Mod 3 Lec 2
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| Dimorphic Fungi cause what kind of infections? | Mycoses that involve major body systems or more than one kind of tissue. Don't need "situational" help.
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| What is a granuloma? | Collection of macrophages, giant cells, and proteinaceous material that walls off the infection.
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| How can yeast forms be disseminated to other organ systems? | Can enter the lymph through macrophages.
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| How should these specimens be processed? | Tissue - minced; Pleural fluid and CSF - concentrated; Mucus or pus - mucolytic agent
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| When a dimorph is suspected what should be done? | Quick transport; don't hold at room temp; don't refrigerate
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| How should dimorphic fungi be set up for culture? | Primary isolation on SDA or SABHI w/ and w/out antimicrobials; incubate at 30C, possibly BHI; PDA for subculture
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| What should not be performed on dimorphic fungi in the lab? | Slide cultures
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| What type of immune response do they cause? | Cellular
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| Where is Blastomyces dermatitidis found? | Endemic in Mississippi river valley; soil saprobe, wood, bark, rotting vegetation, river banks
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| What is Blastomycosis? | Chronic granulomatous disease affecting lungs, skin, mucous membranes
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| Blastomyces dermatitidis macro | At 25C slow growth mould on SDA, white to beige waxy colony; 37C yeast after 10-15 days on enriched media (BHI)
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| Blastomyces dermatitidis micro | Mould = fine, septate, hyaline hyphae; conidia directly on hyphae or on lateral conidiophores; Yeast = hyaline, large cells, Broad Based Budding
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| Where is Coccidioides immitis found? | Endemic in SW US and northern Mexico; saprobe in mould form (desert soil); occupational hazard
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| What is the most virulent of all agents of human mycoses? | Coccidioides immitis; causes mild infection in all who inhale it
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| Coccidioides immitis macro | 3-5 days on SDA/SABHI; arthroconidia in 7-10 days; white and cottony, cobwebs; yeast form not found in lab
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| Coccidioides immitis micro | Septate hyaline hyphae; whide arthroconidia that are barrel shaped; disjuncture cells; easily aerosolized - extremely hazardous
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| Where is Histoplasma capsulatum found? | Endemic to Mississippi and Ohi river valleys; soil saprobe w/ high nitrogen content; chicken, bird, bat guano; occupational hazard
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| What is Histoplasmosis? | Chronic granulomatous lung disease; 5% progress to acute fulminating, rapidly fatal disease = mostly children
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| Histoplasma capsulatum macro | Slow growing mould; tan, fluffy; yeast form in 10-15 days on enriched media (BHI or SABHI)
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| Histoplasma capsulatum micro | Fine, septate hyphae; micro and macroconidia; macroconidia become tuberculate w/age; yeast cells bud at narrow neck
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| Where is Paracoccidioides brasiliensis found? | Endemic to NW, central, and SE South America, Central America, Southern Mexico; Soil saprobe in acid soil
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| Paracoccidioides brasiliensis macro | 2-3 weeks mould colony; flat, white colonies; Yeast will form on enriched media at 37C
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| Paracocccidioides brasiliensis micro | Fine, septate, hyaline hyphae; conidiation absent on modified SDA; Yeast form - multiple thin necked buds "mariners wheel"
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| Where is Sporothrix shenckii found? | Worldwide soil saprobe, occupational risk, gardening "rose gardeners disease"
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| What is Sporotrichosis? | Chronic cutaneous and subcutaneous mycosis characterized by ulcers and abcesses along lymphatic channels; not usually in lungs
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| Sporothrix shenckii macro | Mould in 3-5 days at 25C; mature colonies are dark and flat; Yeast at 37C, white or tan
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| Sporothrix shenckii micro | Mould: delicate, thin hyphae, septate, frequently found at ropes; conidiophores produce multiple conidia in flowerette arrangements; 2 types of conidia: small oval unicellular / large dark walled spheres. Yeast: Cigar shaped at 37C
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