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FUNGI (*Cutaneous Mycoses fungi
fungi causing skin infectons (*Tinea…
FUNGI
*Cutaneous Mycoses fungi
- fungi causing skin infectons
*Tinea dermatophytes
- 3 types of fungi:
--> phytes... and microsporum
- tinea unguium = nail fungus
- tinea corpus = ringworm
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*Tinea Versicolor
- Versicolor = the macular puritic rashes can be either HYPO or HYPER pigmented
*Malassezia Versicolor
- common skin fungi in warm and humid areas
- becomes more prominent when you have sun exposure
- Versicolor = the macular puritic rashes can be either HYPO or HYPER pigmented
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Fungal Growth *Patterns
- Yeasts are broad based budding vs narrow based budding
--> broad budding = Blastomycosis
--> narrow based budding = Asperagillus 45 acute angles
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*Systemic / Pneumonia Mycoses fungi
- fungi causing TB like pneumonias first
- can then spread to the other tissues in the body
- they are also dimorphic fungi
*Dimorphic Fungi
- note most of the DIMORPHIC FUNGI are systemic + SKIN fungal infections simultaneously
- dimorphic means that morph into different things based on the temperature they are in
- at room temp = 25-30
--> MOLD = hyphae
--> think of the initial mold or scaffolding of the yeast in the environment = room temp
- at body temp = 37
--> they are singular yeast cells
--> think of YEASTS = finished product in the body = ball of yeast from the hyphae = mold scaffolding
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*Blastomyces Dermatiditis
- can infect the immunocompromised
- can mimic TB or pneumonia
--> forms granulomas
--> "BLASTS granulomas into the lungs, Broad based BUDS, then to liver and skin"
- liver and skin are most often disseminated areas
BLASTOMYCES BLAST BEASTS in the EASTBLASTOMYCES are BLAST MICE who are HIBERNATING HYPHAE in teh WINTER, but in the summer when it heats up they become BLASTOMYCES BLAST BEASTS in the EAST
- BLASTOMYCES BLAST BEASTS in the EAST
--> dimorphic fungi
to save the rest of the country from the MYCOBLASTS BLAST BEASTS of the EASTS, GRANULOMATUS GRANNY and LAMA put up a THICK DOUBLE WALL that divides the COUNTRY and keeps the MYCOBLAST BEASTS EAST of the MISSIPPI RIVER and near the GREAT LAKES
- MYCOBLAST BLAST BEASTS = have THICK DOUBLE WALLS on histology
- they cause GRANULOMATUS GRANY LAMA disease everywhere
BLASTOMYCES BLAST BEASTS in the EAST wreck havoc on everyone in the EAST and turn it into a ZOMBIE APOCOLYPSE LAND of the EAST
- they start by going over all the lands using their ROUND YEAST COMPASS to make sure they STAY EAST and lay down their BOMBS in BROAD BASED BUDDING patterns just waiting for people to step on them
- they burn up green SKIN MAN and his wife NUDE MONA with their BLASTS
- they BURN green SKIN MAN all the way to his BONES
--> osteomyelitis
--> BLASTOMYCES causes NUDE MONA
- the SKELETON of SKIN MAN then are the ZOMBIES of the land of the EAST
TX for BLASTOMYCES are the two ZOMBIE KILLING heros in the EAST = EYE in the A HOLE and the best ZOMBIE KILLER = AMPHIBIAN TERMINATOR BEE
- BLASTOMYCES ZOMBIE KILLER 1 = EYE in the A HOLE
- BLASTOMYCES ZOMBIE KILLER 2 = AMPHIBIAN TERMINATOR BEE
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*Histoplasmosis Capsulatum
- pigeon /bird and bat dropping
- river valleys and caves (Ohio River valley)
- "Hist - OOval - PLASMo - CELLS"
--> histoplasmosis is like a quieter form of TB
--> it infect macrophages and forms granulomas
--> but in healthy patients it is usually assymptomatic and ONLY found on Imaging
- "Hist - OOval - PLASMo - CELLS"
- form Oval yeast in body temp
- PLASMA CELLS = inside macrophages like being in a CAVE
- CAVES = from caves, form caseating granulomas
--> same avoiding of macrophage lysosome acidification and destruction like TB
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- "HISTO - OVAL - PLASMo"
- HISTO = assymptomatic in healthy people and found on imaging and HISTOLOGY as calcified old granulomas
--> it infect macrophages and forms granulomas
--> healthy people will contain them in granulomas, but they will also spread to liver and spleen
--> even without causing any symptoms
- histoplasmosis is like a quieter form of TB
- OVAL = form Oval yeast in body temp
--> part of PARA penis BLASTS historical SPORES in 2
- PLASMA CELLS = inside macrophages like being in a CAVE
- CAVES = from caves of OHIO mississipi, form caseating granulomas
--> same avoiding of macrophage lysosome acidification and destruction like TB, but no symptoms
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HISTOPLASMOSIS HISTORY CHANNEL movie night in the CAVE on the PLASMA TV screen = HISTOPLASMOSIS HISTORY CHANNEL classroom channel in the CAVE with the HOT teacher MRS NUDE MONA, showing the OHIO and MISSISSIPI river valley doc to CHEESE EATING GRANNY and LAMA with their feet up on the ERYTHEMA NODOSAUR NODOSUM next to MAC MAN filling his MOUTH with YEAST CELLS all the while they are getting SHIT ON by STARLING bird POOP and BAT POOP
- CHEESE EATING GRANNY and LAMA watching the HISTOPLASMOSIS HISTORY CHANNEL in the CAVE
--> ERYTHEMA NODOSAUR NODOSUM in HISTORY CHANNEL in the CAVE on the PLASMA TV
- the HISTORY CHANNEL on PLASMA TV in the CAVE lesson is taught by the HOT teacher MRS NUDE MONA
--> HISOTRY CHANNEL in CAVE PLASMA screen = NUDE MONA
HISOTRY CHANNEL DOC in the CAVE is a DOC on OHIO and MISSISSIPI RIVER VALLEYS
- HISTOPLASMSOSIS in OHIO river valleys and caves
the DOC is ABOUT to start... CHEESE EATING GRANNY and LAMA have their snack and are ready with their feet up on the ERYTHEMA NODOSAUR NODOSUM
- the late one coming in just intime before the HISTORY DIC starts is MAC MAN MACROPHAGE who stuffs INSIDE his MOUTH with YEAST CELLS as his snack
--> HISTORY CHANNEL PLASMOSIS in the CAVE grows INSIDE MAC MAN
all the while they are getting SHIT ON by STARLING bird POOP and BAT POOP
*ERYTHEMA NODOSAUR NODOSUM dinosaur = ERYTHEMA NODOSUM
- NODOSAURS only have spikes to protect their backs
--> NO spike protection on ERYTHEMA NODOSAUR dinosaurs legs
--. ERYTHEMA NODOSAUR is a RED RASH on the shins of your legs
- ALBERTAs famous NODOSAUR dinosaur was a RED HED
--> RED RASH on NODOSAURS
DISEASES with ERYTHEMA NODOSAUR NODOSUM
- SARCOIDOSIS DINOSAURS
- HISTOPLASMOSIS HISTORY CHANNEL movie night in the CAVE on the PLASMA TV = HISTOPLASMA
--> CHEESE EATING GRANNY and LAMA watching the HISTOPLASMOSIS HISTORY CHANNEL in the CAVE
- 1 more item...
*Coccidioides immitis
- desert areas of US
- "Don't get COCCKY in the Desert ... U'LL need a THICK WALL SPHERE home and buy PILE OF BULLETS"
- THICK WALL home SPHERE bullets = thick walled spherules --> contain many endospores
--> note there can also be empty ones
- COCKY in the desert = Coccidioides is imminent in the desert
Clinical Cases
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Notes:
- note the coccidioidomycosis is not that dangerous, although some presentations may seem very insidious they are not
- they usually cause asymptomatic infections or mild pneumonias
- they also usually get a bilateral rash on limbs and bilateral arthralgias
- thin walled cavities may form in the lung from coccidioides immitis and this is what can cause hemoptysis
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COCK AT SEA away off of the CALIFORNIA DESERT COAST surviving on a OSTEO BONE DRAGON ROW BOAT
- COCK AT SEA away off of the CALIFORNIA DESERT COAST
--> Coccidioides Immitis
- the OSTEOMYELITIS BONE DRAGON ROW BOAT is captained by GRANNY LAMA
--> COCK OUT AT SEA = GRANNY LAMA disease systemic in the bidy
- the rowers of the COCK OUT AT SEA BONE BOAT are a huge group of MEN IN TIGHTS
the FLAG of the COCK OUT AT SEA BOAT is a SKIN MAN = cutaneous lesions and on the FRONT of the boat is BEAUTIFUL NUDE MONA who is actually FISHING for CASEATING LUNG SPONGE
--> CASEATING LUNG SPONGE NECROSIS of the lungs in COCK OUT AT SEA
KEY differential for COCK OUT AT SEA from the DESERT
- it is DIMORPHIC = Hyphae in cold and SPHERULE AT SEA
--> most other DIMORPHIC FUNGI are HYPHAE in COLD and YEAST in the WARM BODY
- think of the DESERT and COCK OUT AT SEA off of CALIFONRIA having FAULT LINE CRACKS and erathquakes
--> HYPHAE on LAND and floating SPHERULE at SEA
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*Sporothrix
- "Rose Branch / Bush Gardner smokes CIGARS and POT"
- "ROSE BRANCHES" = rossete branching hyphae
SPORO THRIX are for PRIX!SPORO THRIX CEREAL (and SHINCKLES BACON) - THRIX are for PRIX = THORN PRIX and PEAT MOSS
- you get SPORO TRIX are for PRIX from THORN PRIX and from PEAT MOSS
- you first get pustulating ulcers at the site of the THORN PRIX
the SPORO THRIX CEREAL rabbit is a bad role model for kids since he SMOKE CIGAR SHAPED CIGARS
--> SPORO THRIX CEREAL on microscope are cigar shaped
- he also is showing his DIRTY EYE A HOLE on the box
--> Itraconazole is the tx for SPORO THRIX CEREAL
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*ParaCoccidioides immitis
- BRAZIL and LATIN /SOUTH AMERICA
--> it is called the BLASTOMYCES of BRAZIL
- any fungal infection from BRAZIL is PIRATE SHIP COCK AT SEA until proven otherwise
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PIRATE COCK AT SEA in off the COAST of BRAZIL
this TIME, stearing the PIRATE COCK AT SEA PIRATE SHIP from BRAZIL and using his PIRATE WHEEL he goes around the entire LATIN SOUTH AMERICA in BUDDING PATTERN pathway at sea
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PARA penis blasts historical Cock Spores in 2!!!
- PARA = paracoccidioides
- penis = penicillium
- blasts = blastomyces
- historical = histoplasmosis
- cock = coccidioides
- spores = sporothrix are for PRIX
*Opportunistic Fungal Infections
- common in HIV, organ transplants, immunosuppresses
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*Asperigillus Fumeratus
"Asking Per IT!!! with TB (Cavities) or ABC's (Bronchioles)"
- opportunistic fungi
--> following TB usually, asthma or CF
- Acute Angle hyphae
- NOT dimorphic = AA - dimorphic
- people with latent TB granulomas are "Asking Per IT!!"
--> asperigillus follows TB and other caseating diseases
--> Asp can infiltrate the granuloma and cause infection
- form Aspergillomas in the old TB lung cavitations
--> these are usually assymptomatic, but can cause hemoptysis all on its own with no other symptoms
- cause meningitis and encephalitis
- have high eosinophil count and IgE
Aspergilloma
- aspergillus colonizing an old TB cavitation of the lung
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"Asking Per IT!!! with TB (Cavities) or ABC's (Bronchioles)"
- Asking Per IT!!! = TB (Cavities)
--> asperigillus follows TB and other caseating diseases
--> Asp can infiltrate the granuloma and cause infection
- form Aspergillomas in the old TB lung cavitations
--> these are usually assymptomatic, but can cause hemoptysis all on its own with no other symptoms
- Asking Per IT!!! = ABC's (Bronchioles)
--> 10-15% of asthmatics get Asperigillus infections in the bronchioles
--> they are on inhaled corticosteroids = immunocompromised
--> high IgE and Eosinophils to Asperigillus
ASPARGUS FUMIGATUS - trying to attack the LUNG HOUSE that is being GUARDED by the
- the ASPARAGUS FUMIGATUS are led by their trustee leader the NECROSIS CROW ON BROCCOLI with NUDE MONA
--> ASPARAGUS FUMIGATUS causes necrotizing pneumonia and bronchitis
- the ASPARAGUS FUMIGATUS start to invade the house
--> this fungi will invade any old cavities and spread
the LUNG HOUSE is protected by ALLERGIC ALLIGATOR from the CHIMNEY and also from IgE ELECTRIC GOBLIN flying overhead on EOSINPHILIA EAGLE--> ASPARAGUS FUMIGATUS can cause an allergic reaction to its spores
--> it causes the samme type of allergic reaction with IgE and Eosinophiliameanwhile ... there is an ASPARAGUS GNOME in the LUNG HOUSE who is MOPPING up the blood from the HEMOPTYSIS and watching the CAVITIES int he TV get filled up with the INVADING ASPARAGUS FUMIGATUS
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3 common infection types of Aspergillosis
- 1 = invasive aspergillosis for immunocompromised patients with leukemia or lymphoma treatments
- 2 = Allergic Asperigillosis in Asthmatics
- 3 = Asperigillosis Fungus balls in old granulomas
--> TB, etc of the lungs
- note that aspergillosis likes to spread through the blood
- 2 favourite places for aspergillosis to spread are
--> brain
--> paranasal
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Allergic Asperigillosis in Asthmatics
- Asking Per IT!!! = ABC's (Bronchioles)
--> 10-15% of asthmatics get Asperigillus infections in the bronchioles
--> they are on inhaled corticosteroids = immunocompromised
--> high IgE and Eosinophils to Asperigillus
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Classic histology with aspergillosis Aspergillosis
*Septate hyphae vs non-septate hyphae
- septate = separated sections of the branching hyphae = filaments of fungi
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*Cryptococcus neoformins
- "Crypt Keeper = Lungs to Brain, large THICK Capsule skull, but nothing in it"
--> oval yeast cells on India ink stain that are clear with a thick capsule
- opportunistic fungi --> assymptomatic unless HIV or immunocompromised (coricosteroids also)
- found in soil and pigeon crap
- Micheal Scott scared of 2 things... CRYPT keeper and his pigeon and climbing trees
-> think of extra companies for Micheal Scott for the stains
--> Sabre = Sabouraud Agar
--> call centre and Vikra = India stain --> clear with halos
- climbing trees = THICK polysaccharide capsule
- AID defining illness
--> Cryptococcus neoformins and pneumocystis jirrovecci are AIDS defining illnessess
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Cryptococcus Histology
- India stain clear cells with THICK CAPSULES
- "Crypt Keeper = Lungs to Brain, large THICK Capsule skull, but nothing in it"
--> oval yeast cells on India ink stain that are clear with a thick capsule
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Cryptococcus Meningitis
- India stain clear cells with THICK CAPSULES
--> think of thick
- Lumbar puncture for Cryptococcus shows low glucose and high protein
--> fungi will eat the glucose but will not use the protein like bacteria will
- CSF culture on Sabourand agar
--> pigeon --> Micheal Scott --> SABOR = Sabourand Agar for Crypoccocus
- Tx for cryptococcus neoformins = Amphotericin B and Flucytosine (Acute Tx)
--> long term treatment after stable = fluconazole
--> think Amphotercin B IV for ANY serious fungal infection
--> make the bird = cryptococcus FLU AWAY
--> flucytosine and fluconazole for cryptococcus
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Cryptococcus Cerebral infection Presentation
- slowly progressive headache, nausea and vomiting, confusion, neck rigidity, and papilledema
--> CLOGS the arachnoid villi with yeast antigens
--> since their capsules are so THICK they clog the archnoid vili
--> leading to obstructed cerebrospinal fluid outflow.
--> elevates ICP
- Seizures and brain herniation can subsequently occur
--> note that seizures are particularly a very bad sign an indicate a more serious pathogen like a fungi
why didn't the CRIPPLED COCK CROSS the road? ... for many reasons
- the CRIPPLED COCK was CRIPPLED because she though she saw some DOVES with HALOS on their heads so she though GOD was talking to him
- it turned out the DOVES with HALOS on their heads were actually INDIAN PIGEONS disguised as DOVES with HALOS on their HEADS
- the INDIAN PIGEONS disguised as DOVES with HALOS on their HEADS started to POOP CLEAR INDIA INK on the CRIPPLED COCK
--> CRIPPLED COCK stains clear with INDIA INK and has double layer halo around them
- to protect himself the CRIPPLED COCK wears a GUTINATED LATEX GLOVE over his head which antibodies stick to
--> latex agglutination can check for CRIPPLE COCK
CRIPPLED COCK is being repaired by MEN IN TIGHTS who give him an AIDS BAND AID
- the MEN IN TIGHTS also give his travelling wife the NUDE MON a FLUTE A HOLE = fluconazole to fire at the MONOCYTIC MONOPOLY GUY drinving by in his fancy DOUBLE CAPSULE CAR
across the road is AMPHIBIAN TERMINATOR = Amphotericin B firing back with a FLUTE SIDE TOE = flucytosine
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*Mucor and Rhizopus Spp.
- opportunistic fungi
- Rhizopus = Romboid = wide angle hyphae
--> ASperigillus = acute angle 45 hyphae
MUCUS RHINO and the OBTUSE NUN with SCEPTOR who is growing with the RHINO MUCUS a WIDE OBTUSE TREE
- MUCUS RHINO = mucor and rhizopus
- the OBTUSE NUN with SCEPTORs MUCIS TREE was growing out of control because of the MUCUS dripping on it
- so she called in LUKE with KEY = leukemia to cut it down, but he failed
- next she had TYPE 1 DYED BEADS PANCREAS try to kill the tree by stabbing it with KETONE KEYS and then filling the holes with GLUCOSE GLUE
all this didn't work and the tree grew and grew until it grew right through the CRIB BRAIN CRIBIFORM PLATE of the RHINO and formed an ABSCESS in his FRONTAL LOBE
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*Candida Ablicans
- normal flora of the GI tract and oral cavity in 40–60% of healthy adults
- opportunistic fungi
--> unless patients are severely immunocompromised
--> could be contamination of sputum culture
- alba = white
- oral and vaginalcandidiasis
- vulvovaginalis
--> diabetics and Abx use
- endocarditis in IV drug users
- very common in TPN and CVCs = central venous catheders
--> CATHEDER = CANDIDA
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SUMO growing HYPHAE brings his CANADIAN OWL CAN to the CANDID FLOWER FUNGAL SHOW centred around the ESOPHAGUS SARCOPHAGUS TRASH IN COMPOST
- CANADIAN OWL CAN is normal flora of the mouth and urinary system
- CANADIAN OWL CAN is the most common cause of ESOPHAGUS SARCOPHAGUS TRASH IN COMPOST
CANADIAN OWL CAN is beat by FEVER BEAVER who brought her FLAMING VAGINNA
- CANADIAN OWL CAN causes vaginal thrush
when they ask the FEVER BEAVER his secret to growing the FLAMING VAGINA plant he reveals that he grows it in WHITE COTTAGE CHEESE DISCHARGE
- CANADIAN OWL CAN vaginal thrush has WHITE COTTAGE CHEESE discharge
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Host Defense against Candida
- 2 methods of host defense
- 1 = T Helper cells
--> these are low in HIV patients in particular
- 2 = neutrophils
--> cancer patients and people on chemotherapy often get neutropenia
--> higher risk for candida infections
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CATHEDER = CANDIDA
- very common in TPN and CVCs = central venous catheders
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Histology
Candida Albicans - PSEUDO hyphae = germ tubes at PSEUDO = FAKE BODY temperature
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Candida Albicans - true hyphae = germ tubes at room temperature
- look like blue strings
- single-celled budding yeast with pseudohyphae - C albicans can also make "germ tubes," hyphal structures formed when the organism is grown in a specific nutritionally rich serum
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*Pneumocystis jirovecii and HIV pneumocystis pneumonia
- pneumocystis pneumonia characteristic in HIV AIDS
- "PNEUMO Jirovecci = NEW JURY IS OUT" = AIDS defining disease
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NUDE MONA SISTERs in JEEP leaving their job they just quit at the SILVER MOTH MINING FACTORY
- NUDE MONA SISTERs in JEEP = pneumocystic Jirovecii
- both the NUDE MONA CYSTERS in JEEP have interstitial pneumonia from the SILVER MOTH MINING FACTORY
- NUDE MONA SISTERs in JEEP are being driven in the JEEP by FEVER BEAVER with FUN GUY in the front seat also
- FUN GUY always needs to have fun so he starts to PLAY his 200 song playlist from his IPOD
just then a COP notices the NUDE MONA SISTERs in JEEP are going OVER 200 m/hr
- so he pulls them over in his TAMPON SMX snowmobile and gives them a warning instead of the 200 DOLLAR fine
--> start prophylaxis in HIV patients for NUDE MONA SISTERs in JEEP when they reach level of CD count < 200
--> NUDE MONA SISTERs in JEEP is an AIDS defining illness and they will get it
meanwhile at the SILVER MOTH MINING FACTORY it is MANDAOTRY LUNG LAVAGE time for the employees to see ho bad their lungs are
- HYPOXEMIA HIPPO is feeding the head of SILVER MOTH MINING FACTORY with some SAUCER SHAPED tea cup TEA
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