Questions and Answers
What is the most likely diagnosis for the 28-year-old pregnant patient described?
Cryptococcal Meningoencephalitis
What will be your differential for this case and why?
Liver condition such as Fungal Liver Abscess
Is it possible to treat or prevent Cryptococcal Meningoencephalitis?
True
Study Notes
Fungal Infections
- Septate hyphae are characteristic of Phialophora richardsiae
- Aspergillus fumigatus and Histoplasma capsulatum can exhibit both mold and yeast forms
- Aspergillus hyphae can invade nearby tissues
DERMATOPHYTES
- KOH (potassium hydroxide) and Wood's Lamp Examination are diagnostic tools
PITRYIASIS (TINEA) VERSICOLOR
- Characterized by a "Spaghetti and Meatballs" appearance of Malassezia on microscopy
SPOROTHRIX SCHENCKII
- Primary site of infection shows ulceration
- Fungus can spread through the lymphatic vessel, causing new ulcers to appear
- Traumatic injury to the skin (e.g., thorn prick) can introduce the fungus
- Cigar-shaped yeasts are visible on microscopy
CANDIDA
- Yeast cells and pseudohyphae are "yeast" forms, while germ tubes are "hyphae" of Candida albicans
- Causes oral thrush, esophageal thrush, candida vaginitis, intertrigo, and diaper rash
ASPERGILLUS
- Aspergillus hyphae can invade nearby tissues, causing invasive aspergillosis
- Can invade the lung, causing aspergilloma (a "fungus ball" in existing lung cavities) or allergic bronchopulmonary aspergillosis (an asthma-like condition)
- Can also invade the brain tissue
ZYGOMYCETES
- Zygomycetes molds are present in decaying organic matter
- Can cause chronic sinusitis and orbital cellulitis (skin infection)
PNEUMOCYSTIS
- Causes pneumocystis pneumonia, characterized by disc-shaped cysts
CRYPTOCCOCUS
- Characterized by thick capsules
- Causes cryptococcal pneumonia and cryptococcal meningoencephalitis (beginning with fever, fatigue, and headache, and later causing confusion and behavioral changes)
CASE STUDY
- The patient's symptoms (jaundice, right upper abdominal pain, fever, and malaise) and eventual progression to altered mental status and vomiting suggest a fungal infection, likely cryptococcal meningitis
- The patient's low healthcare literacy and potential pre-existing liver condition may have contributed to the delayed diagnosis and poor outcome
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Description
This quiz covers the morphology and diagnosis of different fungal infections, including septate and non-septate hyphae, dermatophytes, and various species of fungi. It includes microscopy and laboratory examination techniques.
