Respiratory Fungal Infections (3)-Leah Flashcards Preview

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In terms of fungi, what does dimorphic mean?

What do dimorphic fungi cause (in terms of the pulmonary system)

MOLD in the COLD (25C)
Yeast in the heat (37 C)

Acute pulm infection --> chronic granulomas
Or miliary disease. Similar to TB.


What areas of the body does blastomycosis effect?

Bone Lungs And Skin


How to distinguish Histo and Blasto?
Why do you need to distinguish them?

Blasto = "Broad Based Budding" yeast (B= BBB) on KOH

Histo= inside macrophages/ histiocytes on enzyme immunoassay

*They have similar endemic areas (BOTH Midwest, SE US)*


How does acute Blasto pneumonia present?

Blasto mimics Bacteria acutely. (Consolidated lobe).
Mimics TB/cancer chronically.

....I'm not sure that this is specific to Blasto. But she mentioned it here. All dimorphic fungi can cause granulomas.


What animals spread histo?

Birds and bats
*may get a vignette about spelunking on step.....*


DOC for disseminated fungi?
DOC for localized fungi infection?

--according to first aid--

Systemic: give amp B, note that it may cause drug induced fever
Local: give --Azoles


Rare severe outcomes of Histo

-ARDS, inflammatory sequelae, mediastinal fibrosis


Area, time of peak incidence

South west; esp Arizona
Incidence increases during EARTH QUAKE
(Earth quake = in Rx vignette)


Appearance of coccidiomycosis?

Big Spherules full of endospores on Saburaud agar at 37 C.

This was an Rx question.


Coccidiomycosis symptomatic presentation?
Special populations effected?

"Great imitator"
Commonly self limited but can actually go to any part of the body. Might be mistaken for toxo, syphillis, others.

-more common in males, Immunocompromised, preggos, certain ethnicities (Hispanic, AA, Filipino etc)


Paracoccidiosis micro appearance &; location

"Captains wheel"; South America


Paracoccidiomycosis symptomatic presentation?

Painful lesions at mucous membranes, lung, skin

*Will spread if left all of the dimorphic fungi. (But she decided to "say" that here.)


Penecillin Marneffei is a dimorphic yeast that effects what patients? What might it mimic?

AIDS patients;
TB, Histo, leishmaniasis, toxo


Three "opportunistic" fungi and what do they look like?
(They USE these buzzwords for presentation on Rx!!!!)

-aspergillosis (septate hyphae branching at Acute Angles = 45 degrees!!)
-pneumocystis (cup shaped)
-cryptococcosis: round lesions with clear halo on INDIA INK.