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Alle Oberthemen / Biology / Microbiology

Respiratory Fungi (28 Karten)

Sag Danke
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Primary & Opportunistic Systemic Fungi
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Are fungi transmitted person to person?
No
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Coccidioidomycosis Immitis & C. posadasii
Valley Fever.

Endemic in south-west USA, Mexico, Central / South America

Can be aerosolized. Infection through respiration.

Dimorphic because they form spheres or Hyphae (the form in the lungs)

Hyphae: IN VITRO. Mold and can be aerosolized
Sphere: IN VIVO. Sphere divides in tissue lesions

Can develop resistance after the first infection. (Hence can have vaccines).
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Coccidioidomycosis Immitis & C. posadasii

Range of symptoms
60% subclinical. Symptomatic in 40%

Fever, Pneumonia, Rash. Most recover from this severity
ex. rash = Coccidioidal Erythema Nodosum


Dissemination of fungus -> skin, bones, meninges (Polygranulomatous lesions). Possibly lethal if it progresses to this stage

Bad for certain ethnic groups, late pregnancy, immunocompromised pts.
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Coccidioidomycosis Immitis & C. posadasii

Treatment
Surgery

Antifungal azoles: Fluconazle, Itraconazole, Voriconazole, Posaconazle

Polyene: Amphotericin B
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Coccidioidomycosis Immitis & C. posadasii

Diagnosis
Biopsy

Culture - molecular testing (ie DNA probe)

Serologic Testing - Antibody testing
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Histoplasmosis (Histoplasma Capsulatum var. capsulatum)
AKA Reticuloendothelial Cytomycosis, Spelunker's Disease


Mississippi River Valley Soil (bird droppings)
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Where does it reside in vivo? In nature?
Mold-like in nature. Lives in the soil.

Small yeast in hosts

Lives in mononuclear cells of Reticulendothelial System


Dimorphic at 37C
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What does it look like on CT? What are symptoms?
Patchy Pneumonia
Hilar Lymphadenopathy
Most recover.


If spreads within / outside of lungs=>

Can look like TB
Rarely in Bone

Can give pulmonary calcifications after healing
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Diagnostic Criteria of Histoplasmosis
Look for small yeast in mononuclear cells

Molecular probe
Ab detection
Antigen in serum / urine

Stains:
H&E or Methamine Silver
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Treatment of Histoplasmosis / Epidemiology
Itraconazole (other azoles don't work so well)

Liposomal Amphotericin B



Found in human and non-human droppings
Endemic in the US.
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Blastomycosis (Blastomyces Dermatitidis)
Soil of USA

Large yeast phase (15 m)

Dimorphic (yeast at 37C)

Conidia inhaled, leading to respiratory infections.

Can spread to other systems (pyogranulomatous lesions)

Can look like tuberculosis, mycosis, carcinoma
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Diagnosis of Blastomycosis
Biopsy, Culture for dimorphic

KOH of pus.
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Treatment  & Epi of Blastomycosis
Surgical
Itraconazole, fluconazole, voriconazle, amphotericin B (polyene antifungal)

Midwest - Easter US.

Some in Africa
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Paracoccidioidomycosis (Paracoccidioides brasiliensis)
S. America

Dimorphic mold - at 37C
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What is the gender distribution of paracoccoidiodomycocis? Why?
Mostly in males because estrogen inhibits -Glucan which is necessary for conversion from hyphal to yeast form
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Treatment & Epi of Paracoccoidioidomycosis
Itraconazole
Amphotericin B
Sulfonamide

Only in tropical areas.
Armadillos only organisms infected
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Diagnosis of Paracoccoidiodomycosis
Biopsy/ Culture
Serology
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Aspergillosis (what are the species?)
Aspergillosis Fumigatus

Hyphal organisms in soil.
Ubiquitous. Probably breathing right now
Bad for immuno-compromised patients
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Symptoms / Diseases of Aspergillus Fumigatus
Makes conidia which are inhaled

Toxicosis - aflatoxin
Allergic Bronchopulmonary disease
-Asthma-like (IgE)
-Farmers lung like (IgE, IgG)
Pneumonitis
Sinusitis
Fungus Ball - pulm cavity


Vasoinvasive disease in immunocompromised form (if Hyphal form)
-Nose / paranasal sinus
Lungs, skin - in neutropenic patients


Risk factors:
Diseases: lymphoma, diabetes mellitus, CF
- Neutropenic pts. (Aplastic Anemia)
- Immunocompromised pts. (organ transplant recipients)


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Diagnosis of Aspergillus Fumigatus
Culture
Antigen
Galactomannan in serum
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Treatment & Epi of Aspergillus Fumigatus
Steroids for allergic reaction
Itraconazole
Smphotericin B
Caspofungin
Voriconazole for invasive form
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Pneumocystosis (Interstitial Plasma Cell Pneumonia)
Never been cultivated in medium

Glucan, Mannan, Aminosugars in cell wall
- important for adhesion to cells

Cholesterols & Sterols present (but not ergosterol)
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Pathogenesis of Pneumocystis Jirovecii
Looks kinda like a protozoa (cyst morpho)

Respiratory tract infection. Remains quiescent until immunocomprimise. (Leukemia, AIDS, protein deprived infants)
=> Then active, produces pneumonia.


Infectious cause of death in AIDS patients
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Treatment / Prophylaxis of Pneumocystis
Trimethoprim-sulfamethoxazole
Pentamidine, atovoquone
Clindamycin + Primaquine (unusual)
trimexetrexate, Caspofungin
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Symptoms of paracoccoidiodomycosis
Initially in lungs.
Lymphadenopathy (cervical nodes)
Mucocutaneous
Systemic Visceral
Pyogranulomatous lesions
27
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Who is Domingo Escurra
First recognized patient with Coccidioidomycosis
28
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Answer
Kartensatzinfo:
Autor: yaoyu
Oberthema: Biology
Thema: Microbiology
Veröffentlicht: 10.02.2010
Tags: Respiratory Fungi
 
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