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Candida [C. albicans] _____species are oval, narrow budding yeasts. _____can make pseudohyphae/“germ tubes”. common in oropharyngeal, gastrointestinal, and female genital flora. Pseudohyphae produce proteinases invasion into the extracellular matrix. has receptors that bind C3
proteinases C. albicans species are oval, narrow budding yeasts. can make pseudohyphae/“germ tubes”. common inoropharyngeal, gastrointestinal, and female genital flora. Pseudohyphae produce _______ invasion into the extracellular matrix. has receptors that bind C3
germ tubes C. albicans species are oval, narrow budding yeasts .can make pseudohyphae/____ ___. common in oropharyngeal, gastrointestinal, and female genital flora. Pseudohyphae produce proteinases invasion into the extracellular matrix. has receptors that bind C3
Candida [C. albicans] Causes white Oral thrush in the immunocompromised. Bleeds upon attempted removal.
C. albicans _______infects the mucosa up to the cervix. produces a thick, curd-like discharge and itching of the vulva. “Cheese/bread smelling” exudate. grows better with glucose.
diaper rash C. albicans #1 cause of _____ ______ in babies. The initial lesions are erythematous papules or confluent areas associated with tenderness, erythema, and skin fissures (dry cracking skin.)
Fungemia, septicemia Candida is the #1 cause of _____, and the #3 cause of _____ overall
fluconazole Even though candida is the fungus with the highest rate of resistance, we can still assume that it is still susceptible to most of our treatments. Treat C. albicans with _______
Fluconazole [triazoles] C. glabrata and C. krusei, are resistant to _______, so if those species have not been ruled out, echinocandins/amphotericin B should be used.
melanin Cryptococcus neoformans and C. gattii are perfectly spherical yeasts with a large,______ -containing capsule
India ink Using an ___ ______staining technique shows capsule as large halos around Cryptococcus neoformans and C. gattii yeast cells.
cryptococci _______ are normal flora in the cloacae of birds, inhalation of soil contaminated with bird feces are a major route of exposure."Pigeon Handler’s disease" Also from pine/Eucalyptus trees.
CNS Cryptococcosis may present as a pneumonic process or, more commonly, as a _____ infection secondary to hematogenous and lymphatic spread from a primary pulmonary infection [<15%]. More common in the immunocompromised.
ring enhancing Cryptococcosis -Radiology reveals a "_____ ______lesion."[just one usually] Organ damage is primarily due to tissue distortion.
Phagocytosis, inflammation Cryptococcosis -The large melanin-containing capsule inhibits ______and ______ and facilitates spread to CNS.
Pacific Northwest, British Colombia .C. gattii is mainly a tropical pathogen . C. gattii grows on some species of eucalyptus trees and can be found in what part of the U.S.A/Canada?
lumbar puncture Diagnosis of cryptococcus is a case where you actually do want to do a _____ _____ first thing to diagnose, rather than a blood draw.
amphotericin B Patients with cryptococcus are treated with 2 weeks of _______ + fluconazole, and monitored for decline in numbers of cryptococci in CSF. This means that you’re doing multiple lumbar punctures.
Aspergillus ______molds have acute-angle branching hyphae, and are very, very common. are ubiquitous saprobes in nature and may be found in soil, potted plants, decaying vegetation, pepper, and construction sites
A. niger ______mold colonies have jet-black centers [black mold in the house]
Aspergillus Pepper makes you sneeze in part because peppercorns are part of the reservoir for various _______ molds, and almost all of us all have some IgE against some ______epitopes.
aspergilloma (Aspergillus mycetoma) In patients who already have a chronic pulmonary disease, such as cavitating tuberculosis, molds can form a radiologically visible fungus ball or________within a preexisting cavity.
aspergillosis Invasive __[fungi]___occurs in preexisting pulmonary disease (bronchiectasis, chronic bronchitis, asthma, tuberculosis) or immunosuppression. Lung tissue invasion may penetrate blood vessels, causing hemoptysis or erosion into other structures.
Aspergillus terreus Only one species of Aspergillus, Aspergillus _____, has been shown to cause fungemia.
Lung Aspergillus overwhelmingly most likely fungal cause of infection due to _____ transplant
Liver Candida overwhelmingly most likely fungal cause of infection due to_____ transplant
fusarium Keratits caused by _______ species in immunologically-normal contact lens wearers. Colonies grow as blue-green, pink, or lavender fuzzy.
moldy bread Zygomycetes/Mucor/Rhizopus are the main cause of ____ ____. Also they can cause infections, especially in diabetic patients
Zygomycetes/Mucor/Rhizopus ______/______/_______: Branches between hyphae are very rare, have right angles when they do occur. Hyphae don’t have “septa” (cell dividing walls within a hypha) Spores are in a bubble-shaped body on the top of a single hypha
rhinocerebral zygomycosis Fungal disease_____ ______ in patients with diabetic ketoacidosis. Infection usually involves the nose, less commonly the eyes and CNS. a history of fever, unilateral facial pain or headaches, nasal congestion, visual disturbances, and lethargy.
Pneumocystis jiroveci /Pneumocystis carinii exists as a normal pulmonary transient. It behaves more like a protozoan parasite than a fungus, however genetically it is a fungus. exists in three forms that reflect similarity to protozoans: trophozoite, sporozoite, and cystic forms.
Pneumocystis pneumonia (PCP) _____ _______is rare/absent in normal health. one of the most common opportunistic infections, & an indicator disease of AIDS. The disease is uniformly fatal if untreated. Fever (>80%),Nonproductive cough (95%)Pulmonary symptoms: mild crackles and rhonchi
Pneumocystis pneumonia (PCP) lung biopsies demostrates a foamy eosinophilic material during _____ _______infection. This material is composed of masses of the organism, alveolar macrophages and other host cells and proteins.
Pneumocystis jiroveci /Pneumocystis carinii Fungal infection treated with Trimethoprim, Clindamycin (antibacterial) + Primaquine (antimalarial),Pentamidine (antiprotozoal), Dapsone (stops macrophage migration)
Trichophyton Infects hair, nails and skin
Epidermophyton Infects nails and skin
Microsporum Infects hair and skin
Dermatophytes _______infect the skin, hair and nails. They grow deep enough into the skin to provoke an inflammatory response. they are keratinolytic.
Malassezia furfur Wood’s lamp (a UV lamp/ “blacklight”) illumination reveals characteristic fluorescence. Coppery orange: doesn’t hurt or itch
Microsporum spp. Wood’s lamp (a UV lamp/ “blacklight”) illumination reveals characteristic fluorescence. Bright green : doesn’t hurt or itch
phyton schoenleinii Wood’s lamp (a UV lamp/ “blacklight”) illumination reveals characteristic fluorescence. Dull green: doesn’t hurt or itch
Aflatoxin Aspergillus flavus: ______, disables p53. Acts synergistically with Hepatitis B infection in causation of hepatocarcinoma.
p53 Aspergillus flavus: Aflatoxin, disables ____. Acts synergistically with Hepatitis B infection in causation of hepatocarcinoma.
Claviceps purpurea [mold]_____ ______: main cause of ergotism, a condition characterized by convulsions and loss of blood flow, potentially leading to tissue death.Some____ molds also produce the hallucinogen LSD.
ergotism Claviceps purpurea: main cause of _____, a condition characterized by convulsions and loss of blood flow, potentially leading to tissue death. Some Claviceps molds also produce the hallucinogen LSD.
Saccharomyces cerevisiae ______ ______, brewer’s and bakers yeast, used to make alcoholic beverages
Amanita spp., Amanitins ________[mushroom], _______[toxin] Inhibits transcription in all cells by binding irreversibly to animal RNA polymerase
Psilocybe spp , Psilocybin / psilocin ________[mushroom], _______[toxin] , causes hallucinations [not LSD]
opportunistic Candida[C. albicans ], Cryptococcus[ C. neoformans ], Aspergillus spp,Fusarium, Zygomycetes/Mucor/Rhizopus,Pneumocystis jiroveci /Pneumocystis carinii. These are not dimorphic. They are_______ – They are either in mold form or yeast form NEVER both. IC'd
Fibronectin Candida can bind to ______ on the surface of our cells (T pallidum would cover itself with ______, but that’s not the case here).
cryptococci ________ is a scenario where we see soil that is rich with bird droppings (C.Psittici and Histoplasma are the other two)
prostate Cryptococcosis -Dissemination occurs to the CNS, the skin,______ , and bone, causing osteomyelitis, and many other organs.
Gliotoxins ______ are secreted by growing aspergillus molds that screw with macrophages a little to keep them from getting ingested.
Aspergillus in culture with characteristic fruiting bodies—conidiophore covered with conidia.“Dandelion flowers”
Eikenella corrodens are small, Gram-negative bacteria that are normal oral flora in humans, and very inflamed infection if traumatically inoculated under skin (human bite wound /bar fight example tooth in fist), they “corrode” pits in agar they’re grown on
Pasteurella multocida normal oral flora in domestic animals, like cats&dogs Cellulitis & swollen lymph node (closest to bite site) following dog/cat bite; treated w/ antibiotics/self-resolves. cultured from wound->large colonies overnight on blood or chocolate agar
Capnocytophaga filamentous, gram-negative rods capable of aerobic and anaerobic growth in the presence of carbon dioxide. Must have CO2 to grow in culture.When contracted from dog/cat bite, symptoms similar to Pastuerella. Self-resolving
Bartonella henselae “cat scratch fever”: Swollen, warty-like lesion at site of cat scratch/bite/broken skin infected by cat flea feces.progresses to lymphadenopathy, slight fever. Typically self-resolving. blood agar plates, most cultures negative, ~1 month to see growth.
Streptobacillus moniliformis: a long, thin, gram-negative rod "Rat-bite fever"+ rash + arthralgias
Francisella tularensis very small, irregularly-shaped Gram-negative bacteria that can replicate inside of macrophages.Require cysteine for growth:infects rabbits, cats, deer and Ixodes ticks. most common in the southern-midwest. chocolate/charcoal agar, incubated for >3 days
NOD-protein F. tularensis escapes from the phagosome, replication in cytoplasm, lots of ____-____ activated inflammation & death of cells
Oculoglandular tularemia _______ _______ = conjunctival infection with F. tularensis + cervical lymph node swelling. transmitted by dressing animal + wiping face
Ulceroglandular tularemia ____ _____ = wound infection with F. tularensis accompanied by lymph node swelling. Painful papule at infected tick bite site/broken skin + exposure to pathogen site progresses to necrotic lesion with raised, edematous edges (cp. to anthrax),
Pulmonary tularemia _____ ______ bilateral pneumonia possibly-> sepsisis. most common in lab workers, who can accidentally aerosolize bacteria while working with patient samples. Replicated inside alveolar macrophages>release pro-inflammatory cytokines>edema in alveoli
Brucella Gram-negative coccobacilli, Strict aerobe.intracellular bacteria that grow in reproductive tissues of non-human mammals, can be aerosolized from those body fluids, and then infect humans who inhale them. Consume unpasteurized dairy products
rough, smooth Brucella can transition from “_____” strains that lack the O-polysaccharide of LPS to “_____” strains that have lots of O-polysaccharide. not killed by macrophages>growth inside of macrophages>T-cell mediated inflammation> systemic symptoms
NOD-protein After being internalized by macrophages, smooth Brucella escapes from the phagosome, >replication in cytoplasm, > lots of _____-_____ activated inflammation & death of cells
Undulant fever ______ _____ caused by Brucella. comes in waves rises in the afternoons and falls at nights. Last for months and years
canis Brucella ______ : Mild in humans,found in dogs (especially feral or wild dogs)
melitensis Brucella________ : Most severe symptoms in humans, found in sheep and goats
pigs Brucella suis: more severe and chronic in humans, found just in _____and deer
cattle Brucella abortus: mild in humans, fetal loss in _____
rRNA sequencing - DIAGNOSIS of Brucella :______ ______ most sensitive and specific
Legionella pneumophila ________ _______ lives in ameobae in fresh water->inhalation->Wrap their phagosome with parts of rERto prevent fusion,escape & replicate inside alveolar macrophages. Old male, 60+long-time smoker+ drinker.
Pontiac fever Legionella pneumophila can cause _____ ______is the most common consequence of a Legionella infection :Myalgia, fever, Can develop into pneumonia –but NOT productive cough.
Legionnaires’ Disease Legionella pneumophila can cause _____ ______is a much more serious condition experienced by some-infected patients following their initial “Pontiac fever” symptoms :Severe headaches, migraine, Photophobia,Pneumonia –multi-lobar consolidation
Legionella pneumophila _______ ________bacteria can’t be seen with Gram stains.Direct fluorescent antibody (DFA)test, Buffered charcoal yeast extract (BCYE)agar, Ground-glass appearance –like B. anthrax. specific antigens are in the urine of patients for 1 month – 1 year
ribavirin drug used to treat HCV, RSV, others – Inhibition of cellular IMP dehydrogenase -
lamivudine A Nucleoside Reverse transcriptase inhibitor[NRTI]:Nucleoside analog that the reverse transcriptase incorporates into the growing DNA strand but then halts further DNA synthesis. ________is used to treat both HBV and HIV
Ganciclovir __________ drug is a modified nucleotide treatment for CMV(HHV5)
Herpes acyclovir, ganciclovir, foscarnet, famciclovir (mostly thymidine kinases) are used to treat what family of viruses???
pleconaril drug used to treat Rhinovirus by interacting w/ ICAM In a “canyon” .Will block ICAM binding to Groove site
Zanamivir/Oseltamivir _______and _______, are Neuraminidase inhibitors – (for H1N1 flu) prevent NA neuramadase from allowing the virus to cleave and detach out.
Foscarnet this drug goes to DNA and inhibits DNA polymerase NOT thymidine kinase!!!!!
Amantadine/Rimantadine _______and _______no longer used to treat Influenza virus. they work by blocking viral assembly/uncoating.
Interferon Alpha2b lamivudine and _______ are used to treat HepB virus
Non-Nucleoside Reverse transcriptase inhibitor[NNRTI] efavirenz, nevirapine, delavirdine are examples of what class of drugs?
2 “ine”(NRTI) + 1 Navir ( protease inhibitor). [or] 2 “ine”(NRTI) + NNRTI: efavirenz, nevirapine, delavirdine highly active antiretroviral therapy (HAART) calls for what combination of drugs?
Schizogony form of cell division. multiple nuclear divisions within a cell are followed by formation of cell membranes around individual nuclei. original plasma membrane ruptures, releasing new cells.
trophozoites internal, metabolically active and dividing forms of protozoa known as ________, e.g. Amoeba spp.
Polymorphism _______ means many forms, and many protozoal parasites switch between external, environmentally resistant cystic forms (cysts, oocysts) to internal, metabolically active and dividing forms known as trophozoites, e.g. Amoeba spp.
cystic(cysts, oocysts) protozoal parasites switch between external, environmentally resistant ______forms
encyst Intestinal parasites grow and divide within the bowel and are passed into the environment. Some _____into resistant forms when they are shed, thus feces may contain both trophozoites and cysts.
Entamoeba histolytica _____ _______ is the pathogenic amoeba responsible for dysentery[pass 10–12 bloody, mucousy stools per day], abscesses of the liver or other organs, ulcers, flask shaped lesion in the intestinal epithelium, may mimic acute appendicitis
E. dispar ________is identical to E. histolytica and 10 times more likely to be found in a fecal sample.
trophozoite The active ______ stage of Amoebae-Entamoeba histolytica exists only in the host and in the fresh loose stool.
Cysts ______ of Amoebae-Entamoeba histolytica often found in the stool survive outside of the host, in water, soil and on foods.
Entamoeba histolytica Both trophozoites and cysts appear in stools, but trophozoites die quickly in the environment. Cysts are long lived in moist soil or water.
E. histolytica liver aspirate of this would have an “anchovy sauce appearance” as red brown pus
Dientamoeba fragilis is a flagellate which lacks a flagellum and a cystic stage, abdominal pain, persistent diarrhea, loss of appetite, weight loss and flatulence. Occasionally, eosinophilia, urticaria and pruritus
metronidazole iodoquinol, tetracycline and _______ have been used successfully to treat D. fragilis
Giardiasis lamblia 1 of the most common parasitic diseases worldwide, causing both endemic & epidemic intestinal disease & diarrhea. transmitted via ingesting contaminated H20. Water-washed food, day care centers and oral-anal sexual practices also contribute to incidence.
Giardiasis lamblia, Giardiasis infects wild mammals, Muskrats, notably the beaver, which release it into freshwater streams. Consumption of lake or stream water may result in ______, or “beaver fever”.
Giardiasis lamblia Trophozoites of ______ _______ have an unmistakable pear shaped appearance with two nuclei. Lactose intolerance, protein and fat malabsorption result (steatorrhea).
string test Entero-Test or ____ _____ or biopsy of small intestine may be performed to diagnose Giardiasis lamblia
Balantidium coli largest human protozoan pathogen & the only ciliate known to parasitize humans. exists in 2 forms, a motile, elongated trophozoite, covered in cilia, & a spherical cyst. pigs=reservoir host. Pigs defecate infective cysts which contaminate water.
fulminant Balantidiasis-ulcers. may suffer chronic infection with non-bloody diarrhea, cramping, halitosis, and abdominal pain. A ______ form results in mucoid, bloody stools, resembling intestinal amoebiasis.
sporozoa The intestinal ______ (also known as coccidia) are apicomplexa acquired by ingestion of an oocyst as a result of fecal contamination of water or food.
oocyst The _____ transforms into a sporozoite and multiplies in intestinal epithelial cells to produce a self-limited watery diarrhea in healthy people.
Cystoisospora (Isospora) belli produces inflammatory changes in the affected intestinal epithelium. If clinically evident, infection produces a self-limited diarrhea lasting for 2-3 weeks with a low grade fever in immunocompetent patients.
Cyclospora cayatenensis outbreaks due to Guatemalan strawberries and various fresh herbs.7 days after ingestion of sporulated oocysts and may include watery diarrhea, loss of appetite, weight loss, cramping, bloating, gas, nausea and fatigue. Low grade fever may be present.
Cryptosporidium spp. fecal oral transmission. resist chlorine; public swimming pools.Infection usually results in asymptomatic carriage or a mild & self-limiting watery diarrhea. sporozoites excyst from an oocyst & invade epithelial cells of the intestinal wall ( jejunum).
Cryptosporidium parvum acute watery diarrhea and possible gastroenteritis (nausea, vomiting, anorexia, abdominal cramping, fever and weight loss) which lasts from a few days to as long as 5 weeks. Acid-fast oocysts in stool are diagnostic
Microsporidia minute obligate intracellular protozoa >produce infectious spores which have a complex tubular extrusion mechanism used for injecting the infective material (sporoplasm)-> cells. Diarrhea,Ocular & muscular infections, severely immunocompromised pt's
Trichomonas vaginalis cause of urogenital infections, sexual activity, burning/itching in the urethra in men, or the vulvar area in women. The vulva may be red. Men may have a discharge from the penis, and women may suffer a thin, greenish, foul smelling vaginal discharge.
Trichomonas vaginalis _____ ______ exists as Trophozoites only, causes urogenital infections, sensitive to metronidazole and tinidazole. As in all STDs, both partners must be treated.
Sporozoa / Coccidia, Protozoa Plasmodium, Babesia, Toxoplasma are all ______/_______ type of ________
Flagellates, Protozoa Trypanosoma, Leishmania are both _______ type of ________
Amoeba, Protozoa Naegleria, Acanthamoeba are both _______ type of ________
Malaria _______ is a worldwide disease. It is transmitted between humans by the female Anopheles spp mosquito. presents as recurrent bouts of chills and fevers. It can self-resolve, persist or create serious damage to internal organs including the brain.
Malaria ______is caused by four species of plasmodium: P. vivax, P. ovale , P. malariae, and P. falciparum.
sporogony Sporozoa-the definitive host supports the sexual cycle of the protozoa in a process known as______.
merogony Sporozoa-An intermediate host supports the ________ asexual cycle.
Mosquito, humans The sexual cycle (fusion of gametes to create a zygote) occurs in the ______, produces Sporozoites. The asexual cycle occurs in _____-> Schizogony-> infective merozoites
"hypnozoites." P. vivax and P. ovale may also become dormant, making curative treatment difficult. Dormant Plasmodium are _______
hepatocytes In an exo-erythrocytic stage following Plasmodium spp infection, sporozoites infect______, which go on to produce merozoites by schizogony.
erythrocytic In the ______ stage, merozoites infect RBC’s, propagate within them by schizogony, and are then released by lysis of the RBC’s. They then infect new RBC’s.
benign tertian P. vivax -Because the cyclic fever brings paroxysms every 48 hours, and it is not often fatal, it is referred to as “______ _____ malaria”.
P. vivax The Duffy blood group antigen is the ______ receptor.
P. vivax, P. ovale _____ is the most prevalent species. It infects immature RBCs and so is limited in the extent of anemia it causes. _____ also only infects immature RBCs.
P. malariae, quartan ______ only infects mature RBCs and is unable to relapse after eradication (no hypnozoites form). It causes_____ malaria (72 hr cycles).
P. falciparum The vast majority of deaths are caused by_______ It infects any stage of development of the RBC[mature or immature]. Multiple parasites can infect the same RBC. Maurer’s dots on RBC’s
Malignant tertian ______ ______ malaria- Blockage of blood flow to the brain produces cerebral malaria leading to coma and death. Kidney damage produces “Blackwater fever” characterized by darkened urine,
Shuffner’s dots P. vivax infection-> RBC’s are enlarged, pale and have ______ _______
Oval & fimbriated P. ovale infection-> RBC’s are ______ and ______
Malignant tertian ______ ______ malaria- Blockage of blood flow to the brain produces cerebral malaria leading to coma and death. Kidney damage produces “Blackwater fever” characterized by darkened urine,
Shuffner’s dots P. vivax infection-> RBC’s are enlarged, pale and have ______ _______
Oval & fimbriated P. ovale infection-> RBC’s are ______ and ______
banana The "______ shaped" gametocyte characterizes P. falciparum
band The "_____” shaped gametocyte in P. malariae is also easily recognizable. P. malariae infected RBCs contain the fewest merozoites.
folate synthesis Pyrimethamine and sulfdoxine act on _____ _______(similar to TMP/SMX).
Quinine ______ based drugs kill schizonts within RBC's.
primaquine P. vivax and P. ovale require ______ treatment in order to kill hypnozoites within hepatocytes, effecting the “radical cure.”
Artemisinin _______ is currently the most effective of all antimalarials. It is a natural product.
B. microti [Babesia microti] _____ infects RBCs. Unlike malaria, it is a zoonosis with reservoirs in deer, cattle and rodents. The vector is the tick Ixodes scapularis. It is found worldwide, and most commonly in the northeast coastal region of the US.
Maltese cross The “____ _____” is a characteristic form of Babesia microti merozoites within RBCs.
B. microti [Babesia microti] high fever, chills, diaphoresis (excessive sweating), weakness, anorexia and headache. Later the patient may develop jaundice. Congestive heart failure, kidney failure and acute respiratory distress syndrome
Toxoplasma gondii Humans acquire the illness through ingestion or inhalation of oocysts from cat litter. Or eating undercooked, raw or contaminated meat and meat juices, lamb and pork.
TORCH test : Toxoplasmosis, Others[HIV], Rubella, CMV, Hepatitis test A test given to pregnant women to make sure they don’t have……AT RISK!!!-neonates (during birth or breast feeding), crosses blood-placenta barrier.to test for IgG and IgM of……
bradyzoites In animal tissues, Toxoplasma gondii survives within cysts as slowly-developing forms (_____).
Toxoplasma gondii Infection in pregnant mother->The fetus may suffer a severe infection resulting in a classical tetrad of signs including chorioretinitis, hydrocephalus, convulsions, and intracerebral calcifications.
Ring enhancing [Cryptococcosis had just one usually] Toxoplasma gondii -AIDS and immunocompromised patients may reflect a reactivation of a previous infection due to the loss of immunity. Encephalitis, multiple cerebral mass _____ _____ lesions and disseminated infections may result.
Sabin-Feldman Chronic T. gondii infection employs the ____-______dye test
pyrimethamine/sulfadiazine Treatment for Toxoplasma gondii _____/_______
Naegleria fowleri amoeba found in freshwater;lakes/streams->very rare/fatal brain infection. rapidly progressing primary acute meningoencephalitis. illness is difficult to recognize and has usually progressed to an irreversible end by the time it has been diagnosed
Acanthamoeba spp. is also a free-living amoeba found in environmental water sources. Wearing contact lenses is a significant risk factor for infection. causes a keratitis resulting in eye pain, redness, tearing and potential loss of vision.
chlorhexidine Treat Acanthamoeba spp.infection with topical _____
Trypanosoma cruzi, trypanosomiasis _______causes American ____ or Chaga’s disease. It is a zoonosis transmitted by the reduviid bug. Mud walled houses are associated with disease
Trypanosoma brucei, trypanosomiasis cause eastern (zoonotic) and western (mainly human) forms of African____ or sleeping sickness. The vector is the tsetse fly.
reduviid bug This bug defecates as it feeds, and the infected feces are scratched into the bite wound (autoinoculation).-> Trypanosoma cruzi
amastigotes Metacyclic trypomastigotes are acquired from the vector. They infect macrophages, smooth and cardiac muscle cells, transforming into intracellular "______”
trypomastigotes "amastigotes." multiply, kill the host cell and are released as infective "_________."
chagoma Chaga's disease may be asymptomatic, mild or an intense, febrile illness with formation of a “_____” (swelling at the site of inoculation
Romana's sign Chaga's disease may be diagnosed by ____ _____ (swelling around the eye -
Chaga’s _____ disease->cardiac enlargement, megacolon or megaesophagus, may include cardiac arrythmias, constipation and the inability to swallow.
Xenodiagnosis _____ involves permitting an uninfected reduviid bug to feed on a patient. The bug is then inspected for infection.
trypomastigotes T. brucei transform into_____. This is the blood form and the form that infects Tsetse flies when they take a blood meal
T. brucei Parasitemia A local erythematous rash and an ulcer forms at the site of the bite.fever, lymphadenopathy, hepatoslenomegaly, edema and other signs such as a generalized rash, pruritis, malaise, weight loss, arthralgia and tachycardia.
sleeping sickness The "CNS stage" of ______ ______ produces signs such as personality changes, lack of interest, sleepiness in day, restless and insomnia in night, a shuffling gait, ataxia, tremors, tremulous speech and uncontrollable rages
Winterbottoms ________sign is a result of T. brucei parasitemia.
West The ___ African (Gambian) form has a slower “chronic” appearance that takes on average 3 years to kill in the absence of treatment.
East The____ African form is a more acute disease, taking less than a year to kill. CNS invasion is rapid and heart failure a common cause of death.
Leishmaniasis Humans acquire the illness from a sand fly bite. The disease is maintained as a zoonosis in mammals with a sylvatic cycle.
Visceral leishmaniasis Sand fly bite-> presents with fever, chills & sweating. hepatosplenomegaly, lymphadenopathy, pancytopenia, and weight loss. It is also associated with black pigmentation of skin (Kala azar = black fever).
Post-kala-azar dermal leishmaniasis (PKDL) a chronic rash seen in kala-azar patients following treatment and apparent cure. The rash is macular either red or hypopigmented and sometimes nodular.
Cutaneous leishmaniasis From sand fly bite is characterized by a papule with a painless crusted or ulcerative lesion. They may be singular or diffuse. It heals in 2-10 months leaving a disfiguring scar
Mucocutaneous leishmaniasis From sand fly bite occurs months or years after the cutaneous form heals. It destroys mucous membranes of the nasal septum and related tissue structures producing disfiguring lesions.
Rickettsia rickettsii Very small, non-motile, Gram-negative rods,Obligate intracellular,endothelial & epithelial cells,Giemsa/silver staining ,Rocky Mountain Spotted Fever, spread by American dog tick. southern Atlantic region.high fever, classic rash, myalgias, headaches,
Rickettsia prowazekii Small, intracellular Gram[-] bacteria, Spread by human body lice. eastern US/Canada. Epidemic typhus (louse)- high fever, severe headache, and myalgias. Recurrence typhus (Brill-Zinsser disease) is a milder form of the disease. poor hygiene.
R. typhi/R. felis: rodents and cats, spread by cat fleas (especially in southern US/Texas, South/Central America)Endemic/murine typhus symptoms look similar to those caused by R. prowazekii but are less severe, with symptoms lasting <1 month and not recurring
Ehrlichia , Anaplasma _____&______ are spread by Ixodes species ticks and by “Lone Star” ticks that fed on infected mice or deer. both stop phagosome-lysosome fusion, replicate in phagosome in leukocytes. Northeast and Southeast US.
Morulae ________ are clumps of bacteria growing in vacuoles in Ehrlichia and Anaplasma infected cells that can be seen in Giemsa-stained samples of patient WBCs
Coxiella burnetii stable extracellular-->fragile intracellular form; transmission via inhalation of extracellular from infected cattle, sheep, or goats causes “Q fever”, mild flu[no rash] chronic endocarditis, pneumonotis, & granulomas.Treat with doxycycline.
Ehrlichia causes flu-like symptoms due to inflammatory response to infected cells. spread by Ixodes and “Lone Star” ticks, infects monocytes. 40% of patients have rash.
Anaplasma causes flu-like symptoms due to inflammatory response to infected cells. spread by Ixodes and “Lone Star” ticks, infects granulocytes. <10% of patients have rash
Mycoplasma, Ureaplasma, Chlamydia, and Chlamydophila [1]___, [2]____,[3]____ and [4]______ species are obligately-intracellular bacteria that lack all peptidoglycan and have no cell wall.resistant to beta-lactams and all other antibiotics that target cell wall synthesis for this reason.
Mycoplasma , Chlamydia ________and Ureaplasma can make their own ATP, but ________ and Chlamydophila can’t and must use ATP made by their host cells.
Small , Large Coxiella burnettii: Inhaled “______cell” variant not metabolically active, but transmissable, has O-polysaccharide; “Large cell” variant grows inside phagosomes, lacks O-polysaccharide.
Mycoplasma pneumoniae _______ _______ is the #1 cause of “atypical” or “walking” pneumonia and is also frequently carried asymptomatically. Prime age = 5 – 15 years old
P1 adhesin M. pneumoniae binds to ciliated respiratory epithelia via “______” on pilus surface,-> ciliostasis and IL-1, TNF, and IL-6 secretion-> lung infiltration
M. pneumoniae Type O – blood + serum from Type O – blood + serum from ________ patient clots on ice. (60% of the time) patient clots on ice. (60% of the time)
sterols Mycoplasma and Ureaplasma organisms are the the smallest free-living bacteria they do not have a cell wall and their cell membrane contains ______
Elementary body forms (EBs), Reticulate bodies (RBs) ______ body ______ of Chlamydiae are non-metabolic, slightly more durable, and transmissible. ______ ______ are metabolically-active and nontransmissible.
Chlamydia ______has symptoms like gonorrhea, but with a thinner "mucoid" discharge. It’s more likely to be asymptomatic in both men and in women than gonorrhea is.
Chlamydia Obligately intracellular bacteria,Use host cell ATP,Lack respiration or via fermentation pathways,TARGETs non-ciliated columnar, cuboidal, and transitional epithelial cells, transmitted via sex, face flies–feed on secretions from lacrimal gland
C. trachomatis ________ infections can ascend into the uterus and Fallopian tubes, causing inflammation and scarring that can cause tubal pregnancy
Chlamydia causes Trachoma[follicular conjunctivitis], reactive arthritis[reiter syndrome], especially in young men, Neonatal conjunctivitis, Infant pneumonia,Lymphogranuloma venereum-Swelling of inguinal lymph nodes+Ulcerated painless genital lesion
inclusion bodies Giemsa stain of Chlamydia will show _____ _______
Trachoma a conjunctivitis caused by Chlamydia trachomatis,eyelids to turn inward that can lead to corneal scarring and blindness
Chlamydophila psittaci Obligately intracellular bacteria,Use host cell ATP. bird dropping->Lung->blood->liver->jaundice + hepatomegaly, "parrot fever",cyanosis, interstitial pneumonitis
Ergosterol fungi have a cell wall,made out of chitin, _______, and beta-glucans.
yeast fungi grow in single celled stages this is typically referred to as a _____ form. look GLOSSY
mold In the multicellular life stages different kinds of hyphae will tell use about our fungae. This stage is called a ______ . colonies look fluffy.
TLR -2 fungi have Mannose proteins which contain the carb mannose and these can trigger ______in particular that recognize mannose containing proteins.
lectin in response to fungi there are mannose binding_____which is made from the liver as an acute phase protein. Part of complement cascade.
Dimorphic ________fungi. can switch. At cold temp (25C) = mold, At warm temp (37C) = yeast . are very pathogenic. Can cause disease in immune competent people
Hyphae ______ are Long, slender branching support structures that put reproductive spores out into the world in mold form. Spores are also called “Conidia”
buds , spores Yeast always_____ to grow. Mold uses ______ to reproduce.
darken Tinea Nigra, caused by Hortaea werneckii, causes skin to ______
hair shaft Black piedra is a superficial infection of the _____ _____ caused by Piedra hortae. Also white piedra
fingernails, toenails Onychomycosis is a fungal infection of ______ and ______ caused by Trichophyton rubrum and T. mentagrophytes.
Tinea corporis ______ ______- "ring worm" on trunk
Tinea cruris ______ _____- groin "jock itch"
Chromoblastomycosis _________ is an infection that forms warty fungal pigmented lesions which grow outward from site of introduction.
Sabourand Dextrose ______ ______ agar – Used to culture fungi. It is slightly selective, it is slightly acidic. It doesn’t let most bacteria grow. Fungi (including mold) are tolerant of acidity
Silver _______ stains are routinely used to look for hyphal structures on molds. These structures are going to look black.
calcofluor white [ pneumocystis jirkovecii] ____ _____ stain is used to detect yeasts & molds in clinical specimens. fluorescent dye binds to Chitin in the fungal cell wall. False-positive results can occur if cotton fibers are present in the specimen because the dye will also bind to cellulose.
Giemsa The _______ stain is a differential stain used for detection of parasites in blood smears.used to stain some fungi. also used to stain Anaplasma, Ehrlichia and Borrelia (found in granulocytes).
trichrome The ______ stain is used for the detection of intestinal protozoa. The parasite’s cytoplasm stains blue-green, and the internal structures stain red or purplish red
Polyenes, Amphotericin B anti fungal class of drugs_______ example______ targets Ergosterol and destroys it. drug is always intravenous. can also sometimes target cholesterol. toxic to liver and kidneys. Liposomal form more $$$ , and does NOT cause renal and hepatic toxicity.
azoles, Fluconazole anti fungal class of drugs_______ example_______ don’t directly destroy Ergosterol, but they stop its synthesis by inhibiting the C14-α-demethylase needed by fungi to go from lanosterol to ergosterol. topically/orally
Echinocandins, Capsofungin anti fungal class of drugs_______ example_______inhibit [Beta (1,3) Glucan Synthase]the synthesis of 1,3-β-glucans,so that they can no longer be put into the cell wall therefore making the fungus susceptible to osmotic stress. only intravenously
Anti-metabolites, Flucytosine anti fungal class of drugs_______ example_______ is converted to 5-fluorouracil in cell by cytosine deaminase, 5-FU stops DNA and RNA synthesis in fungi
Allylamines, Terabinafine anti fungal class of drugs_______ example_______ interfere with ergosterol synthesis, inhibit the enzyme squalene epoxidase an earlier step than triazoles do.topically. the active ingredient in the anti-Athlete’s foot infection Lamisil.
WI-1 glycoprotein Blastomyces sheds all this ____, and overwhelms the immune system, so macrophages are too busy dealing with WI-1 and the fungus escapes. free ______ may soak up antibody & even complement. Push immune response from Th1>Th2= reduced NK cell response
Blastomyces [B. dermatiditis] dimorphic fungus,dogs, Mississippi river &Ohio river valley, WI-1 protein,Inhaled conidia>differentiate to broad based budding yeast>produce fever, myalgia, flu, lobar pneumonia productive cough with purulent sputum, X-ray for chronic resembles TB.
Blastomyces [B. dermatiditis] dimorphic fungus,dogs, Mississippi river &Ohio river valley,can spread via blood to organs, skin, painless damaging lesions Skin lesions – spread from lungs
Coccidiomycosis [C. immitis] Infectious conidia=BARREL SHAPED, Southwestern deserts of US/Latin America ,rodent feces->lung >Valley Fever->disseminated skin infection,Spherules[H&E or calcofluor white]
SOW glycoprotein [C. immitis]Stimulate an ineffective TH2 immune response – secretion of ___protein. Urease=neutralization pH in phagolysosome, Proteinase=cleaves IgG, IgA, collagen. Progesterone= increased growth and virulence in pregnant women
Erythema nodosum Coccidiomycosis causes _____ ______ –seen after resolution of valley fever=Hard, painful, red lesions – granulomatous response
amphotericin B TREATMENT for Coccidiomycosis [C. immitis]
azole, liposomal amphotericin B Treatment for Blastomyces dermatiditis: Disseminated:_____ Severe cases – ________ _________
African Disseminated disease of Coccidioides most likely in pregnant women, Pacific islanders, those of _______descent *and immunocompromised
tuberculate macroconidia and microconidia Histoplasma capsulatum is cultured & characterized microscopically as a mold producing both ______ _______ and _______
Histoplasma capsulatum Mississippi&Ohio river valley,Moist,nitrate enriched, bird & bat feces laden soils.Inhalation of conidia >yeasts>hide in alveolar macrophages>ingested by phagocytes>neutralize phagolysosome>replicate inside & kill macrophages> hematogenous spread
cell wall differential diagnosis btw histoplasma and psittaci: psittici lacks a ____ ____ thus not see it in pt sample on gram stain, cannot be cultured (obligate intracellular)
tongue Histoplasma capsulatum causes fevers, chills headaches, mild pneumonia, dissemination:Jaundice and hepatosplenomegaly, _____ lesions
Paracoccidoides brasiliensis fungus found in the lowland farms and rain forests of Central and South America. inhale the conidia from soil and there is NO human-human transmission. Farmers/Men are susceptible bc growth inhibited by estrogen. prolonged latency >40 years
Pilot’s wheel Paracoccidoides brasiliensis on Giemsa stains shows a _____ ______– mother cell producing multiple daughter cells by budding.  
1,3 alpha-glucan Paracoccidoides brasiliensis_________ in cell wall prevents killing by neutrophils
oral Paracoccidoides brasiliensis: Acute pulmonary disease>Productive cough, dyspnea, malaise, fever, and weight loss. Disseminated:painful ______ mucosa lesions and cutaneous lesions,Osteomyelitis
Sporothrix schenckii traumatic wound,soil fungus, rose gardeners or people who work with sphagnum moss or wood. Infection normally produces a single lesion or pustular draining nodules that progress along lymphatic channels
flowerette Sporothrix forms narrow-based yeast cells in tissue and delicate hyphae with a cluster“_______” of conidia (spores) at the end of a narrow stalk. The yeasts and conidia can be darkly pigmented, so this fungus is classified as a dematiaceous mold.
Created by: SabaMDJuan