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systemic mycoses
PA CLin Med
39
Health Care
Graduate
09/28/2009

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Term
general characteristics of systemic mycoses:
Definition
deep mycoses affects internal organs and may disseminate to multiple sites of the body caused by pathogenic/opportunistic fungi
Term
3 pathogenic fungi:
Definition
histoplasma
blastomyces
coccidiodes
Term
4 opportunistic fungi:
Definition
1. candida
2. cryptococcus
3. aspergillus
4. pneumocystis
Term
which are involved in systemic mycoses:
Definition
histoplasmosis
blastomyces
coccidiomycosis
Term
cave fever:
Definition
histoplasmosis
Term
histoplasma capsulatum comes from
Definition
bat/bird poo
Term
TEST Q: histoplasmosis is most endemic in:
Definition
Ohio, Missouri, Mississippi river valleys
Term
clinical findings in histoplasmosis:
Definition
90% are asymptomatic!
3-14d post exposure:
F/C, HA, Malaise, mayalgia, arthralgia, erythema nodosum (5-10%)
Term
histoplasmosis CXR
Definition
pneumonitis w hilar/mediastinal lymphadenopathy
Term
__-__% of histoplasmosis pts in endemic areas have ocular envolvement
Definition
1-10%
Term
which part of the eye is affected in histoplasmosis
Definition
macula may lead to blindness
Term
what is the gold standard dx test for histoplasmosis?
Definition
culture
Term
what are the serum/urine tests for histoplasmosis. what are the problems with these tests?
Definition
antigen detection in serum/urine, not specific could also be blastomyces and coccidiodes
Term
how much of an increase in complement fixing antibodies suggests infection
Definition
4X normal
Term
histoplamosis Tx:
Definition
acute = itraconazole, progressive disseminated = amphotericin B
Term
warm mosit soil of wooded areas rich in organic material =
Definition
blastomyces
Term
who is most at risk for blastomyces
Definition
middle aged men w outdoor occupations
Term
LOCATION of blastmoyces
Definition
Ohio and Mississippi river valleys and the Great Lakes area
Term
blastomyces is in a _____ form at body T
Definition
yeast
Term
major virulence factor of blastomyces:
Definition
thick cell wall prevents phagocytosis of yeast
Term
clinical findings of blastomyces acute infection
Definition
mimic bacterial pneumonia or influenza
rapid onset of: F/C cough, dyspnea, pleuritic chest pain
Term
CXR of blastomyces infections show:
Definition
alveolar infiltrates w consolidation
Term
cronic infection w blastomyces clinical findings
Definition
mimics malignance or TB; F/C, productive cough, hemoptysis, wt loss
Term
CXR of chronic blastomyces:
Definition
alveolar infiltrates, mass lesions, fibronodular infiltrates
Term
what is the most common extrapulmonary manifestation of blastomyces?
Definition
skin: 20-40% raised, verrous cutaneous lesions
Term
lab studies for blastomyces:
Definition
culture, microscopy, serum/urine Ag, and immunoassay for antibodies
Term
Tx for blastomycosis:
Definition
itraconazole, then amphotracin B if itraconazole fails
Term
Valley fever =
Definition
coccidomycosis
Term
sandy alkaline soil with incresed salinity =
Definition
coccidioides
Term
LOCATION of coccidioides:
Definition
southwestern US
Term
if the coccidioides infection is not cleared it turns into:
Definition
granuloma formation
Term
primary pulmonary infection of coccidioides clinical findings:
Definition
asymptomatic in 60% of cases
mild illness 1-4 WEEKS after exposure
same Sx as other fungal infections
Term
which is assoc w spherules and endospores:
Definition
coccidioides
Term
most common findings in CXR of coccidioides:
Definition
localized infiltrate
Term
coccidioides Tx
Definition
no Tx for asymptomatic dz,
mild progressive dz = fluconazole
severe/progressive/extrapulmonary dz = amphotericin B
Term
glactomannan antigen =
Definition
aspergillosis
Term
CT scan shows ______ ________ in aspergillosis
Definition
halo sign[ area of ground glass infiltrate surrounding nodular densities
Term
aspergillosis Tx;
Definition
oral prednisone then itraconazole
surgical resection of fungal ball if Tx fails
Term
if aspergillosis desseminates to brain the mortality rate =
Definition
100%
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