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145 Cards in this Set
- Front
- Back
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Yeasts - single or multiple buds |
Blastomycosis, Histoplasmosis, Paracoccidioidomycosis, Penicilliosis, Sporotrichosis |
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Yeasts w/ capsule |
Crytococcosis |
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Hyphae - septate |
Hyalohyphomycosis - sp. of Aspergillus, Fusarium, Geotrichum, Trichosporon |
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Hyphae - septate in skin or nail specimens |
Dermatophytosis |
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Hyphae-nonseptate |
Mucormycosis-sp. of Rhizopus, Lichtheimia, Cunninghamella |
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Hyphae - septate; brownish cell walls |
Phaeohyphomycosis - sp. of Bipolaris, Cladosporium, Curvularia, Exserohilum |
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Yeasts & Pseudohyphae |
Candidiasis - spp. of Candida |
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Yeasts & Hyphaee in skin scrapings |
Pityriasis versicolor |
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Spherules |
Coccidioidomycosis |
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Sclerotic cells - brownish cell walls |
Chromoblastomycosis |
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Sulfur granules |
Mycetoma |
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Arthroconidia in hair |
Dermatophytosis |
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Conidia in pulmonary cavity |
Hyalohyphomycosis - spp of Aspergillus, Fusarium |
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Cysts (Asci) in pulmonary specimens |
Pneumocystis |
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chronic infection of stratum corneum |
Pytiriasis Versicolor (Mallassezia infection) |
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charaterized by discrete, serpentine, hyper- or hypopigmented maculae that develop on the skin, usually on the chest, upper back, arms or abdomen |
Pytiriasis versicolor |
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causative agents of pytiriasis versicolor |
Malassezia globosa, Malassezia furfur, Malassezia sympodialis |
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specimen of choice for Pytiriasis versicolor |
scrapings of infected skin |
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for diagnosis of pytiriasis versicolor |
Direct KOH microscopic examination |
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treatment for malassezia infection |
Selenium sulfide, & topical or oral azoles |
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superficial chronic and asymptomatic infetion of the stratum corneum |
Tinea nigra |
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Causative agent of tinea nigra |
Hortaea (Exophiala) werneckii (dematiaceous fungus) |
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appearance of lesions of tinea nigra |
dark (brown to black) discoloration, often on the palm |
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microscopic appearance of Malassezia spp |
short unbranched, nonpogmented hyphae, & spherical cells |
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sample for microscopic examination of tinea nigra |
skin scrapings |
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appearance microscopically of the causative agent of tinea nigra |
branched, septate hyphae & budding yeast cells w/ melanized cell walls |
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treatment for tinea nigra |
keratolytic solutions, salicylic acid, or azole antifungal drugs |
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Nodular infection of the hair shaft caused by Piedraia hortae |
Black piedra |
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larger, softer, yellowish nodular infection caused by Trichosporon spp. |
white piedra |
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infections of piedra |
hair of the axilla, genitalia, beard, and scalp hair |
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treatment for piedra |
removal of the infected hair, and topical antifungal agent |
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3 genera of dermatophytosis |
Microsporum, Tricophyton, Epidermophyton |
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Classification of dermatophytes |
Geophilic, Zoophilic, Anthropophilic |
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Appearance of Trichophyton mentagrophytes |
grape-like clusters of spherical microconidia |
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Appearance of Trichophyton rubrum |
pear-shaped microconidia |
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appearance of T. tonsurans |
elongated microconidia |
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appearance of Microsporum canis |
composed of 8- to 15-celled macroconidia; have curved or hooked tips |
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appearance of M. gypseum |
composed of 4- to 6-celled macroconidia |
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appearance of Epidermophyton floccosum |
Composed of 2- to 4- celled macroconidia and formed in small clusters |
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circular patches w/ advancing red, vesiculated border, & central scaling. pruritic loc. of lesions: nonhairy, smooth skin |
Tinea corporis (ringworm) |
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Causative agent of Tinea corporis |
Trichophyton rubrum, Epidermophyton floccosum |
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Causative agent of Tinea corporis |
Trichophyton rubrum, Epidermophyton floccosum |
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Acute: itching, red vesicular. Chronic: itching, scaling, fissures Loc. of lesions: interdigital spaces on feet of persons wearing shoes |
Tinea pedis (athletes foot) |
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causative agent of Tinea pedis |
T. rubrum, T. mentagrophtes, E. floccosum |
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Erythematous scaling lesions in intertriginous area. pruritic loc. of lesions: groin |
Tinea cruris (jock itch) |
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causative agent of Tinea cruris |
T. rubrum, T. mentagrophytes, E. floccosum |
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causative agents for tinea capitis |
T. metagrophytes, M. canis, T. tansurans |
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Edematous, erythematous lesion loc. of lesions: beard hair |
Tinea barbae |
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Causative agent for tinea barbae |
T. mentagrophtes, T. rubrum, T. verrucosum |
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nails thickened or crumbling distally; discolored; lusterless. usually associated w/ tinea pedis loc. of lesions: nail |
Tinea unguium (onychomycosis) |
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causative agents for Tinea unguium |
T. rubrum, T. mentagrophytes, E. floccosum |
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Pruritic vesicular to bullous lesions. most commonly associated w/ tinea pedis
loc. of lesions: usually sides & flexor aspects of the fingers. palm. any site of the body |
Dermatophytid (id reaction) |
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no fungi presenr in lesion. may become secondaaarily infected w/ bacteria |
Dermatophytid |
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lab diagnosis for dermatophytosis |
direct KOH examniation for hair, skin, nail scrapings |
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culture for dermatophytosis |
SDA slants (/ cycloheximide & chloramphenicol), incubated for 1-3 wks at RT |
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Treatment for dermatophtosis |
removal of infeted and dead epithelial structures and application of a topical & antifungal drugs |
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treatment for Tinea Capitis |
Griseofulvin or terbinafine (PO) Miconazole cream & topical antifungal agents Alternative: Ketoconazole & itraconazole |
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treatment for Tinea corporis, tinea pedis, &related infection (cruruis & barbae) |
Itraconazole & terbinafine (PO) Miconazole nitrate, tolnaftate & clotrimazole (topical) sever cases: Griseofulvin (PO) |
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treatment for tinea unguium |
Itraconazole or terbinafine (PO) Surgical removal of the nail Imidazole and luliconazole (topical) |
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dimorphic dungi that lives on vegetation associated w/ grasses, trees, sphagnum moss, rose bushes, and other horticultural plants |
Sporothrix schenckii |
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at RT sporothrix schenckii form: |
mold form: producing branching, septate hyphae & conidia |
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at 35-37C sporothrix schenckii: |
yeast form |
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chronic granulomatous infection secondary spread w/ involvement of the draining lymphatics & lymph nodes |
Sporotrichosis |
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Lab diagnosis for Sporotrichosis |
KOH or calcofluor white stain Gomori methenamine silver - cell wall (black) periodic acid-Schiff stain - cell wall (red) fluorescent antibody staining |
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culture of sporothrix schenckii |
SDA w/ antibacterial antibiotics & incubated at 25-30C. confirmed at: 35C & conversion to the yeast form |
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treatment for sporotrichosis |
DOC: itraconazole or other azole Systemic: aphotericin B |
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Chronic infection and characterized by the slow development of progressive granulomatous lesions that in time induce hyperplasia of the epidermal tissue |
Chromoblastomycosis |
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fungal aganets of chromoblastomycosis |
Pialophora verrucosa, Fonsecaea pedrosoi, Fonsecaea compacta, Rhinocladiella aquaspersa & Cladophialophora carrionii |
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Laab diagnosis for chromoblastomycosis |
KOH - dark spherical cell; granulomas and hyperplasia of dermal tissue culture: SDA w/ antibiotics |
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treatment for chromoblastomycosis |
surgical excision for small lesions Flucytosine or itraconazole |
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infetions characterized by the presence of darkly pigmented septate hyae in tissue |
Phaeohyphomycosis |
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fungal agents of phaeoyphomycosis |
Exophiala jeanselmei, Phialophora richarsiae, Bipolaris spicifera, & Wangiella dermatitidis (systemic: Exserohilum rastratum, Alternaria spp. & Curvularia spp.) |
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lab diagnosis for Phaeohyphomycosis |
KOH - presence of melanin in cell wall culture: SDAw/ antibiotics |
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treatment for phaeohyphomyosis |
itraconazole or flucytosine brain abscesses: amphotericin B & surgery |
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local swelling of the infected tissue and interconnecting, often draining, sinuses or fistulae that contain granules, w/c are microcolonies of the agent embedded in tissue maerial |
Mycetoma |
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Fungal agents of Mycetoma |
Pseudallescheria boydii, Madurella mycetomatis, Madurella grisea, E. jeanselmei, & Acremonium falciforme |
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lab diagnosis for mycetoma |
Biopsy and culture |
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treatment for Mycetoma |
P. boydii - nystatin or miconazole (topical)
Madurella - itraconazole, ketoconazole, & amphotericin B E. jeanselmei - flucytosine |
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Etiology
Histoplasma capsulatum |
Histoplasmosis |
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Ecology Avian and bat habitats (guano); alkaline soil |
Histoplasmosis |
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Geographic distribution Global; endemic in Ohio, Missouri, and Mississippi River valleys; Central africa (var. duboisii) |
Histoplasmosis
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Tissue form Oval yeast, 2x4 um. intracellular in macrophages |
Histoplasmosis
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Etiology Coccidioides pasadasii or Coccidioides immitis |
Coccidioidomycosis |
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Ecology Soil, rodents |
Coccidioidomycosis
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Geographic distribution Semiraid regions of southwestern United States, Mexico, Central and South America |
Coccidioidomycosis
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Tissue form Spherules, 10-80 um, containing endospores, 2-4 um |
Coccidioidomycosis
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Ecology Unknown (riverbanks) |
Blastomycosis |
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Geographic Distribution Missisipi, Ohio and St. Lawrence River valley; southeastern United States |
Blastomycosis
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Tissue Form Thick-walled with broad-based usually single, buds, 8-15 um |
Blastomycosis
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Etiology Paracoccidioides brasilliensis |
Paracoccidioidomycosis |
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Etiology Blastomyces dermatidis |
Blastomycosis
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Ecology Unknown (soil) |
Paracoccidioidomycosis
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Geographic Distribution Central and South America |
Paracoccidioidomycosis
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Tissue form Large, multiply budding yeasts, 15-30 um |
Paracoccidioidomycosis
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Clinical features 1. Asymptomatic 2. Pneumonia 3. Disseminated: affect the lungs, skin, bones, and meninges |
Coccidioidomycosis |
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Clinical features 1. Asymptomatic 2. Pneumonia: (may look similar to tuberculosis) 3. Disseminated : can occur in almost any organ, especially in the lung, spleen, or liver |
Histoplasmosis
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Clinical Feature 1. Asymptomatic (uncommon) 2. Pneumonia 3. Disseminated: weight loss, night sweats, lung involvement, and skin ulcers 4. Cutaneous: skin ulcers |
Blastomycosis
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Clinical feat 1. Asymptomatic 2. Pulmonary granulomas 3. Disseminated: Chronic progressive pulmonary disease. |
Paracoccidioidomycosis
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COCCIDIOIDOMYCOSIS
Specimens |
sputum,exudate from cutaneous lesions, spinal fluid, blood, urine, and tissue biopsies
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COCCIDIOIDOMYCOSIS Microscopy |
KOH or calcofluor white stain: spherules and endospores
H&E, GMS, or PAS |
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COCCIDIOIDOMYCOSIS Culture |
IMA or Brain-Heart Infusion blood agar slants: at roomtemperature or at 37 °C.
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COCCIDIOIDOMYCOSIS Serology |
IgM and IgG antibodies are detected by the immunodiffusion(ID) or complement fixation (CF) test.
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COCCIDIOIDOMYCOSIS Treatment |
1. Itraconazole: mild cases.
2. Amphotericin B (IV): severedisease 3. Fluconazole: coccidioidalmeningitis |
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HISTOPLASMOSIS Specimen |
sputum, urine, scrapings from superficial lesions, bonemarrow aspirates, buffy coat of blood cells.
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HISTOPLASMOSIS Microscopy |
GMSor PAS Giemsa-stained smears of bone marrow or blood |
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HISTOPLASMOSIS Culture |
Glucose cysteine blood agar at 37 °C; SDA or IMA at 25-30 °C; minimum of 4 weeksincubation. |
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HISTOPLASMOSIS Laboratory diagnosis |
1. Culture 2. PCR testing forspecific DNA sequences. 3. Serology: CF test 4. Skin Test |
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HISTOPLASMOSIS Treatment |
1. Itraconazole: mild to moderateinfection.
2. Amphotericin B: systemic |
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BLASTOMYCOSIS Specimen |
sputum,pus, exudates, urine, and biopsies from lesions
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BLASTOMYCOSIS Culture |
Sabouraud’sor enriched blood agar at 30 °C within 2 weeks. |
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BLASTOMYCOSIS Laboratory diagnosis |
1. Culture 2. Serology: CF, ID test 3. EIA |
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BLASTOMYCOSIS Treatment |
1. Itraconazole
2. Amphotericin B |
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PARACOCCIDIOIDOMYCOSIS Specimen |
sputum,exudates, and biopsies from lesions
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PARACOCCIDIOIDOMYCOSIS Microscopy |
KOHor calcofluor white |
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PARACOCCIDIOIDOMYCOSIS Culture |
SDA or yeast extract agar: at RT and confirmed byconversion to the yeast form by in vitro growth at 36 °C.
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PARACOCCIDIOIDOMYCOSIS Serology |
CFor ID test |
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PARACOCCIDIOIDOMYCOSIS Treatment |
1. Itraconazole 2. Amphotericin B |
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Oral Thrush: Patches of creamy white exudate with a reddish base coverthe mucous membranes of the mouth.
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CANDIDIASIS |
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Vaginitis: inflammation vaginal mucosa and patches of cottage cheese-appearingwhite clumps affixed to the vaginal wall |
CANDIDIASIS
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Diaper rash: Warm moist areas under diapers and in adults between skinfolds
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CANDIDIASIS
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CANDIDIASIS Specimen |
swabs and scrapingsfrom superficial lesions, blood, spinal fluid, tissue biopsies, urine,exudates, and material from removed intravenous catheters
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CANDIDIASIS
Culture |
37C |
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CANDIDIASIS Microscopy |
KOH and calcofluor white (skin or nail scrapings)
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CANDIDIASIS
Antigen detection |
Real time PCR |
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CANDIDIASIS Serology |
latex agglutination test or enzyme immunoassay
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CANDIDIASIS Treatment |
Thrush and othermucocutaneous forms of candidiasis: topical nystatin or oral ketoconazole orfluconazole.
Systemic candidiasis:amphotericin B (sometimes in conjunction with oral flucytosine, fluconazole, orcaspofungin. |
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CRYPTOCOCCOSIS
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Cryptococcusneoformans Yeast, a spherical, single-celled fungus It lives in soil, the feces of birds, and the sap of eucalyptus trees. |
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CRYPTOCOCCOSIS Two variants |
C. neoformans var. gattii C. neoformans var. neoformans |
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CRYPTOCOCCOSIS |
Presenceof polysaccharide capsule Productionof melanin The yeast has apredilection for the central nervous system |
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CRYPTOCOCCOSIS Specimen |
cerebrospinal fluid (CSF),tissue, exudates, sputum, blood, cutaneous scrapings, and urine. |
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CRYPTOCOCCOSIS Culture |
37C |
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CRYPTOCOCCOSIS Microscopy |
detection of encapsulatedyeast |
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CRYPTOCOCCOSIS Serology |
Latex slideagglutination test or enzyme immunoassay (EIA)
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CRYPTOCOCCOSIS Treatment |
Intravenous amphotericin B and oral flucytosine for 6–10 weeks. AIDS patients: oral fluconazole treatment. No vaccine against Cryptococcusis available. |
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ASPERGILLOSIS Causitive agents |
: Aspergillus fumigatus, Aspergillus niger andAspergillus flavus |
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Asthma type reaction with shortness of breath and high fever |
Allergic Bronchopulmonary Aspergillosis |
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associated with hemoptysis (bloody cough) |
Aspergilloma |
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Necrotizing pneumonia (immunocompromised patient) |
Invasive Aspergillosis |
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Liver damage and liver cancer |
Aflatoxin Consumption |
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ASPERGILLOSIS Specimen |
Sputum, otherrespiratory tract specimens, and lung biopsy tissue |
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ASPERGILLOSIS Microscopy |
KOH or calcofluorwhite stain |
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ASPERGILLOSIS Culture |
Room temp |
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ASPERGILLOSIS Serology |
ID test |
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ASPERGILLOSIS Treatment |
Allergic forms of aspergillosis: corticosteroids ordisodium cromoglycate Aspergilloma: itraconazole or amphotericin B and surgery. Invasiveaspergillosis: amphotericin B or voriconazole |
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circular bald patches w/ short hair stubs or broken hair w/in hair follicles. Kerlon ror. Microsporum-infected hairs fluoresce loc. of lesions: scalp hair. Endothrix: fungus inside hair shaft. Ectothrix: fungis on surface of hair |
Tinea capitis |
