Mississippi and Ohio River

Hides in Macrophages

History of contact with animals

AIDS-defining illness if systemic

Healthy people get pneumonia

Northeast US

Granulomatous systemic illness

"Broad-based budding"

Southwest (Arizona etc)

Spherule with endospores in tissue, no yeast form

Valley Fever: pneumonia + meningitis with systemic spread

Rare but severe illness

Latin America

"captain's wheel" formation in histology

Rose-gardeners

Thermally dimorphic, cigar-shaped

Local ulcer + lymphadenitis

Treat with potassium iodide (KI)

Malassezia furfur

damages melanocytes (hyper or hypopigmentation)

"Spaghetti and Meatball" on KOH prep

Pedis (athlete's foot)

cruris (groin)

corporis ("ringworm")

capitus (sebborhea dermatitis)

Microsporum, Trichophyton, Epidermophyton

Mold hyphae only

T-cells prevent local infection (Chronic Mucocutaneous candidiasis)

Neutrophils prevent hematogenous spread (Phagocyte immunodeficiencies)

Catalase +

Can cause diaper rash, endocarditis

See "germ tubes" in histology

Hyphae branch at acute angles

Catalase + (commonly seen in NADPH oxidase deficiency aka Chronic Granulomatous Disease)

Asthmatics: allergic brochopulmonary type

Fungus balls in old cavitary lesions

Disseminated disease in immunocompromised

Associated with HCC

Inhaled-->blood-->meninges

Causes fungal meningitis in immunocompromised patients

Hevily encapsulated yeast on histology

Soap bubble lesions in brain

Buds at right angles

Loves ketones/glucose: Patients in DKA

Brain abscess

Disk-shaped yeast on silver stain

AIDS ppx when CD4<200

Treat w dapsone, pentamidine, bactrim

See either trophozoite or the cyst in stool

IgA deficiency prone to mucosal infection

Bloody diarrhea and liver abscess

*Note, another liver asbcess is caused by the helminth "Echinococcus"

They eat RBCs

Treat w/ Flagyl or iodoquinol

AIDS-defining severe GI illness

Treat with nitazoxanide

Cysts on acid-fast stain

Brain abscess in HIV

(different than congenital infection)

Treat with sulfadiazine and pyrimethamine

Ameoba in water causes fatal CNS disease

hail mary = amphotericin

Trypanosoma

brucei

gambiense

rhodesiene

African Sleeping Sickness after painful Tsetse fly bite

Can rearrange genome to evade host defense

Treat blood-borne: Suramin

Treat CNS: Melasoprol

Falc= severe w/ irregular fever cycles

Mala= 72-hr fever cycles

Treat with chloroquine (first-line) and mefloquine (second-line)

See RBC schizont with merozoites

48-hr fever cycles

Treat dormant form in liver with primaquine

See RBC schizont with merozoites

Ixodes tick transmits it and Lyme

Babosiosis symptoms are fever and hemolytic anemia

See ring or maltese cross on histology

Treat with quinine or clindamycin

Chaga's disease is cardiomyopathy + mega (colon, esophagus)

Reduviid kissing bug transmits

treat with nifurtimox

#2 most common parasitic illness worldwide, causes a visceral infection called

"kala-azar": cyclic fevers, HSM, pancytopenia

speckled macrophages

Treat with sodium stibogluconate

anal pruritis, pinworm

pyrantel pamoate or -bend-

giant roundworm with giant eggs in feces

Treat with pyrantel pamoate or -bend-

ingested roundworm

Muscle inflammation and periobital edema

Treat with -bend-

skin-->intestine

vomiting, diarrhea, anemia

Treat w ivermectin or -bend-

Skin-->intestines

GI blood suckers

Treat w pyrantel pamoate or -bend-

Drinking water-->skin

treat with niridazole or prolonged extraction

River Blindness

Blackflies, black skin nodules, black sight

Treat with rIVERmectin

Worm transmitted by fly, crawls in your eye

Diethylcarbamazine

Mosquito

Elephantitis (lymph blockage)

Diethylcarbamazine

Food-->Tissues

Granulomas and "viscera larva migrans"

Diethylcarbamazine

Also causes a GI infection (intestinal tapeworm)

Treat w praziquantel

Treat neurocysticercosis w/ -bend-

Raw fish

B12 deficiency

Treat w praziquantel

Rapidly growing liver cyst in immigrants 

*Note: other liver cyst from protozoa entamoeba hystolytica

Surgeon must inject ethanol to prevent anaphylaxis

Treat w -bend-

Granulomas and fibrosis of liver and spleen

S. haematobium: bladder cancer

Treat w praziquantel

Undercooked fish

Biliary diseases

Treat w praziquantel

undercooked crab

hemoptysis

Treat w praziquantel

Gingivostomatosis HSV1

EBV heterophile antibody test, infects B-cells but see abnormal reacting T-cell on histology, can lead to nasopharygeal cancer

CMV pneumonia in immunocompromised

Kaposi's is sexually transmitted

Tsanck smear of vesicle: intranuclear inclusions in keratinocytes and multinulceated ginat cells

Exception to rule: All envelopes are acquired from the cell membrane (it is acquired in herpes from nuclear membrane)

Hep B virus

Enveloped

Exception to: "All DNA viruses are linear" (partial circular DNA)

Exception to "All dsDNA viruses have infectious naked genome"

has reverse transcriptase

Viral hemorrhagic UTI, viral pharyngitis, viral pneumonia, viral conjunctivitis

Protoypic DNA virus: dsDNA linear icosehedral nuclear-replicating virus w infectious naked genome

Exception to: "All DNA viruses are dsDNA" (-ssDNA)

Sickle cell crisis, other adults can get RBC aplasia and RA-like features

warts also from HPV 1, 2

Exception to: "All DNA viruses are linear" (circular)

Exception to: "All DNA viruses are linear" (circular)

JC virus invades oligodendrocytes and causes PML

BK virus in transplanted organs

Enveloped, large

Exception to: "All DNA viruses are icosehedral.." (it's complex), "...replicate in nucleus..." (replicates in cytoplasm).

Exception to "All dsDNA viruses have infectious naked genome"

Molluscum contagiosum and "vaccinia/cowpox/milkmaid blisters"

Coltivirus-colorado tick fever

Rotavius- diarrhea

Exception to: "All RNA viruses are ssRNA (its dsRNA), have envelopes (its naked) and are one piece (its segmented genome)"

Enteroviruses (except rhino "common cold") can cause viral meningitis (except Hep A)

Exception to "All RNA viruses have envelopes"

Polio, Hep A, Echovirus, Coxsackie, Rhinovirus

HepEvirus

Waterborne epidemics

High mortality in pregnant women

Exception to: "All RNA viruses have envelopes"

Exception to "all RNA viruses have envelopes"

Norwalk viral gastroenteritis

Hepatitis C virus + arboviruses

yellow fever, Dengue, West Nile, St Louis encephalitis

Rubella + equine enchephalitis

RNA virus

Exception to: "All viruses are haploid" (it has 2 copies of ssRNA)

Exception to: "All RNA viruses replicate in the cytoplasm" (it replicates in the nucleus)

HIV is exception to: "All +ssRNA viruses have icosohedral capsid" (its capsid is conical and complex)

Also HTLV T-cell lymphoma

common cold and SARS

Exception to: "All +ssRNA viruses have icosohedral capsid" (its helical)

Influenza -ssRNA

Exception to: "All RNA virus have one-piece genome" (it's segmented) and replicate in the cytosol (it replicates in nucleus)

Contains neuraminidase and hemaglutinin

Vaccine: increase circulating antibodies to hemaglutinin promotes humoral immunity

Patients at risk for fatal bacterial superinfection

croup aka parainfluenza, RSV, measles, mumps

Contains Fusion Protein that makes respiratory epithelial cells fuse and form miltinucleated giant cells

RSV: treat w ribavirin, ppx w pavilucimab (F-protein Ig)

Rabies (#1 is skunk)

ssRNA virus migrate in axon retrograde and invade Purkinje cerebellar cells

long incubation period

Ebola and Marburg

-ssRNA

Exception to "All RNA viruses are linear (its circular) and one-piece (its segmented).

lymphocytic choriomeningitis virus

lassa fever encephalitis spread by mice

Hantavirus: hemorrhagic fever and pneumonia

Arboviruses: Sandfly/Rift Valley fevers, Crimean Congo hemoorhagic fever, california encephalitis 

Exception to "All RNA viruses are linear (its circular) and one-piece (its segmented).

Hepatitis D

Exception to "All RNA viruses are linear" (its circular)