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Mycology & Parasitology

Terms

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Hyphae without septate and zygospores
Phyla Zygomycota
Tinea corporis
Tinea capitis
Tinea cruris
Tinea mannum
Tinea unguium
Tinea favosa
Tinea imbricata





body tinea
head tinea
groin tinea
hand tinea
nail tinea
favus tinea (hair of children?..T. schoenleinii)
body tinea (T concentricum)





Candidiasis
*moniliasis, thrush (creamy patches on buccal mucosa and tongue), yeast infection*

C. albicans - fungal infection of skin, nail, and mucocutaneous membranes
- in normal flora.. so only cause infection in immunocompromised pts
- onycomycosis - nail infection in individauls whose hands are usually wet due to their occupational work
- diaper candidiasis
- vulvoganitis = imidazole cream





Cauliflower-like skin masses and sclerotic bodies
Chromoblastomycosis

- Cladosporium carrionii
- Fonsecaea pedrosoi
- Phialophora verrucosa
- Rhinocladiella aquaspersa




Positive Germ Tubes
Candida albicans

(C. albicans and Malassezia furfur are considered normal flora!)

Brown pigmented hyphae
Phaeohyphomycosis

*Different from chromoblastomycosis is that ph RARELY produces sclerotic bodies in the infected tissue*

- cutaneous abscesses and granulomatous cysts

*Wangiella dermatitidis = systemic infection --> high rate of mortality





Cigar-shaped yeast cells
Sporotrichosis
- often induced by rose thorns/splinters
Broad-based buds
Blastomyces dermatitidis

- North America - Gilchrist's disease

- infection of URT
*primary pulmonary




Spherules with endospores
Coccidioidmycosis

- Valley fever, Posada's disease

Dry area (Texas, New Mexico, etc.) of the Americas
Coccidioides immitis

Primary
- Pulmonary (most are asymptomatic)
- Cutaneous (rare)

Secondary
- Pulmonary (benign chronic and progressive)
- Disseminated (CNS, chronic cuteanous, generalized)







Intracellular budding cells,
Bat guano or chicken houses,
Neutropenia and/or thrombocytopenia

Histoplasma capsulatum

- Darling's disease, reticuloendoteliosis

- affects healthy individuals (chronic) & compromised immune system pts









Multiple budding cells
Paracoccidioidomycosis

- Granulomatous infection that disseminates to the skin, mucous membranes, etc.

- Also present in healthy individuals



Sulfur grains (compact mass of hyphae)
Eumoycetoma
Spaghetti and meatballs,
Scaly round patches
Pityriasis versicolor... caused by Malassezia furfur (requires oil to grow in culture)

Tinea versicolor

Macular skin lesion
Pityriasis nigra (tinea nigra)
Circular lesion,
Arthrospores and hyaline septate hyphae
Dermatophytes
Single budding cells within capsule,
POsitive india ink stain,
Bird/pigeon droppings

Cryptococcosis,
Cryptococcus infection,
Cryptococcus neoformans

- most frequent form of crypto. Meningitis, meningoencephalitis, cryptococcoma



Nosocomial infection
Aspergillosis

- (opporunistic fungi?)
- systemic candidiasis??

*poor prognosis*




Nematode
Ascaris
Enterobiasis
Onchocerciasis
Dracunculiasis

- Strongyles = ONLY nematode infection exacerbated in immunosuppression (HIV)




Cestodes
Tapeworms - segmented

- taenia saginata
- taenia solium
- echinoccocus (?)



Trematodes
Flatworms - flukes

- fasciola
- paragonimus
- schistosoma



Sarcodina
Amoebae

- unicellular, simple structures
- tough, cystic wall
- pseudopod movement

entamoeba; entamoeba coli; isopora (diarrhea); microsporidium (from silkworms, bees); cyclospora (outbreak from strawberries in MI)





Intestinal diseases
Giardia
Crptosporidia
Amebiasis
Ascaris
Trichuris
Strongyloides
Chagas disease
[Trypanosomiasis]
Tape worms
Visceral leishmaniasis








Giardiasis
- Most important *WATERBORNE* pathogen in the U.S. ..but is a worldwide disease

- Not of greater severity in immunocompromised patients BECAUSE.. it does not cause an inflammatory response!!

- fecal/oral route

- trophozites develop into oval cysts


TX: metronidazole
Immunity - IgA









Cryptosporidiosis
Destroys enterocytes! - causes waterborne enteritis

Fecal/oral route

Cysts - inflammatory response!!

TX: oral rehydration if immune system intact.. Aids patients use spiramycin





Amoebiasis
Entamoeba Histolytica

- Middle East & South America
- Fecal/oral route
- lower bowel hemorrhage and liver abscesses

TX: idioquinol





Ascaris
Human roundworms..
- largest nematode

Ingestion of mature eggs, larvae released on ingestion, coughed up and return to gut

- causes death by obstruction of duodenum

TX: albendazole






Trichuris
Whipworm
- blood suckng parasite of large bowel
- "wormy people"

Fecal/oral route... anemia & hemorrrhagic diarrhea

TX: albendazole





Dermal parasitic infections
Ectoparasites - lice, mites, fleas, bugs, ticks, flies

Endoparasites - tungiasis, myiasis

- enterobiasis, onchocerciasis, dracunculiasis, Loa loa, leishmaniasis ???



Pediculosis
*Lice*
- blood suckers on head
- transmission: contact

TX: insecticides



Phthirius
*crab lice

Transmission: venereal - sticks to pubic hair region

TX: put clothes in dryer for 20 min



Sarcoptes
*mites*

- cause mange (scabies in humans)
Transmission: contact
- eggs laid in burrowed tunnels
- causes itchiness
- HIV/AIDS pts: norwegian scabies (extensive darkened and scaling skin)

TX: ivermectin







Demodex
hair follicle mite
Fleas
blood suckers

transmission: contact (especially with cat flea on animal, furniture, carpet..etc)

- hypersensitivity

TX: insecticides





Ticks
periodic blood suckers

- Wnat to get rid of tick within 24 hrs!..otherwise they start to transmit disease

- Transmission: contact
- TX: pull out

Lyme disease






Cimex
bed bugs

- irritating bites
- sensitization to salivary antigens


Triatoma
kissing bugs

- drop from ceiling and suck blood from host while pooping out back end onto host

- can transmit Chaga's disease (Romano's sign - swollen eye because of allergy.. 10 years later because of autoimmune interaction between parasite and host)



Myiasis
Jiggers, chiggers

- lump on skin contains larvae of Housefly, black spot in center of lump is site of entry

- bacon therapy



Enterobiasis
pinworms (nematode)

fecal/oral route

- sticky eggs causes itchiness and perianal irritation
- vulvo/vaginitis in females

TX: albendazole






Onchocerciasis
Nematode

Causes River Blindness.. transmission by Black Fly

Causes blindness and severe dermatitis when worm dies, thin skin (atrophy), destroyed melanin pigment

TX: ivermectin





Dracunculiasis
Guinea Worm

- warborned filarial nematode
Transmission: ingestion of contaminated water

- Adult under skin sheds larvae into water.. can cause ulceration

TX: wind worm around a stick as it emerges






Loiasis
Loa Loa

In itself, it does not cause disease

Transmission: insect vector
TX: ivermectin??




Leishmaniasis
Protozoa

Transmission: Sand Fly is vector
- Lives and replicates in macrophages
- ulcer.. parsites at edge



Reproductive/Urinary Tract Parasitic Diseases
Trichomonas
Schistosomiasis
STD
Crab Lice


Trichomoniasis
Transmission: ONLY veneral - partner to partner (high prevalence among sex workers)

- infects squamous cells, can survive several hours in moist environment, no cystic forms occur (is NOT in environment, like toilet seats etc)

- symptomatic in females: yellow discharge, erythrematous vulva
- discharge contains large # of neutrophils!

**Differential diagnosis with candidiasis.. (does NOT have pungent odor!!)

TX: metronidazole
immunity if PMNs and macrophages capable of killing









Schistosomiasis
"Bilharzia"

Trematode

Transmission: freshwater snails, birds

- bladder cancer!
- liver fibrosis (scarring)

TX: praziquantel








Pulmonary Parasitic Diseases
Malaria
Paragonomiasis
Trichinella
Nematodes
Filariasis



Pneumocystis carinii
Protozoa!

Transmission: aerosol
- silver stains
- opportunistic proliferation in T-cell deficient immunocompromised

TX: aerosolized petamindine





Paragonamiasis
Trematode

Transmission - house dust mites, cockroaches

- leads to lung fibrosis, allergies, asthma



Trichinella
- pigs get infected by eating garbage

transmission: eating poorly cooked pork

- invade muscle cells (NURSE CELLS!) - live there for years, waiting for another anmial to eat muscle

- enteritis syptoms, hard to breath, eyelids and tongues muscles attacked

TX: albendazole and anti-inflammatory agents







CNS parasitic diseases
Toxoplasma
Cysticercosis
Acanthamoeba
Naegleria


Toxoplasma
coccidain parasite
- need to be conerned about if pregnant! (may contract from cats)

Transmission: from cats, transplacental, oral ingestion of tissue cysts eg. cattle meat

- inflammation!!




Naegleria
Transmission: warm fresh water, swimming hole

- invades via olfactory epithelium --> olfactory nerve --> brain

- induces purulent meningitis in brain
*FATAL*




Acanthamoeba
Tranmission: contaminated contact lens solution

- invasive to cornea, perivascular location

FATAL



Taenia Saginata

&

Taenia Solium



saginata: not problematic, zoonotic infection, ingesting infected beef

solium: ingesting infecte dpig.. larvae invade eye, CNS< muscle, skin, neurocysticercosis = serious CNS problem

Control - vaccinate pigs TX: albendazole and surgery
Trypanosomiasis
T. Brucei
- African sleeping sickness
- Tsetse fly vector

T. Cruzi
- South America
- Triatomid bugs (kissing bugs)
- Chaga's disease






Vascular parasitic diseases
Malaria
Schistosomiasis
Lympathic filariasis

Filariasis
Nematode

1/15 people infected
transmission: mosquito
- adult in lymphatics (does not block them)
- microfilia in blood

Elephantitiasis: skin changes
Lymphedema: accumulation of lymph fluid in tissues
Hydrocele: accumulation of lymph in scrotal sac








Hookworms
*Systemic parasitic infection*

- blood suckers - major cause of anemia

Transmission: skin penetration by larvae --> venules --> lungs --> gut

TX: albendazole





Malaria
*systemic parasitic infection*

- greatest causes of mortality/morbidity
- mosquito borne
- fevers, cerebral syndrome (ring hemorrhage), anemia, renal complications, hepato-splenomegaly

TX: artemesin







Toxocara
Dog and cat roundworms

Fecal/oral route

- cannot complete cycle in humans!! eggs present and mature in moist soil

TX: anhelmintics





Echinococcus granulosus
Hydatid disease - small tapeowrm of dog cut

Tranmission: dog feces

- cystic larvae eaten by dogs to complete life cycle and dog feces eaten by herbivores

TX: anhelmintics & surgery





Strongyloides
free living non-pathogenic soild nematodes!

- Transmission: skin penetration
**Autoinfection - larvae penetrate lower bowel, enter venule, recycle themselves.. can persist for many years in huge #s

- hemorrhage due to invasion

TX: Albendazole






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