FUNGI

FUNGI

1. systemic

   • histoplasmosis
     • smaller than RBC, mississipi and ohio, erytema nodoso, palatal tongue ulcers, splenomegaly, dx urine
   • blastomiycosis
     • coccidioidomycosis
       • para-coccidioidomycosis
         • latin america, captain wheel, much larger than RBC, cervical lymphadenopathy, similar to coccidioidomycosis
       • southwesterns, california, much larger than RBC, cavities in lungs, disseminates skin/bones, erythema nodosum, arthralgias, meningitis
     • eastern and central Us, same size RBC, inflamatory lung disease, disseminates to bone and skin, granulomas, dx urine
   • pneumonia/ dimorphic fungi: mold (20) and yeast (37)/ granulomas like TB/ fluconazole(local) amphotericin B(systemic)

2. cutaneous

   • dermatophytes: microsporum, trichophyton, epidermophyton, visible KOH, pruritus, lamps
   • tinea capitis
     • associated with alopecia
   • tinea corporis
     • usually torso, scaly rings
   • tinea cruris
     • does not show central clearing like tinea corporis
   • tinea pedis
     • interdigital, moccasin, vesicular
   • tinea unguium
     • onychomysosis
   • tinea versicolor
     • malazzesia
     • degradation of lipids produces acids that inhibit tyrosinase(melanin synthesis)-->hypopigmetation
     • hyperpigmentation occur due to inflammatory response
     • less pruritic than dermatophytes
     • spaghetti and meatballs apperance

3. opportunistic

   • candida albicans
     • white, catalase +, oral and esophageal thrust (immunocomprised: neonates, steroids, diabetis, aids) vulvovaginitis( diabetes and use atibiotics), diaper rash, endocarditis( IV drugs users). TX: nystatin, amphotericin B
   • aspergillus fumigatus
     • catalase +, cause: 1-allergic bronchopulmonary aspergillosis 2-aspergillomas 3-angioinvasive aspergillosis
   • cryptococcus neoformans
     • most commun fungi that causes meningitis. cryptococcosis, cryptococcal encephalitis
   • Mucor and Rhizopus
     • ihnalation: fungi proliferate in blood vessel walls, penetrate cribifroms plate, and enter brain. mucormycosis: rhinocerebral, frontal lobe abscess, cavernous sinus thrombosis,
   • pneumocystis jirovecii
     • pneumocystis pneumonia, asymptomatic, immunosuppresion predisposes disease.bilateral ground-glass opacities on chest imaging. Dx: biopy or bronchoalveolar lavage
   • sporonthrix schenckii
     • cigar-shaped yeast, rose gardener disease. causes local pustule or ulcer with nodules along draining lymphatics