c


                
  - Worldwide In healthy people: - Using India ink: The - Colour: Ivory to beige - C. neoformans may be

   - Primarily found in - usually asymptomatic, mild or yeast͛s polysaccharide - Texture: Mucoid visible on direct Gram
(Cryptococcosis) pigeon droppings self-limiting capsule creates a halo stain of CSF
- encapsulated yeast In immunocompromised: around the cell - Yeast cells may vary in
-Dissemination in CNS - Antigen test is more size
- Skin & viscera also involved in sensitive for
small % of Patients C.neoformans
detection
- Histology of clinical
material: intracellular
encapsulated yeast
(occasionally)
 - Worldwide - Originates as an asymptomatic  Mold:
 - Endemic areas in US: or self-limiting, mild pulmonary Colour ʹ white to tan, pale - produces round, warty
(Histoplasmosis) Ohio-Mississipi valleys infection yellow reverse (tuberculate)
- thermally dimorphic: where the organism is - A small % of patients develop Texture ʹ fluffy macroconidia
i. small, non- found in soil enriched chronic pulmonary lesions  - Microconidia may also
encapsulated yeast in with bird or bat - Disseminated disease rare in Colour ʹ cream be present
macrophages within droppings normal people, but common in - may be glabrous
host tissue immunocompromised At 37C, small budding
ii. mold in environment Conversion between mold- yeast cells produced.
yeast forms important for
identification
- ADNA probe able to
distinguish it from other
white fluffy molds

Paracoccidioides - Limited to Central - Originates as a mild pulmonary Mold: Mold:

brasiliensis and south America infection that may disseminate - White & velvety - Usually do not produce
(Paracoccidiodomycosis) hematogenously to the skin - yellow to brown reverse distinctive structures
- Slow growing, - Most patients present with - Chlamydoconidia,
thermally dimorphic cutaneous lesions and large Yeast: arthroconidia &
- Large, multiply cervical lymph nodes - White microconidia may be
budding yeasts in host - Creamy present
tissue
- Mold in environment Conversion between forms Yeast:
important for identification - Multiple buds at 37C
Èlastomyces - Primarily in the - Majority of patients with - Yeast cells divide with Mold: Yeast:
dermatitidis United States along blastomycosis have self limiting a characteristic broad- - slow growing - Thick walled broad-
(Èlastomycosis) the major river valleys pulmonary infections based bud - white to beige based budding yeast
- Dimorphic - Most cases present with - fluffy texture forms at 37C
cutaneous lesions reflecting
hematogenous dissemination Yeast: Mold:
- Less common sites of - cream colored - Round to oval conidia
dissemination: viscera, bone, - irregularly shaped form at end of short
prostate gland conidiophores
Conversion between forms
important for identification.
- ADNA available for
confirmation
Coccidioides immitis - Found primarily in - Majority of patients have self- Histological Mold: - With age, the hyphae
- dimorphic fungi western hemisphere limiting pulmonary infections preparations of host - Appear glabrous at first begin to form
- Appears as spherules - Endemic areas in with varying degrees of severity tissue may reveal the - Soon become white to tan arthroconidia
in host tissue semi-arid regions - Patients who develop flu-like presence of spherule with fluffy aerial hyphae - The arthroconidia are
- Appears as mold in e.g: southwestern symptoms are said to have form of C.immitis. - Reverse is neutral to gray barrel-shaped and
environment Unites States, Mexico, Valley Fever due to high - These spherules alternate with empty cells
parts of South incidence in the San Joaquin contain endospores Conversion of mold to (disjunctor cells)
America Valley in California spherules not routinely - The hyphae fragment,
performed in clinical releasing arthroconidia
laboratory hich are readily airborne
- ADNA probe available to and highly infectious.
distinguish from other white
fluffy molds

- The arthroconidia of
coccidioides are readily
airborne and pose a serious
hazard to lab personnel. It is
recommended that all molds
be handled in a biosafety
cabinet
I made this table because my eyes cried when reading the notes Dr gave us. Squinting is not fun! ʹ (Not a true story. I didn͛t cry. Èut squinting is still not fun)