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Mycology and Virology > SUBCUTANEOUS MYCOSES > Flashcards

SUBCUTANEOUS MYCOSES Flashcards

1
Q

◦Etiologic agents are found as (?) usually native to the soil, on plants, and in decaying vegetation and
wood.

A

saprobes

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2
Q

◦Infections can usually be traced to (?)

A

traumatic inoculation

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3
Q

◦Typical patient works outdoors, usually (?), in shorts and other lightweight clothing that provides
little protection

A

without shoes

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4
Q

◦ Occurring months or years before the lesion appears

A

SUBCUTANEOUS MYCOSES

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5
Q

◦Chronic, localized infections of skin and subcutaneous tissue, and adjacent lymphatics

A

SUBCUTANEOUS MYCOSES

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6
Q

SUBCUTANEOUS MYCOSES Caused by

A

traumatic implantation of etiologic agent

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7
Q

◦Usually remain localized to the subcutaneous tissue or may spread to local nodes through the (?)

A

lymphatics

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8
Q

◦Usually of (?) – has to enter the subcutaneous tissue in order to cause disease

A

low virulence

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9
Q

◦Most frequently seen in residents of (?)

A

tropics and subtropics

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10
Q

◦Fungi are capable of producing (?) which will ulcerate

A

nodules

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11
Q

◦Spread the (?) to the lymph channels, producing more nodules

A

etiologic agent

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12
Q

◦Such nodules may drain into the skin’s surface, leading to (?)

A

secondary bacterial infections

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13
Q

◦For diagnosis, the fungus must be seen in (?) and the fungal morphology must be consistent with the patient’s symptoms

A

specimens or lesions

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14
Q

◦Combination of (?) may
be indicated for therapy.

A

drugs and surgical intervention

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15
Q

4 kinds of infection

A
  1. Mycetoma
  2. Sporotrichosis
  3. Chromoblastomycosis
  4. Phaeohyphomycosis
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16
Q

Tumefaction,
draining sinuses

A

Mycetoma

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17
Q

Granules

A

Mycetoma

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18
Q

No, localized

A

Mycetoma

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19
Q

Ulcers and smooth,
painless nodules

A

Sporotrichosis

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20
Q

Asteroid bodies

A

Sporotrichosis

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21
Q

Spreads along
lymphatic
channels

A

Sporotrichosis

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22
Q

Warty crusted
nodules,
microabscesses

A

Chromomycosis

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23
Q

Sclerotic bodies

A

Chromomycosis

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24
Q

Possible

A

Chromomycosis & Phaeohyphomycosis

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25
Q

Diverse symptoms

A

Phaeohyphomycosis

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26
Q

No specific
element

A

Phaeohyphomycosis

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27
Q

◦Chronic granulomatous infection

A

MYCETOMA

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28
Q

◦Lower limbs are most commonly affected

A

MYCETOMA

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29
Q

→ caused by an actinomycete
◦Nocardia, Actinomadura, Streptomyces, Actinomyces

A

ACTINOMYCETOMA

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30
Q

→mycetoma caused by a fungus
◦Pseudallescheria boydii, Madurella spp., Exophiala
jeanselmei, Acremonium spp., Fusarium spp., Curvularia
spp. and occasionally other moulds

A

EUMYCETOMA (Maduromycosis, Madura foot)

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31
Q

MYCETOMA ETIOLOGIC AGENTS:

A

◦ Eumycetoma (40%)
◦ Actinomycotic mycetoma (60%)

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32
Q

◦ Madurella mycetomatis (most cases,
in arid regions)

A

Eumycetoma (40%)

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33
Q

◦ Madurella grisea (South America and India)

A

Eumycetoma (40%)

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34
Q

◦ Pseudallescheria boydii and
Scedosporium apiospermum (US)

A

Eumycetoma (40%)

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35
Q

◦ Nocardia brasiliensis

A

Actinomycotic mycetoma (60%)

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36
Q

◦ A clinical syndrome characterized by
localized, swollen lesions of cutaneous and subcutaneous tissues with later
involvement of muscle and bone

A

MYCETOMA

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37
Q

◦ Triad of symptoms

A
  1. Tumefaction
  2. Draining sinus tracts
  3. Discharging grains/Granules (300 mm-5mm)
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38
Q

◦ Combination of microcolonies of the causative organism and proteinaceous materials from the host

A

Grains

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39
Q

Granules (white, yellow or red)

A

Actinomycotic
Mycetoma

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40
Q

◦ Narrow (1 um or less in diameter) intertwined filaments

A

Actinomycotic
Mycetoma

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41
Q

◦ Radially oriented

A

Actinomycotic
Mycetoma

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42
Q

◦ Most numerous at the edge of the granule

A

Actinomycotic
Mycetoma

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43
Q

◦ Nocardia → partially acid fast

A

Actinomycotic
Mycetoma

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44
Q

◦ Actinomadura and Streptomyces → not acid-fast

A

Actinomycotic
Mycetoma

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45
Q

◦ All are gram-positive

A

Actinomycotic
Mycetoma

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46
Q

◦ Stain well with GMS & Giemsa but not with H&E , PAS or Gridley
fungus

A

Actinomycotic
Mycetoma

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47
Q

◦Granules (white, yellow brown or black )

A

EUMYCOTIC MYCETOMA

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48
Q

◦ Contain septate, variously shaped, somewhat distorted hyphae (2 – 6 um in diameter)

A

EUMYCOTIC MYCETOMA

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49
Q

◦ Accompanied by numerous chlamydoconidia and swollen cells

A

EUMYCOTIC MYCETOMA

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50
Q

◦ Fungal forms are most commonly visible at the periphery of the granule

A

EUMYCOTIC MYCETOMA

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51
Q

Histopathologic appearance of “?” due to Madurella mycetomatis using a
Gridley stain

A

black grain mycetoma

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52
Q

H&E STAINED TISSUE
SECTION SHOWING
BLACKED GRAINED
EUMYCOTIC MYCETOMA
CAUSED BY

A

Madurella
mycetomatis.

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53
Q

Red

A

Actinomadura pelletieri

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54
Q

Soft to hard

A

Actinomadura pelletieri

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55
Q

White

A

Nocardia brasiliensis, Acremonium falciforme & Pseudallescheria boydii

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56
Q

Soft

A

Nocardia brasiliensis, Acremonium falciforme, & Pseudallescheria boydii

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57
Q

Yellow

A

Streptomyces somaliensis

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58
Q

Hard

A

Streptomyces somaliensis & Madurella spp

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59
Q

Black

A

Exophiala jeanselmei & Madurella spp.

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60
Q

Brittle

A

Exophiala jeanselmei

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61
Q

White to Yellow grain species

A

HYALINE FUNGI

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62
Q

Black grain species

A

DEMATIACEOUS FUNGI

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63
Q

HYALINE FUNGI

A

Pseudallescheria boydii
Fusarium species
Acremonium species

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64
Q

DEMATIACEOUS FUNGI

A

Exophiala jeanselmei
Madurella mycetomatis
Madurella grisea
Phialophora verrucosa
Curvularia species

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65
Q

◦ Anamorph: Scedosporium apiospermum
: Graphium species

A

Pseudallescheria boydii

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66
Q

◦ Colony appear white
and fluffy becoming
brownish brown to black, reverse is gray
to black.

A

Pseudallescheria boydii

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67
Q

• Produces both sexual and asexual conidia in culture

A

Pseudallescheria boydii

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68
Q

• Walls are composed of 2-3 layers of septate hyphae

A

Pseudallescheria boydii

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69
Q

• “Cleistothecia” (Sexual ascocarps)

A

Pseudallescheria boydii

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70
Q

• 50-200mm, dark-brown to black

A

Pseudallescheria boydii

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71
Q

• Clavate to subglobose asci(contain up to 8 ascospores)

A

Pseudallescheria boydii

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72
Q

◦ Single, lemon-shaped annelloconidia

A

Anamorphs: Scedosporium
apiospermum

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73
Q

◦ “Synnemata”

A

Anamorphs: Scedosporium
apiospermum

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74
Q

◦(bundles or tufts of conidiophores

A

Anamorphs: Scedosporium
apiospermum

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75
Q

DIAGNOSIS OF MYCETOMA
◦ Specimens:

A

◦ Aspiration (best)
◦ Drainage
◦ Tissue biopsy / section

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76
Q

DIAGNOSIS OF MYCETOMA
◦Examination of grains

A

◦ Size, color, texture, consistency

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77
Q

DIAGNOSIS OF MYCETOMA
◦Direct microscopic examination

A

◦ 10% KOH
◦ LPCB

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78
Q

DIAGNOSIS OF MYCETOMA
◦Culture

A

◦ Standard mycological media or aerobic/anaerobic
bacterial culture condition

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79
Q

is difficult due to inability of drugs to infiltrate lesions, combination of medicine and surgery is the best

A

Treatment

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80
Q

◦Eumycotic mycetoma:

A

Amphotericin B

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81
Q

◦Actinomycotic mycetoma:

A

Antibiotics

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82
Q

diseases of Sporotrichosis

A

oBeurmann’s disease
oRose gardener’s disease
oSchenck’s disease

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83
Q

◦Chronic infection characterized by nodular lesions of
the cutaneous & subcutaneous tissues and adjacent
lymphatics

A

Sporotrichosis

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84
Q

Sporotrichosis
◦Etiologic agent:

A

Sporothrix schenckii

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85
Q

Dimorphic fungus common in soil worldwide

A

Sporotrichosis

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86
Q

Sporotrichosis
oEcologic niche:

A

Thorny plants, splinters, sphagnum
moss, hay

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87
Q

Sporotrichosis
oTransmission:

A

oPenetrating injury or scratch with plant material or
soil-contaminated object
oRarely through inhalation of conidia
oScratch or bite from an infected domestic cat

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88
Q

Sporotrichosis
oRisk groups/Factors:

A

oGardeners
oPlant nursery workers
oAgricultural workers
oChildren (in highly endemic areas)
oCat owners and veterinarians

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89
Q

▪ Primary lesions develop at the site of
implantation

A

Fixed cutaneous sporotrichosis

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90
Q

▪ Limbs, hands , Fingers

A

Fixed cutaneous sporotrichosis

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91
Q

▪ May heal spontaneously with scarring

A

Fixed cutaneous sporotrichosis

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92
Q

◦
Primary lesions develop at the site of implantation

A

Lymphocutaneous sporotrichosis

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93
Q

◦
Most common

A

Lymphocutaneous sporotrichosis

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94
Q

◦
secondary lesions also appear along the lymphangitic channels

A

Lymphocutaneous sporotrichosis

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95
Q

◦No systemic symptoms are present

A

Lymphocutaneous sporotrichosis

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96
Q

 typically elevated subcutaneous nodules

A

Lymphocutaneous sporotrichosis

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97
Q

 regional lymphatics of the forearm

A

Lymphocutaneous sporotrichosis

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98
Q

◦Osteoarticular

A

Extracutaneous

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99
Q

◦Pulmonary

A

Extracutaneous

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100
Q

◦Eyes

A

Extracutaneous

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101
Q

◦Meningeal forms

A

Extracutaneous

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102
Q

◦ inhalation of conidia

A

Pulmonary sporotrichosis

103
Q

◦ hematogenous dissemination

A

Pulmonary sporotrichosis

104
Q

Pulmonary sporotrichosis
◦ Symptoms are non-specific

A

• sputum production
• fever, weight loss and upper-lobe lesion

105
Q

• Hemoptysis:

A

massive and fatal.

106
Q

 Lung lesion:

A

gradual progression to death

107
Q

◦ cutaneous lesions

A

Osteoarticular sporotrichosis

108
Q

◦ stiffness and pain in a large joint

A

Osteoarticular sporotrichosis

109
Q

• Knee, elbow, ankle, wrist

A

Osteoarticular sporotrichosis

110
Q

: seldom occurs without
arthritis

A

Osteomyelitis

111
Q

◦ lesions usually confined to the long bones near affected joints

A

Osteoarticular sporotrichosis

112
Q

◦ Multiple dispersed lymphocutaneous lesions and/or visceral
dissemination

A

Disseminated sporotrichosis

113
Q

Sporotrichosis
◦ Increased risk for:

A

◦ People living with AIDS (PLWA)
◦ Diabetes
◦ Alcoholism
◦ Sarcoidosis
◦ Long-term corticosteroid therapy and TNF-a antagonists

114
Q

biopsy material or exudate from
granulomatous or ulcerative lesions

A

Clinical material

115
Q

Tissue sections

A

Direct Microscopy

116
Q

◦ Directly with KOH or calcofluor white stain

A

Direct Microscopy

117
Q

◦ GMS→ black cell walls

A

Direct Microscopy

118
Q

◦ Periodic acid Schiff stain → red cell walls

A

Direct Microscopy

119
Q

◦ Fluorescent Ab stain

A

Direct Microscopy

120
Q

Approximately star-shaped w/ rays of eosinophilic materials radiating from a central yeast-like cell

A

Asteroid bodies

121
Q

◦ Lymphocutaneous sporotrichosis

A

Asteroid bodies

122
Q

◦ Most reliable method of diagnosis

A

Culture

123
Q

◦Inhibitory mold agar

A

Culture

124
Q

◦ Saboraud’s agar containing antibiotics

A
125
Q

◦ Grown at 25 – 30C

A

Culture

126
Q

◦ID is confirmed by growth at 35C and conversion to the yeast
form

A

Culture

127
Q

◦ Low limited value

A

Serology

128
Q

◦ Agglutination of yeast cell suspensions or of latex particles
coated with antigen

A

Serology

129
Q

◦ Sera of infected patients with high titer

A

Serology

130
Q

◦ itraconazole

A

Cutaneous lesions

131
Q

◦ terbinafine

A

Cutaneous lesions

132
Q

◦ Local heat has also been shown to improve cutaneous
lesions

A

Cutaneous lesions

133
Q

◦ combination of antifungal treatment with Amphotericin B or
itraconazole

A

Extracutaneous forms

134
Q

◦ with surgical debridement

A

Extracutaneous forms

135
Q

: saturated solution of potassium
iodide

A

Second-line therapy

136
Q

– (mould) young colonies are cream to white with a
glabrous texture.

A

Colony

137
Q

May develop dark pigment as they age.

A

Sporothrix schenckii

138
Q

◦ Mature colonies are flat, leathery to velvety and black with
black reverse pigments.

A

Sporothrix schenckii

139
Q

Sporothrix schenckii
◦ Yeast form resembles (?)

A

Candida albicans

140
Q

◦ Pigments are white, beige or tan.

A

Sporothrix schenckii

141
Q

Sporothrix schenckii
Identification:

A

•
Hyphomycete
•
thermal dimorphism
•
clusters of ovoid,
denticulate conidia

142
Q

Sporothrix schenckii
◦ (?) – delicate, septate hyphae with small, clear pyriform conidia which may surround the tip of the conidiophore to form a rosette

A

Microscopic

143
Q

◦ Characterized by verrucoid crusted lesions on the skin

A

Chromoblastomycosis

144
Q

◦ If not treated, will elevate to resemble cauliflower (w/
cayenne pepper)

A

Chromoblastomycosis

145
Q

Chromoblastomycosis
◦ Causative agents:

A

◦ Phialophora verrucosa
◦ Fonsecaea pedrosoi
◦ Fonsecaea compacta
◦ Cladophialophora carrionii

146
Q

◦ development in tissue

A

Chromoblastomycosis

147
Q

◦ dematiaceous (brown-pigmented/copper)

A

Chromoblastomycosis

148
Q

◦ MOT: traumatic implantation of fungal elements into the skin

A

Chromoblastomycosis

149
Q

CHROMOBLASTOMYCOSIS
◦ Similar in their:

A

◦ Pigmentation
◦ Antigenic structure
◦ Morphology
◦ Physiologic properties

150
Q

CHROMOBLASTOMYCOSIS
◦ Colonies

A

◦ Compact, deep brown to black, develop a
velvety, often wrinkled surface

151
Q

CHROMOBLASTOMYCOSIS
◦ In tissue: appear the same → producing spherical brown cells (4 – 12 mm) termed (?) which divide by transverse septation

A

MURIFORM or SCLEROTIC BODIES

152
Q

Phialophora verrucosa
◦ (?) : produced from flask-shaped phialides with cup-shaped collarettes

A

Conidia

153
Q

◦ Mature, spherical to oval conidia are extruded from the phialide and usually accumulate around it

A

Phialophora verrucosa

154
Q

◦ Produce branching chains of conidia by distal (acropetalous) budding

A

Cladophialophora (Cladosporium) carrionii

155
Q

◦ Terminal conidium of a chain gives rise to the next conidium by a budding process

A

Cladophialophora (Cladosporium) carrionii

156
Q

Cladophialophora (Cladosporium) carrionii
◦ Species are identified based on (?)

A

DIFFERENCES IN THE LENGTH OF THE CHAINS AND THE SIZE AND SHAPE OF CONIDIA

157
Q

◦ (?) : elongated conidiophores with long, branching chains of oval
conidia

A

C. carrionii

158
Q

◦ Produces lateral or terminal conidia from a lengthening conidiogenous cell → a sympodial process

A

Rhinocladiella aquaspersa

159
Q

◦ Conidia are elliptical to clavate

A

Rhinocladiella aquaspersa

160
Q

◦ Polymorphic genus

A

Fonsecaea pedrosoi

161
Q

Fonsecaea pedrosoi
◦ Isolates may exhibit:

A

(1) phialides, (2) chains of blastoconidia, (3)
sympodial, rhinocladiella-type conidiation

162
Q

◦ Blastoconidia are almost spherical, with a broad base connecting the
conidia

A

Fonsecaea compacta

163
Q

◦ Smaller and more compact than those of F. pedrosoi

A

Fonsecaea compacta

164
Q

◦ (?): becomes verrucous and wart-like with extension along the draining lymphatics

A

Primary lesion

165
Q

◦ (?) nodules with crusting abscesses eventually cover the area

A
166
Q

◦ Small ulcerations or “(?)” of hemopurulent material
are present on the warty surface

A

black dots

167
Q

◦ (?) to other parts of the body is rare

A

Dissemination

168
Q

◦ (?) can occur due to either local lymphatic spread or to autoinoculation

A

Satellite lesions

169
Q

◦ (?) are granulomatous and the dark sclerotic bodies may
be seen within leukocytes or giant cells

A

Lesions

170
Q

(?): Skin scrapings and/or biopsy

A

Clinical Material

171
Q

Direct Microscopy: Skin scrapings:

A

◦ 10% KOH and Parker ink
◦ calcofluor white mounts

172
Q

◦ Stains:

A

◦ H & E
◦ PAS digest
◦ Grocott’s methenamine silver (GMS)

173
Q

◦ Dark brown sclerotic cells which divide by binary fission and not by budding

A

CHROMOBLASTOMYCOSIS

174
Q

◦ sclerotic bodies in tissue

A

CHROMOBLASTOMYCOSIS

175
Q

◦ (?) is the only reliable means of distinguishing these fungi

A

Culture ID

176
Q

◦ primary isolation media: (?)

A

SDA

177
Q

◦ clinical history
◦ direct microscopic

A

◦ Interpretation

178
Q

◦ Flucytosine (w/ or w/o thiabendazole)
◦ itraconazole
◦ terbinafine

A

Management

179
Q

◦(?): margin of uninfected tissue

A

surgical excision

180
Q

◦ Colony – olive-green to olive-gray to black with jet black
reverse pigment. Surface is spreading and flat with velvety or
woolly texture.

A

Fonsecaea pedrosoi

181
Q

◦ Microscopic – dark brown, branching hyphae

A

Fonsecaea pedrosoi

182
Q

◦Infections characterized by the presence of darkly
pigmented septate hyphae in tissue

A

PHAEOHYPHOMYCOSIS

183
Q

◦Both cutaneous and systemic infections have been
described

A

PHAEOHYPHOMYCOSIS

184
Q

◦Clinical forms vary from solitary encapsulated cysts in
the subcutaneous tissue to sinusitis to brain abscess

A

PHAEOHYPHOMYCOSIS

185
Q

◦Over 100 species of dematiaceous molds

A

PHAEOHYPHOMYCOSIS

186
Q

◦Exogenous molds normally existing in nature

A

PHAEOHYPHOMYCOSIS

187
Q

PHAEOHYPHOMYCOSIS
◦ More common causes:

A

◦ Exophiala jeanselmei
◦ Phialophora richardsiae
◦ Bipolaris spicifera
◦ Wangiella dermatitidis

188
Q

◦ In tissue: hyphae are large (5 – 10 mm) in diameter

A

PHAEOHYPHOMYCOSIS

189
Q

◦ Distorted and may be accompanied by yeast cells

A

PHAEOHYPHOMYCOSIS

190
Q

◦ Presence of melanin in their cell walls

A

PHAEOHYPHOMYCOSIS

191
Q

◦ Specimens are cultured in routine fungal
media

A

PHAEOHYPHOMYCOSIS

192
Q

PHAEOHYPHOMYCOSIS
◦ (?) is the drug of
lchoice

A

Itraconazole or flucytosine

193
Q

◦ MOT: traumatic implantation of fungal elements
(contaminated soil, thorns or wood splinters

A

Subcutaneous phaeohyphomycosis

194
Q

Subcutaneous phaeohyphomycosis
◦ Most common agents:

A

Exophiala jeanselmei and
Wangiella dermatitidis

195
Q

◦ cystic lesions

A

Subcutaneous phaeohyphomycosis

196
Q

◦ overlying verrucose lesions

A

Subcutaneous phaeohyphomycosis

197
Q

◦immunosuppressed patient

A

Subcutaneous phaeohyphomycosis

198
Q

Paranasal sinus phaeohyphomycosis:
◦ Sinusitis

A

◦ Bipolaris
◦ Exserohilum
◦ Curvularia

199
Q

◦ patients with a history of allergic rhinitis

A

Alternaria

200
Q

◦ immunosuppression.

A

Alternaria

201
Q

Bipolaris
◦ Teleomorph:

A

Cochliobolus sp

202
Q

Bipolaris
◦ Colonies

A

◦ moderately fast growing
◦ Effuse, grey to blackish brown, suede-like to floccose with a
black reverse

203
Q

Bipolaris
◦ Microscopic morphology

A

◦sympodial development of pale brown pigmented,
pseudoseptate conidia

204
Q

Bipolaris
◦ Conidia

A

◦straight, fusiform to ellipsoidal, rounded at both ends, smooth to
finely roughened and germinating only from the ends (bipolar)

205
Q

◦ Rapid grower

A

CURVULARIA
Microscopic Features

206
Q

◦ woolly colonies on PDA at 25°C

A

CURVULARIA
Microscopic Features

207
Q

◦colony is white to pinkish gray initially and turns to olive
brown or black as the colony matures

A

CURVULARIA
Microscopic Features

208
Q

◦reverse is dark brown to black

A

CURVULARIA
Microscopic Features

209
Q

◦ Dematiaceous hyphae

A

CURVULARIA
Microscopic Features

210
Q

◦ Conidiophores are simple or branched and are bent at the
points where the conidia originate

A

CURVULARIA
Microscopic Features

211
Q

◦ Darkly pigmented, multicellular poroconidia (or conidia)
with traverse septa, producing whorls

A

CURVULARIA
Microscopic Features

212
Q

◦ Large dark conidia with darker
swollen central cells, resembling a
crescent roll/ curved appearance

A

CURVULARIA
Microscopic Features

213
Q

◦ Rapid grower

A

ALTERNARIA
Macroscopic Features

214
Q

◦ The colony is flat, downy to woolly and is covered by grayish,
short, aerial hyphae.

A

ALTERNARIA
Macroscopic Features

215
Q

◦ Dark brown or dark green colony
with a white fringe

A

ALTERNARIA
Macroscopic Features

216
Q

◦reverse is typically brown to black

A

ALTERNARIA
Macroscopic Features

217
Q

◦conidia may be observed singly or in acropetal
chains and may produce germ tubes

A

ALTERNARIA
Microscopic Features

218
Q

◦ovoid, darkly pigmented, muriform, smooth or
roughened.

A

ALTERNARIA
Microscopic Features

219
Q

◦large, club shaped, and beaked

A

ALTERNARIA
Microscopic Features

220
Q

◦
rare infection

A

Cerebral phaeohyphomycosis

221
Q

◦
immunosuppressed patients following the inhalation of
conidia

A

Cerebral phaeohyphomycosis

222
Q

◦
fungus is neurotropic

A

Cerebral phaeohyphomycosis

223
Q

◦
dissemination to sites other than the CNS is rare

A

Cerebral phaeohyphomycosis

224
Q

◦
Cladophialophora bantiana

A

Cerebral phaeohyphomycosis

225
Q

➢ chronic, localized, sub epidermal infection

A

Lobomycosis (Lacaziosis/ Keloidal
blastomycosis or Lobo’s disease)

226
Q

➢ keloidal, verrucoid, nodular lesions

A

Lobomycosis (Lacaziosis/ Keloidal
blastomycosis or Lobo’s disease)

227
Q

➢ vegetating crusty plaques and tumours

A

Lobomycosis (Lacaziosis/ Keloidal
blastomycosis or Lobo’s disease)

228
Q

➢ Lacazia loboi formerly known as Loboa loboi

A

Lobomycosis (Lacaziosis/ Keloidal
blastomycosis or Lobo’s disease)

229
Q

Clinical material:
◦ Curettage
◦ Surgical biopsy

A

Lobomycosis

230
Q

Direct Microscopy:
◦ 10% KOH & Parker ink or calcofluor
white

A

Lobomycosis

231
Q

Stains:
▪ PAS digest, Grocott’s methenamine
silver (GMS) or Gram stains.

A

Lobomycosis

232
Q

GMS stained tissue specimen showing numerous darkly
pigmented yeast-like cells:

A

9-12 um

233
Q

Lobomycosis
Culture: (?) remains to be cultured

A

Lacazia loboi

234
Q

Serology: There are currently no serological tests available

A

Lobomycosis

235
Q

Identification:
◦ Clinical features
◦ geographic location
◦ microscopic morphology

A

Lobomycosis

236
Q

Lobomycosis
Management:
◦ Clofazimine at (?)

A

100-200 mg/day

237
Q

◦ Once considered a fungi but is now
classified under kingdom Protista.

A

Rhinosporidium seeberi

238
Q

◦ responsible for rhinosporidiosis.

A

Rhinosporidium seeberi

239
Q

◦ infects the mucosa of the nasal
cavity producing a mass like lesion
with a granular surface speckled with
whitish spores.

A

Rhinosporidium seeberi

240
Q

◦ can also affect the lacrimal gland
and also rarely the skin and genitalia

A

Rhinosporidium seeberi

241
Q

◦ classically described as a strawberry
like mulberry mass.

A

Rhinosporidium seeberi

242
Q

◦ Basidiobolus and Conidiobolus.

A

Entomophthorales: Entomophthoromycosis

243
Q

◦chronic, slowly progressive and generally restricted to the
subcutaneous.

A

Entomophthorales: Entomophthoromycosis

244
Q

◦lack vascular invasion or infarction

A

Entomophthorales: Entomophthoromycosis

245
Q

◦prolific chronic inflammatory response, often with eosinophils
and Splendore-Hoeppli phenomena around the hyphae

A

Entomophthorales: Entomophthoromycosis

246
Q

◦ Colonies are moderately fast growing at 30C, flat, yellowish-grey
to creamy-grey, glabrous, becoming radially folded and
covered by a fine, powdery, white surface mycelium.

A

Basidiobolus Species

247
Q

◦ Satellite colonies are often
formed by germinating conidia
ejected from the primary colony

A

Basidiobolus Species

248
Q

◦ Microscopic examination usually
shows the presence of large
vegetative hyphae forming
numerous round, smooth, thickwalled zygospores

A

Basidiobolus Species

249
Q

◦ Colonies grow rapidly and are flat, cream-colored, glabrous becoming
radially folded and covered by a fine, powdery, white surface
mycelium and
conidiophores.

A

Conidiobolus

250
Q

◦ The color of the colony
may become tan to
brown with age.

A

Conidiobolus

251
Q

◦ (?) are simple forming solitary, terminal conidia which are spherical, single-celled and have a prominent
papilla.

A

Conidiophores

252
Q

◦ Conidia may also produce hair-like
appendages, called villae.

A

Conidiobolus

253
Q

Conidiobolus
◦ Conidia germinate to produce
either, (?)

A

(1) single or multiple hyphal
tubes or (2) replicate by producing
multiple short conidiophores, each
bearing a small secondary
conidium

Mycology and Virology (20 decks)

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