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Fungal Disease

Path Y2B2

Pityriasis Versicolor caused by Malassezia furfur which is a normal skin flora superficial mycoses
Trichophyton, microsporum sp, epidermophyton (cutaneous mycoses) species pathogenic to humans superficial mycoses
cutaneous mycoses direct contact from humans or animals; remain confined to keratinous zone of the skin superficial mycoses
cutaneous mycoses submit skin scrapings to calcofluor white staining and examine under a fleorescent microscope; submit skin scrapings to KOH and then look for hyphae superficial mycoses
tinea capitis Ringworm of the scalp superficial mycoses
tinea capitis often associated with alopecia superficial mycoses
tinea capitis a kerion is a raised, edematous lesion of the scalp that manifests granulomatous inflammation and is usually secondarily invaded by bacteria; may or may not be a/w inflammation superficial mycoses
tinea barbae fungal folliculitis superficial mycoses
tinea corporis only involves glabrous skin superficial mycoses
tinea corporis usually annular lesion w/ vesicopustular border superficial mycoses
tinea cruris Jock Itch (in the groin) superficial mycoses
tinea cruris frequently associated w/ tinea pedis superficial mycoses
tinea pedis Athletes Foot; may be dry and hyperkeratatoic superficial mycoses
tinea pedis maybe intertriginous and macerated w/ fissures; secondary bacterial infection is common; may manifest vesicles and pustules superficial mycoses
tinea manus infection of the hand w/ symptoms similar to tinea pedis superficial mycoses
Sporotrichosis inflammatory papule that frequently ulcerates (aka Plaque Sporotrichosis) w/ low grade lymphangitis subcutaneous mycoses
Sporotrichosis eruption of other inflammatory papules in the lyphatic drainage ("chain of lesions") which is called Lymphangitis Sporotrichosis subcutaneous mycoses
histoplasmosis risk factor: prolonged aerosol exposure to bat and bird droppings; immunodeficiency; prolonged aerosol exposure to soil and dust systemic mycoses
histoplasmosis multiple calcified granulomas in the lungs (mass of fibrotic scarification often a/w calcification); granulomatous (often caseating) inflammation systemic mycoses
histoplasmosis multiple calcified granulomas in the spleen (d/t asymtomatic dissemination) systemic mycoses
chronic progressive pulmonary histoplasmosis (chronic fibrocavitary pneumonia) occurs in pts w/ chronic lung diseases, such as COPD, Cystic Fibrosis, etc. systemic mycoses
chronic progressive pulmonary histoplamosis only a minority of pts w/ primary pulmonary histoplasmosis develop chronic disease; causes diffuse fibrosis, often w/ cavities followed by cor pulmonale systemic mycoses
chronic progessive histoplasma mediastinitis lymphatic spread from primary lung infection; intense fibrosis can lead to compromise of vital mediastinal structures systemic mycoses
acute disseminated histoplasmosis may involve the skin, mucous membranes, liver, heart valves, GI tract and CNS; occurs only in immunodeficient pts and simulates bacterial sepsis systemic mycoses
acute disseminated histoplasmosis Sx: hepatosplenomegaly, Leukopenia, DIC, adrenal insufficiency systemic mycoses
chronic disseminated histoplasmosis very uncommon, usu only occurs in immunocompetent older adults systemic mycoses
ocular histoplasmosis syndrome central retinal degeernation and fivrous leading to vision loss systemic mycoses
ocular histoplasmosis syndrome probably a Type IV hypersensitivity rxn rather than an active infection systemic mycoses
coccidioidomycosis San joaquin Vally (CA), southwern USA (AZ), Western TX systemic mycoses
coccidioidomycosis very large yeast form, fungal spherules contain multiple endospores, intense granulomatous inflammation systemic mycoses
primary coccidioidomycosis pneumonia "valley fever," most pts are asym., fever, chronic cough, sob, frequently a/w erythema multiforme or erythema nodosum as a Type IV hypersensitivity response which indicates a vigorous cell mediated response systemic mycoses
coccidioidomycosis lab: b/c of the level of infectivity of C. immitis, health care and lab personel who handle specimens are at risk of aerosol exposure; hospital outbreaks have occurred systemic mycoses
coccidioidomycosis self-limited in immunocompetent individuals, "coin-like" lesions in lung; can be latent for many yrs systemic mycoses
acute disseminated coccidioidomycosis can be hematogenously disseminated in pts w/ immune deficiency (lymph, bone, skin, subq. CNS) systemic mycoses
cryptococcosis pigeon feces, most strains have a thick polysaccharide capsule (C. neoformans), therefore few immunocompetent pts get this systemic mycoses
cryptococcosis prolonged aerosol exposure to soil and dust contaminated w/ pigeon droppings systemic mycoses
cryptococcosis India ink stain systemic mycoses
candidiasis C. albicans (mc) opportunistic mycoses
candiasis all form pseudohyphae EXCEPT C. glabrata opportunistic mycoses
pseudohyphae wall constriction separates strands rather than true septae (blank)
candiasis most common fungal pathogen; common in hospitals opportunistic mycoses
candiasis some risk factors: Diabetes, congenital immunodeficiency, post transplant w/ chronic corticosteroid use opportunistic mycoses
mucocutaneous candiasis oral thrush, vulvovaginal thrush, balanitis (penile surface) opportunistic mycoses
mucocutaneous candiasis scatterred erythematous lesions a/w "cottage cheese" exudate which forms pseudomembranes opportunistic mycoses
mucocutaneous candiasis candidal esophagitis opportunistic mycoses
aspergillosis acute branching hyphae opportunistic mycoses
aspergillosis aspergillus fumigate (mc) opportunistic mycoses
aspergillosis granulomatous inflammation is usu only in immunocompetent pts , NOT immunodeficient opportunistic mycoses
aspergillosis vasculotropic which leads to vascular destruction and down-stream necrosis and hemorrhage opportunistic mycoses
aspergillosis leads to chronic inflammation of lungs (pneumonitis); increase in eosinophils opportunistic mycoses
Pneumonia- healthy pt histoplasmosis, blastomycosis, cryptococcosis (blank)
Pneumonia- immunodepressed aspergillosis, pneumocystis carinii, zygomycosis (blank)
meningitis cryptococcosis, candida (blank)
disseminated- healthy pt histoplasmosis, blastomycosis, coccidioidomycosis (blank)
disseminated- immunodepressed candida, aspergillus, cryptococcosis (blank)
pneumocystis carinii NO ergosterol in cell membrane opportunistic mycoses
pneumocystis carinii "foamy" eosinophilic material in alveolar space; lead to alveolar damage, or spread via blood to other organs (liver, spleen, bone marrow, lymph, eyes) opportunistic mycoses
malassezia furfur disseminated infection only seen in pts on IV hyperalimentation soln opportunistic mycoses
zygomycosis broad, rarely septae, hyphae of uneven width opportunistic mycoses
rhinocerebral zygomycosis central facial swelling a/w dermal discoloration; purulent nasal discharge; proptosis, reduced level of consciousness opportunistic mycoses
aspergillosis Rx: CXR "target lesions" d/t central area of necrosis surrounded by hemorrhage and edema opportunistic mycoses
aspergillosis lab: galactomannan antigenELISA assay - cross reactive w/ some other fungal species opportunistic mycoses
aspergilloma (fungal ball) cavitating lesion of the lung opp. mycoses
sinonasal aspergillosis may become locally invasive causing a fibrosing, granulomatous inflammation opp. mycoses
aspergillus otits externa on cerumen and w/in the external auditory canal opp. mycoses
acute invasive pulmonary aspergillosis only in immunodeficient; simulates a bac. pneumonitis opp. mycoses
cutaneous aspergillosis forms an ulcerated lesion, only occurs in immunodeficient opp. mycoses
chronic necrotizing pulmonary aspergillosis commonly occurs in pts w/ chronic obstructive pulmonary disease opp. mycoses
chronic necrotizing pulmonary aspergillosis vasculotropic fungi cause vascular damage and multiple small pulmonary infarctions surrounded by hemorrhage opp. mycoses
disseminated aspergillosis usu begins as UTI or pneumonia and then disseminates; only in severely immunocompromised opp. mycoses
ABPA (allergic bronc. asp.) 1:10 asthmatics; 1:8 CF pts; NOT in lung tissue opp. mycoses
malt worker's lungs (aspergillus) aka Brewer's lung; very rare, hypersensitivity variant; mold forms on malt and is inhaled in large concentrations opp. mycoses
Created by: fl_sun80