Flashcards in Systemic Mycoses 1 Deck (24):
Endemic mycoses share some features. These are? (6, review more than memorize)
-In a geographic region
-human-human transmission almost never occurs
-healthy CAN be infected
A bronchoscopic biopsy grows mold 5 days after visiting California central valley. I've got fever, chest pain, cough, night sweats. What do I have?
Doc, what will happen to me now that I've got coccidioidomycosis? (3)
-valley fever that goes away on its own (30%)
-progressive lung nodules or dissemination
How is coccidioidomycosis diagnosed? (4)
-spherules on wet prep
-BIOHAZARD for lab (like all dimorphics)
-IgM or IgG in serum are useful for those NOT in endemic areas
-hyphae w/ alternating barrel-shaped arthroconidia
usually not needed
A chimney sweep or a bat cave explorer comes to you w/ pneumonia symptoms. What is it?
inhale microconidia/spores ->budding yeasts in body -> get yeasts in macrophages (or disseminates by bloodstream)
-Lung: either self-limited, or chronic cavitary fibrosing mediastinitis
-Systemic: sepsis in immunocompromised
-BIOHAZARD dimorphic: Giemsa stain & see yeast both extracellular and inside macrophages. (look like acorns)
-Urine antigen test BEST
African histoplasmosis is caused by what organism?
histoplasma capsulatum var. duboisii
How is African histoplasmosis different than normal histoplasmosis?
-Larger, thick-walled yeast
-Get giant cells
-Less pulmonary involvement, but more bone/skin problems.
Usually none. For severe: amphotericin B
Wisconsin! (or EAST U.S.) Lung, skin, & bone lesions, what fungus?
[broad based budding!]
Blastomycosis is asymptomatic in what %?
1/2 (so high virulence for a fungus) (it can turn chronic in some!)
Blastomycosis diagnosis involves what?
-BIOHAZARD dimorphic. Wet prep, culture (which takes 4 wks!), or ELISA for exoantigen A.
-Broad-Based Budding & lollipops coming off the hyphae!
-Amphotericin B (or others, the point is you actually DO treat this fungus)
I've got fever, cough, nodular lung lesions, painful ulcerated oro-labial lesion. Rarely my disease disseminates. I just came from Guatemala. What do I have?
Paracoccidioidomycosis "South American Blasto"
I look like a pilot's wheel on wet prep. What am I? Should I be treated?
I've got a rash on face, lymphadenopathy, palpable spleen tip, bilateral chest x-ray infiltrate. HIV positive, and I came from Vietnam. What do I have?
[think HIV in SouthEast Asia! Soil and bamboo rats.]
What does Penicillium marneffei look like on stain?
elliptical yeast form w/ fission septae. red. (dimorphic beware!!)
Penicillium marneffei treatment?
I rolled in pigeon poo. I've got pulmonary problems, MENINGITIS, fatigue, somnolence, HIV, mental status changes, and you see encapsulated yeast on india ink prep as well as a positive polysaccharide antigen test in CSF (BEST test) as well as mucoid yeast colonies that grew on GMS stain. What do I have?
Cryptococcus neoformans (C. gatii if the pigeon lived in a eucalyptus tree)
[think meningitis in HIV patient! It it's NOT an HIV patient, it's C. gatii)
What antibiotic is used for life for prophylaxis of some fungi for immunocompromised?