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Systemic mycoses
| Question | Answer |
|---|---|
| Macrophage filled with Histoplasma (smaller than RBC) | Histoplasmosis |
| CXR: bilateral hilar adenopathy, hepatosplenomegaly in a young men that expended the weekend exploring caves down to the Ohio River valleys | Histoplasmosis, Bat droppings |
| Culture 25ºC, Broad-base budding doubly refractive wall (same size as RBC), encapsulated | Blastomycosis |
| Potassium Hydroxyde (KOH) sputum | Blastomycosis |
| Spherule filled with endospores (much larger than RBC) | Coccidioidomycosis (can cause Meningitis) |
| Systemic mycoses | All can cause pneumonia and disseminate. All are caused by dimorphic fungi: cold (20°C) = mold; heat (37°C) = yeast. EXCEPTION: coccidioidomycosis, spherule (not yeast) Mimic TB (granuloma formation), unlike TB, no person-person transmission. |
| Systemic mycoses | Treatment: fluconazole or itraconazole for local infection; amphotericin B for systemic infection. |