fungus-micro
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- 60 y/o man from Arizona is in ICU with pulm edema, respiratory distress, and hypotension which progresses to shock. Hx of contact with deer mice. What is the virus/diagnosis?
- HANTAVIRUS PULMONARY SYNDROME
- how common is this virus & what are the man's chances of survival
- rare & 50%
- 76 year old woman presents with respiratory distress and low O2 sats. She reports that a week ago she returned from china. On the plane she sat next to a man who was coughing heavily. 4 days later she developed a cough, high fever, and diarrhea. She assu
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SARS- CoV
a ss RNA corona virus -
8 year old boy with a seizure disorder is in ICU for aspiration pneumonia. Suddenly he begins coughing up copious amounts of a foul-smelling sputum. What type of cx should you order?
Aerobic cx grows staph aurous & anerobic cx grows fusofo -
anaerobic & aeorobic on sputum
Lung abscess/necrotizing pneumonia - 76 year old pneumonia patient is not improving. X-ray shows fluid in the plura. Aspiration of pleural fluid is cultured which shows a G+ cocci (Staphylococcus aureus) [most common] or gram-negative bacilli (Pseudomonas aeruginosa, Klebsiella pneumoniae,
- EMPYEMA (purulent inflammatory exudate of the pleural cavity)
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45 year old migrant field worker presents with chronic cough. X-ray shows destructive lesions. Sputum culture easily grows a filamentous branching organism that stains gram positive and acid fast positive. What is it?
Is this organism a fungus? -
Nocardia asteroides
No - 56 year old brittish man , Bernie McPlaquemouth, is admitted to the hospital for chronic pneumonitis that has been getting progressively worse. He is also showing symptoms of pericarditis. He reports respiratory symptoms began about 3 months ago after he
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Actinomyces israelii
No -
24 year old female presents with white plaques on the back of her throat after being on a broad spectrum antibiotic. Fungus culture quickly grows out a G+ organism. What is the organism?
It is dimorphic, in its pathogenic state what form does it t -
Candida spp.
psudohyphal -
17 year old male with history of asthma becomes symptomatic. He has developed a productive cough with eosinophilia. Culture & microscopic examination shows a filamentous fungi with Y & V shaped branching hiphae. What is the organism?
Is this -
Aspergillosis
monomorphic
fungus ball in the lung - 55 year old male spelunker from the Mississipi river valley, presents with fever, chills, headache, cough, chest pain, weakness, & fatigue. X-ray shows tuburculosis like granulomas. Fungal culture grows what organism?
- Histoplasmosis
- Explain how chronic cavitary disease in histoplasmosis mimics tuberculosis.
- Inhalation of spores reach broncholes/alveoli and germinate into yeast. Yeast is phagocytosed by macrophages. Accumulation of infected macrophages & other cells result in an infiltrate at infected site. Infected macrophages migrate to spleen & liver. 9-15 days onset of aquired immunity causes vasculitis, tissue necrosis, & caseation at the site of infiltrate.
- Does a positive histoplasmosis skin test indicate current infection.
- No, just exposure.
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Philapeno woman who works in the dust fields of the San Juaquine Valley presents with flu like symptoms that progresses to pneumonia. Culture grows spherules.
What fungus do you suspect?- What test is an alternate to the culture which is dangerous b -
Coccidioides immitis
Complement fixation, - What is the life cycle of Coccidiodes immites
- It exists in soil in the MYCELIAL PHASE and matures. Alternate cells along a hyphae become barrel shaped and are easily fragmented & become airborne. In the host the spores swell, become spherical and develop a thick wall. This structure is called a SPHERULE which is the diagnostic feature of a culture. The spherule contains as many as 800 ENDOSPORES which are released and turn into new sperules.
- 30 year old male brazilian agricultural worker with a history of alcoholism presents with chronic progressive lung disease. Sputum fungal culture on a KOH mount grows out a dimorphic fungus in a characteristic “pilot wheel†pattern. What is the organ
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Paracoccidioides brasiliensis
mycelial in soil
yeast form in tissue - 45 year farmer in Mississippi river value presents with fever, chills, headache, cough, chest pain, weakness, & fatigue. Fungus culture grows dimorphic budding yeast with a broad base & thick wall that appears refractile under the microscope. Wha
- Blastomyces dermatitidis
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50 year old male with AIDS presents with abrupt fever, cough and tachypnea.
Or 3 month old infant presents with slight fever insidious onset of dyspnea, & cyanosis. What is the most likely diagnosis? What is the treatment? -
Pneumocystosis carinii
tmp-smz - 16 year old boy with contact to pigeon droppings has a mild respiratory infection and a week later develops meningitis. LP is performed and negative staining of CSF with India ink shows yeast cells with a wide capsule. IV treatment with amhotericin B &am
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Cryptococcus neoformans
patients with AIDS or immunocompromized.