Miscellaneous Quiz / fungal pathogens

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QUIZ: Can you name the fungal pathogens?

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

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