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Questions and Answers
Candida Albicans is a non-dimorphic fungus.
False
Aspergillus Fumigatus can cause invasive aspergillosis primarily in patients with neutrophil dysfunction.
True
Cryptococcus Neoformans is characterized by having a thick, encapsulated yeast form.
True
Mucor and Rhizopus spp produce septate hyphae that branch at acute angles.
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Pneumocystis Jirovecii was originally classified as a virus.
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Oral fluconazole is effective for treating esophageal candidiasis.
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Sporothrix Schenckii is typically transmitted through inhalation.
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Amphotericin B is used for treating cryptococcal meningitis.
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Allergic Bronchopulmonary Aspergillosis is primarily a hypersensitivity response to a fungal infection.
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Diabetic patients are at high risk for developing vulvovaginitis caused by Candida Albicans.
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Candida Albicans presents with germ tubes at 37°C.
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Aspergillus Fumigatus can induce mutations leading to hepatocellular carcinoma due to aflatoxin production.
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The diagnosis of Cryptococcus Neoformans can be assisted by India ink staining showing a clear halo.
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Mucor and Rhizopus spp. have regular, septate hyphae branching at 90-degree angles.
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Pneumocystis Jirovecii primarily causes pneumonia in individuals with normal immune function.
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Sporothrix Schenckii is a dimorphic fungus that causes sporotrichosis.
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Voriconazole is a first-line treatment for Cryptococcus Neoformans infections.
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Allergic Bronchopulmonary Aspergillosis (ABPA) is associated with cystic fibrosis and asthma.
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Treatment for oral candidiasis can include echinocandins.
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Black necrotic eschar on the face is a common presentation in patients with mucormycosis.
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Candida Albicans can be responsible for causing diaper rash in immunocompromised patients.
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Aspergillus Fumigatus only affects patients with neutrophil dysfunction.
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Cryptococcus Neoformans is primarily transmitted through direct contact with infected individuals.
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Mucor and Rhizopus spp are characterized by irregular, broad, non-septate hyphae.
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Pneumocystis Jirovecii is classified as a fungus and is responsible for causing Pneumocystis pneumonia.
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Sporothrix Schenckii causes sporotrichosis when spores are introduced into the skin through trauma.
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Voriconazole is the first-line treatment for pneumocystis pneumonia.
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Oral fluconazole is recommended for the treatment of chronic mucocutaneous candidiasis.
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Aspergillus species can produce aflatoxins that may lead to liver cancer.
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Eosinophilia is a common result of Allergic Bronchopulmonary Aspergillosis.
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Study Notes
Candida Albicans
- Dimorphic fungus that can exist as budding yeasts, pseudohyphae, and germ tubes depending on the temperature
- Commonly associated with oral and esophageal thrush, vulvovaginitis, diaper rash, infective endocarditis, disseminated candidiasis, and chronic mucocutaneous candidiasis.
- Often found in immunocompromised individuals like neonates, those on steroids, diabetics, and people with AIDS.
Aspergillus Fumigatus
- Produces aflatoxins which are known to induce TP53 mutations and lead to hepatocellular carcinoma
- Invasive aspergillosis is primarily observed in individuals with weakened immune systems and neutrophil dysfunction, such as those with chronic granulomatous disease.
- May cause aspergillomas in pre-existing lung cavities especially following tuberculosis infection.
- Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity response to Aspergillus growing in lung mucus and is often connected to asthma and cystic fibrosis.
Cryptococcus Neoformans
- Yeast that is not dimorphic, encapsulated, and stains positive with PAS.
- Can cause cryptococcosis, a serious infection that impacts the brain, lungs, and other organs.
- Typically seen in immunocompromised individuals.
- Can be diagnosed with India ink staining and latex agglutination tests.
Mucor and Rhizopus spp.
- Characterized by broad, irregular, non-septate hyphae that branch at wide angles.
- Associated with mucormycosis, a serious infection that occurs in immunocompromised patients, particularly those with diabetic ketoacidosis (DKA) and neutropenia.
- The fungi proliferate in the blood vessel walls, potentially invading the brain through the cribriform plate.
Pneumocystis Jirovecii
- Yeastlike fungus that causes Pneumocystis pneumonia (PCP), a lung infection.
- Primarily seen in immunocompromised individuals, particularly those with AIDS.
- Diagnosed through chest imaging and microscopy.
Sporothrix Schenckii
- Dimorphic fungus that causes sporotrichosis, a disease primarily acquired upon introduction of spores into a wound.
- Commonly known as "rose gardener's disease" as it is often contracted through contact with vegetation.
- Diagnosed by examining the morphology of the fungus.
Candida Albicans
- A dimorphic fungus, exists as pseudohyphae and budding yeasts at 20°C, and as germ tubes at 37°C
- Commonly found in the oral cavity, gastrointestinal tract, and vagina
- Causes opportunistic infections in immunocompromised individuals, such as neonates, those on steroids, diabetics, and those with AIDS
- Can cause infections like oral and esophageal thrush, vulvovaginitis, diaper rash, infective endocarditis, disseminated candidiasis, and chronic mucocutaneous candidiasis
- Treated with various medications, including fluconazole, azoles, nystatin, echinocandins, and amphotericin B, depending on the location and severity of the infection
Aspergillus Fumigatus
- Produces aflatoxins, which can induce TP53 mutations leading to hepatocellular carcinoma
- Identified by its acute angle (45°) and branching of septate hyphae
- Causes invasive aspergillosis, particularly in immunocompromised individuals with neutrophil dysfunction
- Can form aspergillomas in pre-existing lung cavities, often after TB infection
- Allergic bronchopulmonary aspergillosis (ABPA), a hypersensitivity reaction to Aspergillus, is associated with asthma and cystic fibrosis, potentially leading to bronchiectasis and eosinophilia
- Treated with voriconazole or echinocandins (second-line)
Cryptococcus Neoformans
- A heavily encapsulated yeast with a size of 5-10 µm and narrow budding
- Not dimorphic, meaning it does not change its form with temperature
- Positive PAS staining, indicating the presence of polysaccharides
- Causes cryptococcosis, manifesting as meningitis, pneumonia, and/or encephalitis, often exhibiting "soap bubble" lesions in the brain
- Primarily affects immunocompromised individuals
- Diagnosed via India ink staining (clear halo), mucicarmine staining (red inner capsule), and latex agglutination test for polysaccharide capsular antigen
- Treated with amphotericin B + flucytosine followed by fluconazole for cryptococcal meningitis
Mucor and Rhizopus spp
- Characterized by irregular, broad, non-septate hyphae branching at wide angles
- Causes mucormycosis, primarily in patients with diabetic ketoacidosis (DKA) and/or neutropenia
- Transmitted via inhalation of spores
- Fungi proliferate in blood vessel walls, potentially penetrating the cribriform plate and entering the brain
- Presents with rhinocerebral symptoms, including frontal lobe abscess, cavernous sinus thrombosis, headache, facial pain, and black necrotic eschar on the face
- May involve cranial nerves
- Treated with surgical debridement and amphotericin B or isavuconazole
Pneumocystis Jirovecii
- A yeast-like fungus originally classified as a protozoan
- Causes Pneumocystis pneumonia (PCP), a diffuse interstitial pneumonia
- Predominantly affects immunosuppressed individuals, especially those with AIDS
- Most infections are asymptomatic
- Diagnosed by chest imaging showing diffuse bilateral ground-glass opacities, often with pneumatoceles, and microscopy of bronchoalveolar lavage or lung biopsy
- Prophylaxis is recommended when CD4+ cell count drops below 200 cells/mm3 in people living with HIV
- Treated with various medications, including TMP-SMX, pentamidine, dapsone, and atovaquone
Sporothrix Schenckii
- A dimorphic fungus causing sporotrichosis
- Found on vegetation, commonly transmitted through traumatic introduction of spores into the skin, often through a thorn ("rose gardener's disease")
- Presents with a local pustule or ulcer, along with nodules along draining lymphatics (ascending lymphangitis)
- Disseminated disease is possible in immunocompromised individuals
- Exists as a cigar-shaped yeast at 37°C in the human body and as hyphae with spores (conidia) in the soil
- Treated with itraconazole or potassium iodide (only for cutaneous/lymphocutaneous)
Candida Albicans
- Dimorphic fungus: exists as yeasts and hyphae
- Can cause infections in immunocompromised individuals
- Oral thrush (oral candidiasis)
- Vulvovaginitis
- Diaper rash
- Endocarditis (especially affects IV drug users)
- Disseminated candidiasis (can be fatal, especially in neutropenic individuals)
- Chronic mucocutaneous candidiasis (recurrent skin and mucosal infections)
Aspergillus Fumigatus
- Produces aflatoxins causing hepatocellular carcinoma through TP53 mutation
- Common cause of invasive aspergillosis in immunocompromised individuals, particularly those with neutrophil dysfunction
- Can cause aspergillomas in pre-existing lung cavities
- Allergic bronchopulmonary aspergillosis (ABPA): hypersensitivity reaction to Aspergillus often associated with asthma and cystic fibrosis
Cryptococcus Neoformans
- Encapsulated yeast
- Causes cryptococcosis: manifests as meningitis, pneumonia or encephalitis
- "Soap bubble" lesions on brain imaging associated with cryptococcal meningitis.
Mucor and Rhizopus spp
- Causes mucormycosis, infection that primarily occurs in patients with diabetic ketoacidosis (DKA) or neutropenia
- Fungal hyphae can grow into blood vessels, penetrate the cribriform plate and enter the brain (rhinocerebral mucormycosis)
- Clinical features: headache, facial pain, black necrotic eschar on the face, potential cranial nerve involvement
Pneumocystis Jirovecii
- "Yeast-like" fungus
- Causes Pneumocystis pneumonia (PCP)
- In individuals with weakened immune system
- Most infections are asymptomatic
- Diagnosed by bronchoalveolar lavage or lung biopsy
Sporothrix Schenckii
- Dimorphic fungus
- Causes sporotrichosis
- Transmitted through traumatic inoculation into the skin (e.g., from a thorn puncture)
- Often known as "Rose gardener's disease"
- Local pustule or ulcer with nodules along draining lymphatics
- Can disseminate to other organs in immunocompromised hosts
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Description
Explore the fascinating world of fungal pathogens, focusing on Candida Albicans and Aspergillus Fumigatus. This quiz covers their morphology, associated diseases, and impact on immunocompromised individuals. Test your knowledge on these crucial microorganisms in medical mycology.
