Term
| Today, I was walking back to my home in the city in the dark. I'm paranoid, so when I saw movement behind me I clutched my mace. The faster I walked, the closer the person seemed to be. I spun around and sprayed my attacker with mace. It was my shadow and the wind blew the mace back into eyes. |
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Definition
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Term
Systemic Mycoses
Opportunistic Fungi |
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Definition
most caused by Candida, C. albicans
ubiquitous and low virulence
usually most common systematic infectio |
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Term
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Definition
albicans (most common)
glabrata
tropicalis
kruseii
parapsilosis |
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Term
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Definition
3-5 um yeast, budding
buds that fail to detact form pseudohyphae
colonies white and creamy (ryan, don't lick them eventhough I know you like white creamy stuff in your mouth)
colonies grow on Sabouraud agar, after 24-48 hours at 35C
CHROMagar: selective media for presumptive diagnosis |
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Term
Lab ID of C. albicans
Germ tube test |
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Definition
| bovine serum, 35-37C, 2-4 hrs only species that forms germ tubes |
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Term
Lab ID of C. albicans
Chlamydoconidia formation |
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Definition
| corn meal agar, 25C, 2-3 days, form in adverse env. microscopically see large thick-walled fungi only C. albicans forms |
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Term
Lab ID of C. albicans
Carb. assimilation and ferm. |
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Definition
| ID diff. species of Candida and yeasts |
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Term
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Definition
normal enteric flora
most infections of endogenous origin
isolate from mucosal surfaces of GI tract does NOT imply infection
detection of orgaism in blood, lung, liver, sterile sites implies infection |
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Term
Diseases
C. albicans
Types of Infection |
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Definition
invade normally sterile tissue
overgrowth in normal site |
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Term
| Diseases C. albicans Sites of Infection |
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Definition
Urogenital
oropharynx (oral thush)
skin
CV |
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Term
Diseases C. albicans
What causes Cutaneous infection |
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Definition
Where breakdown in of skin due to:
burns
chronic moisture |
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Term
| Diseases C. albicans Chronic mucocutaneous candidiasis (CMC) |
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Definition
occurs in children with genetic defects in leukocyte fxn (T cells)
RARE recurrent,severe, ulcerative lesions of skin and mucos areas not systemic |
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Term
| Pre-disposing factors C. albicans |
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Definition
steroids/anticaner agents
antiboitoics
catheterization
metabolic abnormalities
neoplasm
IV drugs |
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Term
| Virulence Factors C. albicans |
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Definition
grow at high temp.
adhere to cell surfaces produce
proteases |
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Term
Diagnosis - Lab
C. albicans |
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Definition
Directly examine tissue for yeast/pseudohyphae
PAS, GMS, calcofluor stains |
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Term
Diagnosis - Serology
C. albicans |
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Definition
antibody not helpful
lack of antigen tests with good sensitiviy and specifity |
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Term
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Definition
Topicals for simple cutaneous disease (nystatin, micronazole, clotrimazole)
Amphotericin B, liposomal AMB, fluconazole, voriconazole, caspofungin for invasive disease |
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Term
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Definition
much less common - C. glabrata, C. kruseii, but on the rise.
endocarditis from C. tropicalis and C. parapsilosis from IV drug users |
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Term
Cryptococcus neoformans
Characteristics |
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Definition
pigeons major reservoir, feces have a lot
will survive in dry env. |
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Term
Cryptococcus neoformans
Mycology |
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Definition
4-8 um (lil bigger than yeast)
single or double buds
serotypes (4) A, B, C, and D) |
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Term
| Cryptococcus neoformans Diseases |
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Definition
chronic,subacute, rarely acute pulmonary MENINGITIC INFECTION
enter through pulmonary system
AIDS, lymphoma can lead to serious infection Also, likes to live in CNS |
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Term
Cryptococcus neoformans
Diagnosis - Direct Exam |
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Definition
India ink prep on CSF
histopatholgoic - GMS, PAS, mucicarmine stain |
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Term
Cryptococcus neoformans
Diag - Culture |
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Definition
CSF, also from blood, tissue, resp. secretions
smooth, moist colonies, 35C, 48-72 hrs |
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Term
Cryptococcus neoformans
Diag - ID |
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Definition
capsule by India Ink
urease
only blastospores
pigmented colonies on caffeic acid agar |
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Term
Cryptococcus neoformans
Diag - Serologic |
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Definition
latex agglutination test for cryptococcal polysaccharide in CSF and serum
more sensitive! good |
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Term
Cryptococcus neoformans
Therapy |
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Definition
Amp B + 5 FC
Fluconazole for long term treatment |
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Term
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Definition
fumigatus (most common)
flavus (yellow-brown, carcinoginic toxin)
terreus (resistance to amp B)
niger (otitis externa, black) |
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Term
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Definition
rapildy growing, ubiquitous septate hyline hyphae Conidiophores with terminal vesicles and
Phialides produce chains of conidia |
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Term
| Aspergillus Disease 5 types of disease |
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Definition
Inhalation of conidia
1. allergic bronchopulmonary: allergy, no invasion
2. aspergilloma (fungus ball): patients with preexisting cavities in lungs
3. invasive pulmonary: invasion wiht hyphal progression along vascular pathways
4. disseminated: two or more systems
5. mycotoxicoses: ingestion of food with toxins (aflatoxins) |
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Term
Aspergillus
Disease - other features that make hose more susceptible |
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Definition
neutropenia - very impt.; neutrophils needed to kill fungi
neoplams
transplant
chemotherapy and steroids |
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Term
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Definition
look for septate hyphae with 45 degree angle branching
GMS, PAS, calcofluor
see growth of hyaline in 1-2 days at 25C
pigmentation differs betweens species |
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Term
Aspergillus
Diag - Serologic |
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Definition
antibody for allergic disease adn aspergilloma
galactomannan antigen is useful in some cases |
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Term
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Definition
allergic - steroids
aspergilloma - none, surgery
invaseive - VORICONAZOLE, lipo amp. B, ABM, caspofungin |
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Term
| Zygomycetes Species found in bread |
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Definition
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Term
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Definition
white colonies, mould rapid growht (1-2 days) 25C hyphae are hyaline and non-septate
asexual repro. by sporangia and sporangiospores |
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Term
| Zygomycetes Mycology Rhizoids |
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Definition
Rhizopus - rhizoids directly opposite sporangia
Absidia - rhizoids between two sporangia
Mucor - no rhizoids |
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Term
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Definition
acute and fulminant
respiratory entry, possibly ear |
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Term
| Zygomycetes Disease - clinical presentation |
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Definition
rhinocerebral (most common) - rapidly progressive, sinus, orbits and brain, infarction, necrosis, diabetes not controlled contributes
thoracic
abdominal
skin (from burns) |
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Term
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Definition
broad non-septate hyphae
90 degree branching
culture - rapid grower
no serology |
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Term
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Definition
Big guns and surgery
Lipid amp B
Posaconazole
Surgery |
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Term
Pneumocystis jiroveci
Characteristics |
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Definition
pulmonary infection
secondary to AIDS |
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Term
Pneumocystis jiroveci
Mycology |
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Definition
trophic form - 1-5 um
uninucleated form - 4-5
mature spore case containing 8 oval to fusiform spores (1-3 um) |
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Term
| Pneumocystis jiroveci Disease |
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Definition
resp. tract entry subclinical probabaly common
alveolar macrophages and CD4 TCells
HALLMARK: Interstitial pneumonitis and plasma cell infiltration
Occasional extrapulmonary infection (liver, bone marrow) |
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Term
Pneumocystis jiroveci
Diag |
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Definition
can't grow in culture
must look at in tissue
bronchial washings and sputum
Gomori meth silver stain
Giemsa stain
immunofluorescent antibody stain |
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Term
Pneumocystis jiroveci
Therapy |
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Definition
Primary: trimethoprim/sulfanmethoxazole
2ndary: clind, pentamidine
conrticosteroids in acutely ill, immunosuppressed patients |
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Term
| Hyalohyphomycoses - did not go over in class |
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Definition
ignored.
good chart on p 35 |
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Term
Methods to ID C. Albicans
(3) |
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Definition
Germ tube test
Chlamydoconidia formation
Carbohydrate assimilations and ferm. |
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