SYSTEMIC MYCOSIS

Question 1

Systemic mycosis

Dismorphic fungi

Answer 1

Cold (20°C)=mold, heat (37°C)=yeast

Exception: Coccioides which is a spherule in tissue

Question 2

Systemic mycosis

Disease

Answer 2

Pneumonia and can disseminate

Can form granulomas (like TB), but cannot be transmitted person to person

Question 3

Systemic mycosis

Names

Answer 3

Histoplasma capsulatum
Blastomyces dermatiditis
Coccioides immitis
Paracoccioides brasiliensis

Question 4

Systemic mycosis

Treatment

Answer 4

Fluconazole or itraconazole for local infection
Amphotericin B for systemic infection

Question 5

Histoplasma capsulatum

Map distribution

Answer 5

Missisipi and Ohio River Valleys

Midwestern US

Question 6

Histoplasma capsulatum

Transmission

Answer 6

Respiratory (bat heces)

Question 7

Histoplasma capsulatum

Microscopic findings

Answer 7

Macrophages with intracellular oval bodies

Smaller than RBC

Question 8

Histoplasma capsulatum

Disease

Answer 8

Palatal/tongue ulcers
Pneumonia
Erythema nodosum
Hepatoesplenomegaly (immunocompromised)

Targets the reticuloendothelial system

Question 9

Histoplasma capsulatum

Diagnosis

Answer 9

KOH or rapid serum or urine antigen test

Question 10

Blastomyces dermatiditis

Map distribution

Answer 10

Eastern and central US, Great Lakes

Question 11

Blastomyces dermatiditis

Transmission

Answer 11

Inhalation of spores

Question 12

Blastomyces dermatiditis

Microscopic findings

Answer 12

Broad based budding
Same size as RBC

Question 13

Blastomyces dermatiditis

Disease

Answer 13

Pneumonia (patchy alveolar infiltrate)
Disseminates to bone/skin

Question 14

Blastomyces dermatiditis

Diagnosis

Answer 14

OH or urine antigen test

Question 15

Coccidioides immitis

Map distribution

Answer 15

Southwestern US, California

Question 16

Coccidioides immitis

Transmission

Answer 16

Inhalation of spores

Associated with dust exposure in endemic areas (earthaquakes)

Question 17

Coccidioides immitis

Dismorphic

Exception

Answer 17

Mold=cold, spherule of endospores

Larger than RBC

Question 18

Coccidioides immitis

Pneumonia

Answer 18

Unilateral infiltration
Ipsilateral hilar adenopathy
Pulmonary nodule formation

Question 19

Coccidioides immitis

Disease

Answer 19

Erythema nodosum or multiforme
Arthralgias
Disseminates to bone/skin
Meningitis

Question 20

Coccidioides immitis

Diagnosis

Answer 20

KOH or IgM

Question 21

Paracoccidioides brasiliensis

Map distribution

Answer 21

Latin america

Question 22

Paracoccidioides brasiliensis

Transmission

Answer 22

Respiratory droplets

Question 23

Paracoccidioides brasiliensis

Microscopic findings

Answer 23

Budding yest with “captain wheel’s” formation

Much larger than RBC

Question 24

Paracoccidioides brasiliensis

Clinical presentation

Answer 24

Lymphadenopathy: lymph nodes in cervical region
Mucosal ulcers and cutaneous lesions in the upper mouth leading to small hemorrhages

Lymphadenopathy can go down until it affects the lungs