosis
What does this picture show?
aspergillum
note the conidiophores & conidia
What does this picture show?
periorbital mucormycosis
may have begun as a sinus infection
What does this pic show?
mucorales in tissue
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
D. Invasive Pulmonary Aspergillosis. Note the branching septate hyphae
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
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
