Miscellaneous Quiz / fungal pathogens

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Can you name the fungal pathogens?

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Dx: Microscopy, culture on sabouraud agar (25C vs. 37C), serologic tests (Ab detection tests), X-ray
Pathogenesis: granulomatous inflammatory reaction/possible dissemination
Cx at 37C: mold (no thermal dimorphism). Tissue at 37C: SPHERULES filled with endospores
Reservoir: Soil contaminated by bird or bat feces - Eastern US
Opportunistic, monomorphic pathogens
Transmission: inhalation from environment. No human-to-human transmission
Patho: inhalation (infective form unclear) -> proliferation in alveoli -> foamy alveolar infiltrate -> dissemination
Clinical presentation: pulmonary infections, dissemination (meningitis in AIDS pts)
Tx of pneumocystosis
Clinical presentation: allergic bronchopulmonary aspergillosis; fungal ball (aspergilloma); invasive pulmonary aspergillosis
Patho: inhalation of aerosolized yeast -> production of capsule in alveoli, multiplication -> granulomatous lesions -> dissemination (CNS)
Bind to host cells -> turn into yeast cells; dissemination: skin, mucosa, lymphoid organs....
Key characteristics: ENCAPSULATED YEAST
Clinical presentation: inhalation of sporangiospores -> hyphae formation -> angioinvasive fungi
Disease caused by Crytococcus neoformans
Key characteristics: Filamentous fungus (mold)
Tx of cryptococcosis
Reservoir: Soil - South America
Disease caused by Aspergillus, fumigatus, and flavus
Environment & cx at 25C: Mold: hyphae + barrel-shaped arthroconidia
Patho: inhalation of sporangiospores -> hypae formation ->angioinvasive fungi
True pathogens
Life cycle of alternating spherules and progeny endospores; dissemination via endospore propagation (skin, CNS, bone...)
Disease caused by Paracoccidioides brasiliensis
Tissue & cx at 37C: budding yeasts with 'PILOT WHEEL' MORPHOLOGY
Environment & cx at 25C: Mold: hyphae + micro & macroconidia
Tx of severe or disseminated dz from true pathogens
Disease caused by Histoplasma capsulatum
Reservoir: Desert sand - southwestern US
Patho: inhalation of conidia -> germination into hyphae -> tissue invasion; angioinvasive fungi
Disease caused by Pneumocystis jiroveci
Reservoir: Soil enriched with pigeon droppings
Reservoir: Ubiquitous in soil
Environment & cx at 25C: Mold: hyphae + nondescript conidia
Disease caused by Blastomyces dermatitidis
Tx of mild to moderate dz from true pathogens
Bind to host cells -> turn into yeast cells (extracellular); dissemination: multiple organs, skin (cutaneous form)
Clinical presentation from self-limiting flu-like illness to severe pulmonary infection (similar to TB) and disseminated conditions
Clinical presentation: inhalation (infective form unclear) -> proliferation in alveoli -> foamy alveolar infiltrate -> dissemination
Conidia turn into yeast cells -> multiplication inside macrophages; dissemination via macrophages -> skin, reticuloendothelial system
True pathogens definition
Reservoir: Soil with decaying organic material - Eastern US
Dx: Microscopy, cx on sabouraud agar, serologic tests, X-ray
Environment & cx at 25C: Mold: septae hyphae + nondescript conidia
Tx of aspergillosis, zygomycosis, and mucormycosis
Predisposing conditions: AIDS pts, immunocompromised, or metabolic disorders (DM)
Tissue & cx at 37C: INTRACELLULAR BUDDING YEASTS in reticuloendothelial cells
Disease caused by Rhizopus and Mucor
Key characteristics: Single-celled eukaryotic microorganism. LIFE CYCLE = tropozoites, precyst, cyst. NO ERGOSTEROL IN THE CELL MEMBRANE
Disease caused by Coccidioides immitis
Transmitted from inhalation of dust containing conidia. No human-human transmission

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