Fungi – Microbiology Answers – Flashcards

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question
What are the agents of systemic mycoses?
answer

Dimorphic Fungi -->

Blastomyces dermatitidis

Histoplasma capsulatum

Coccidioides immitis

Paracoccidioides brasiliensis

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What is a dimorphic fungi?
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Mold form at 25-30°C (in natural environment)

 

Yeast form at 35-37°C (in host)

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What is the infectious form of the systemic mycoses?
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Conidia
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What is the clinical form of the systemic mycoses?
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Yeast and/or spherules
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How are systemic mycoses contracted?
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Inhalation of conidia
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In which group are systemic mycoses the most prevalent?
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Middle-aged men
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What is blastomycosis caused by Blastomyces dermatitidis also known as?

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Gilchrist's disease

North American blastomycosis

Chicago disease

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What is the natural reservoir of Blastomyces dermatitidis?

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Soil
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How would you culture Blastomyces dermatitidis?
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Use nonselective media such as Sabouraud dextrose agar or brain-heart infusion agar

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Culture two sets at 25;C and 37;C

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What is the sexual form of Blastomyces dermatitidis called?
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Ajellomyces dermatitidis
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What is the colonial apperance of Blastomyces dermatitidis at 25;C?
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The center can have raised areas called spicules or prickles
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What are the microscopic characteristics of Blastomyces dermatitidis at 25;C?
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Conidia are on short lateral branches and are ovoid to dumbbell shaped
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What are the characteristics of Blastomyces dermatitidis at 37;C?
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Broad based budding yeast that are sphericle and refratile
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How do you confirm the identity of Blastomyces dermatitidis?
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Conversion of mold form to yeast form or the exoantigen immunodiffusion test
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What makes the exoantigens detected in the axoantigen immunodiffusion test?
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Mycelia
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How do Blastomyces dermatitidis;infections present in immunocompetent patients?
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Initially they are usually asymptomatic

Pulmonary disease may follow and it may spread to the skin and bone

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How do;Blastomyces dermatitidis;infections present in immunosuppressed patients?

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May disseminate to multiple organ systems and rapidly fatal
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What is histoplasmosis caused by Histoplasma capsulatum;also called?
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Reticuloendothelial cytomycosis

Cave disease

Sperlunker's disease

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What is the reservoir for Histoplasma capsulatum?
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Soil contaminated with bat and bird feces
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What specimens can be used for Histoplasma capsulatum?
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Specimens from the respiratory tract, liver, spleen, bone marrow, blood and exudates from lesions
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Which specimens are best for finding Histoplasma capsulatum in AIDS patients?
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Bone marrow and blood
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How would you cultures Histoplasma capsulatum?
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Culture two sets on Sabroud dextrose, brain-heart infusion or inhibitory mold agar

One set at 25°C and the other at 37°C

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How do you confirm the ID of Histoplasma capsulatum?
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The conversion of mold form to yeast form though complete conversion is rarely seen
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What tests can you perform to detect Histoplasma capsulatum?
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Exoantigen immunodiffusion test to look for H and M antigens

Immunodiffusion with complement fixation

Skin testing

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What are the early and mature microscopic characteristics of the mycelial culture of Histoplasma capsulatum?
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Early: round to pyriform microconidia

Mature: large echinulate or tuberculate macroconidia 

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What cells do the microconidia of Histoplasma capsulatum invade?
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They are pahagocytized by macrophages in the lungs
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How does histoplasmosis present in patients with an intact immune system?
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Light exposure: imited and usually asymptomatic, organisms can remain viable for years

 

Heavy exposure: acute pulmonary disease

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How does histoplasmosis present in immunocompromised patients?
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Disseminated potentially fatal disease
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How does Histoplasmosis capsulatum appear under direct dectection?
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Small yeasts

Oval to round budding cells

Often clustered within monocytes and macrophages

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What is coccidioidomycosis caused by Coccidioides immitis also known as?
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California disease

Valley fever

Desert rheumatism

 

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Where ecologically can Coccidioides immitis be found?
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the Lower Snoran Life Zone
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Which mycotic agent is the most virulent to humans?
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Coccidioides immitis
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What are the characteristics of the arthroconidia of Coccidioides immitis?
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Barrel shaped, convert to spherules in host
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How would you culture Coccidioides immitis?
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Does not convert readily to spherules at 35°C

Culture one set at 25°C

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What are the colonial characteristics of Coccidioides immitis?
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Initially white to gray, moist, glaborous

Develops mycelium and appears to "bloom"

Mature colonies are tan to brown to lavender

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What are the microscopic characteristics of Coccidioides immitis?
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Aerial hyphae grow at right angles to the vegetative hyphae

Arthroconidia are seperated by disjunctor cells 

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What tests can be used to detect Coccidioides immitis?
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Latex agglutination with immunodiffusion

Complement fixation especially for prognostic studies

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What are possible complications of a primary Coccidioides immitis infection?
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Pulmonary disease

Allergy

Toxic erythema

Erythema nodosum (desert bumps)

Erythema multiforme (valley fever)

Arthritis (desert rheumatism)

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How are primary infections of Coccidioides immitis treated?
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Usually resolve without therapy
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What does the coccidioidin skin test detect?
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Infection with Coccidioides immitis confers strong immunity to reinfection

This is detected using the coccidioidin skin test

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What are possible complications of a secondary infection of Coccidioides immitis?
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Lung nodules

Cavitary lesions

Progressive pulmoary disease

Dissemination

Meningial involvment is common

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What is paracoccidioidomycosis caused by Paracoccidioides brasiliensis also known as?
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South American blastomycosis

Brazilian blastomycosis

Lutz-Splendore-Almeida disease

Paracoccidioidal granuloma

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How would you culture Paracoccidioides brasiliensis?
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Culture two sets, one at 25°C and one at 35°C
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What tests can be used to detect Paracoccidioides brasiliensis?
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Complement fixation

Immunodiffusion

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What are the characteristics of the yeast form of Paracoccidioides brasiliensis?
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Multipolar budding on the periphery resembling a "mariner's wheel"
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What is the usual route of infection for Paracoccidioides brasiliensis?
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Pulmonary
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What are possible complications of infection with Paracoccidioides brasiliensis?
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Often asymptomatic 

Ulcerative granulomatous lesions

Disemination - predilection for adrenal glands

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What phylum causes opportunistic infections?
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Zygomyces
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What does the Zygomyces show a strong predilection for invading?
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Blood vessels
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What is the most common disease caused by Zygomyces?
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Rhinocerebral zygomycosis
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What is Rhinocerebral zygomycosis?
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Most common Zygomycoses

Effects diabetics the most 

Originates in paranasal sinus and can extend to the brain

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What are the characteristics of the Zygomycete Mucor?
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Rapid grower

Cottony dirty white colonies

No rhizoids

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What are the characteristics of the Zygomycete Rhizopus?
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Rapid grower

Brown rhizoids

Clusters of sporangiophores are joined by stolons

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What are the characteristics of Penicillium?
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Rapid grower

Green or blue-green colonies

Phialides with oval conidia in chains

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What are the three species of Aspergillus?
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Aspergillus fumigatus

           flavus

          niger

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What is the most commonly found genus of fungi in the clinical lab?
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Aspergillus 
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What is the most common isolate of Aspergillus?
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Aspergillus fumigatus
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What is the infectious form of Aspergillus?
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Conidia
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What are the hypersensitivity reactions to Aspergillus?
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Types 1 and 4

Allergic bronchopulmoary infection

Asthma

 

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What is an aspergilloma?
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"Fungus ball"

Occurs in cavities from tuberculosis or cancers

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What does Aspergillus cause in immunocompromised patients?
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Invasive penumonia and dissemination
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What causes aspergillus poisoning?
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Aspergillus flavus makes the toxin aflatoxin which contaminates food supplies

Causes liver damage and cancer

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What is the clinical form of Aspergillus?
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Hyphae
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What is the leading cause of yeast infections?
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Candida albicans
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How is Candida albicans acquired?
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Endogenously

It's part of the normal flora

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What are the characteristics of Candida albicans under direct examination?
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Yeast and pseudohyphae 

Cells usually exhibit budding

Pseudohyphae are constricted at ends and remain linked like sausages 

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What are the Candida albicans germ tube test results?
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Positive, usually sufficient for ID
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 What does Candida albicans look like on cornmeal agar?
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Produces blastoconidia, pseudohyphae, true hyphae and chlamydoconidia
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What are the Candida albicans urease results?
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Negative
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Cryptococcus neoformans is a major cause of oppurtunistic infections in what group?
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AIDS patients
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What is the reservoir for Cryptococcus neoformans?
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Soil contaminated with pidgeon droppings
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What are the diseases caused by Cryptococcus neoformans?
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Pneumonia

Meningitis

Fungemia

 

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What is the colonial appearance of Cryptococcus neoformans?
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Mucoid due to capsule
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What are the Cryptococcus neoformans germ tube test results?
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Negative
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What does Cryptococcus neoformans look like on cornmeal agar?
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Does not produce pseudohyphae or true hyphae
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What are the Cryptococcus neoformans urease results?
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Positive
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What does Pneumocystis jiroveci cause in AIDS patients?
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Pulmonary infections
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What is the infective stage of Pneumocystis jiroveci?
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Cyst that contains up to eight spores
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What kind of parasites are Microsporidia?
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Unicellular and obligate intracellular 
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Which Microsporidia are human pathogens?
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Enterocytozoon bieneusi and Encephalitozoon intestinalis
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What kind of infections do Microsporidia cause?
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Castrointestinal infections 
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What is Amphotericin B?
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A polyene macrolide antifungal agent

Drug of choice for serious systemic infections

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Which antifungal agents are polyene macrolides?
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Amphotericin B and Nystatin
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Why is Amphotericin B callwed "amphoterrible"?
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It has very serious side effects such as nephrotoxicity
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What are the antifungal agents?
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Polyene macrolides (Amphotericin B and Nystatin), azole drugs, Griseofulvin and potassium iodide
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What is the causative agent of superficial mycoses?
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Malassezia furfur
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What disease does Malassezia furfur cause?
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Tinea versicolor
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What does Malassezia furfur look like in a KOH preparation?
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Spaghetti and meatball appearance

Septate hyphae

Budding yeast

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What are the causative agents of dermatophytosis?
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Trichophyton, Microsporum and
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