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Fungi 2


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Patient presents with hyperpigmented patches on the skin with light centers. KOH prep reveals hyphae and spherical yeast cells that resemble spaghetti and meatballs. Suspect?
Malassezia furfur (Pityriasis versicolor)
Treatment for Malassezia furfur:
Selenium sulfide containing shampoo, imidazole
Patient presents with dark black patches on the soles of her hands and feet. KOH prep reveals brown-colored branched septate hyphae and budding yeast cells. Suspect?
Exophiala werneckii (Tinea nigra)
Fungi that secrete keratinase:
Microsporum, Trichophyton, Epidermophyton floccosum
Fungi that colonizes rose thorns and commonly infects gardeners with necrotic ulcerating lesions:
Sporothrix schenckii
Patient presents two weeks following a puncture wound with an old garden stake when a small, violet, wart-like lesion develops. KOH prep reveals copper-colored cells. Suspect?
Phialophora verrucosa, Cladosporium carrionii, Fonsecaea spp.
Common opportunistic infection in AIDS patients from the SW USA; respiratory transmission, KOH (+)
Coccidioides immitus
Avid spelunker contracts pneumonia. CXR reveals calcified lesions bilaterally in the lungs. PPD (-). Suspect?
Histoplasma capsulatum
Patient presents with unexplained weight loss, night sweats, uncalcified lung lesions, and skin ulcers. Sabouraud's agar (+). Suspect?
Blastomyces dermatitidis
Man who raises carrier pigeons presents with chronic meningitis, F/N/V, & acne. CSF examination reveals polysaccharide antigens. Suspect?
Cryptococcus neoformans
Fungi that causes oral thrush; normal inhabitant of the skin, mouth, & GI tract; not normally found in blood.
Candida albicans
Patient with no known allergies presents with asthma-type symptoms after eating peanuts, SOB, & fever. Labs reveal high levels of IgE & IgG. CXR = fleeting infiltrates, immediate hypersensitivity reaction. Suspect?
Patient presents with black nasal discharge & mucormycosis. Biopsy reveals broad, non-septated branching hyphae. Suspect?
Rhizopus, Rhizomucor, or Mucor. Treat immediately with Amphotericin B & surgery

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