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What is not a contagious disease, infection is due to contact with organisms in environment, and inhalation is common?
systemic mycoses
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What dimorphic soil dwelling fungus has 2 phases (mycelial phase and yeast phase)?
histoplasma capsulatum (histoplasmosis)
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What is the number one route of infection of histoplasmosis?
inhalation (number 2 is ingestion)
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What cells does histoplasmosis infect?
macrophages
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What is the incubation period of histoplasmosis?
12-16 days (relatively short)
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What type of response does histoplasmosis generate?
granulomatous or pyogranulomatous response
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What is the most common form of histoplasmosis?
subclinical (self limiting) infection confined to the lungs
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What is the least common form of histoplasmosis?
severe fulminant granulomatous pneumonia
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In acute pulmonary form of histoplasmosis, what lymph nodes are moderately enlarged?
hilar lymph nodes
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What form of histoplasmosis is more common than the acute form?
chronic pulmonary form
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What form of histoplasmosis causes MASSIVELY enlarged hilar lymph nodes?
chronic pulmonary form
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Where is the intestinal form of Histoplasmosis more commonly located?
colon
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What are the most common clinical signs of Histoplasmosis?
intractable diarrhea and progressive weight loss
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What is the most common form of histoplasmosis in cats?
Disseminated form (extrapulmonary)
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What is necessary for definitive diagnosis of histoplasmosis?
cytology or histopathology
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What is very effective way to diagnose histoplasmosis?
antigen testing (mira vista)
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How are you able to characterize histoplasmosis?
surrounded by a characteristic clear halo or pseudocapsule which results from shrinkage of cytoplasm from cell wall during fixation
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What is the treatment of choice for histoplasmosis that is not life threatening, and must treat for a minimum of 4-6 months and 1-2 months beyond clinical resolution?
itraconazole
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What is preferred for treating a severe, rapidly progressing infection of histoplasmosis?
itraconazole plus amphotericin B
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What type of treatment for histoplasmosis is not as effective as itraconazole, but is used for refractory ocular and neurologic infection?
fluconazole
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What is the primary source of infection for Blastomycosis?
inhalation of airborne spores
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How can focal skin infection of blastomycosis occur?
from direct cutaneous inoculation through a wound
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Where is extrapulmonary dissemination of Blastomycosis common?
extrapulmonary dissemination is common
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What is the incubation period for blastomycosis?
1-3 months (longer than histoplasmosis)
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What animals are more susceptible to blastomycosis? Cats or Dogs?
dogs
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Lung lesions present in what amount of cases of blastomycosis?
85%
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What percentage of the disseminated form of blastomycosis involves the peripheral lymph nodes?
50-60%
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What percentage of the disseminated form of blastomycosis involves the skin?
40%
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What percentage of the disseminated form of blastomycosis involves the eyes?
40%
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What percentage of the disseminated form of blastomycosis involves the bone?
20%
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What is the best treatment of blastomycosis?
itraconazole
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What types of forms of blastomycosis does fluconazole treat?
refractory ocular or CNS forms
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Why does treatment of blastomycosis normally fail?
severe hypoxemia pulmonary disease, CNS involvement, Widespread dissemination (3 or more organ systems)
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What is the most common type of disseminated form of coccidioidomycosis?
bone
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What does high IgG titers in Coccidioidomycosis mean?
indicate severe pulmonary or disseminated disease
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Why may coccidioidomycosis need lifelong azole treatment?
disseminated coccidioidomycosis is difficult to cure, esp when bones are involved
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What form of cryptococcus is more common in dogs?
C. neoformans
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What form of crytococcus is more common in cats?
C. gatti
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What is the most common systemic fungal disease of cats?
cryptococcus
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In cats where does cryptococcus have a predilection for and what does it cause?
nasal cavity, granulomatous rhinitis and sinusitis
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What are the preferred sites for cryptococcal dissemination?
skin, CNS, and eyes
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What is a common way to diagnose cryptococcus?
capsular antigen test
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Cats with CNS involvement and dogs with any form the cryptococcus have what type of prognosis?
guarded
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What is the most frequently reported rickettsial disease in the US, and the most fatal rickettsial disease?
RMSF
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How is RMSF transmitted?
transovarially in ticks (nymphs and larvae are infected without feeding- different than erhlichiosis)
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What is the minimal amount of time a tick must be on the body to transmit RMSF?
5 hours
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After infection, the majory of cases of RMSF are what?
subclinical
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