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What is the most common way to acquire systemic mycosis? are they contagious?
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Which common systemic mycotic agent is not endemic to a specific region of the US?
cryptococcosis (from pigeon droppings)
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Which systemic mycosis is more commonly found in cats? What is the most common presentation/clinical sign?
- cryptococcosis
- firm swelling over bridge of nose (chronic UR signs)
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where does crypto commonly disseminate to in the cat?
- -direct extension through cribiform plate to CNS or to paranasal soft tissue
- -hematogenous spread to skin, eyes, CNS
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Which mycotic agent resides in sandy, acidic soil near water?
blastomycosis
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Extrapulmonary dissemination is common with blastomycosis. What are the common sites? which is specific to the cat?
- lymph nodes, skin, eyes, bones
- cat: CNS
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Where does histoplasmosis typically first invade? Then where/how does it spread?
invades lungs then spreads to mononuclear phagocyte system --> to spleen, liver, etc
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What is the most common clinical form of histoplasmosis?
subclinical (self limiting- stays confined to the lungs)
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does histoplasmosis usually present to the clinic as an acute or chronic pulmonary disorder? which is more fatal to the patient?
- chronic more common
- acute rare but more fatal (severe fulminate granulomatous pneumonia)
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is blastmycosis found intra- or extra-cellularly? what about histoplasmosis? Which agent is easier to spot on cytology?
- blasto = Extracellular (more plentiful, easier to find)
- histo = intracellular (in macrophages)
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What is the most common form of histoplasmosis found in cats?
disseminated form (extrapulmonary)
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which mycotic agent and presentation is most likely to have drastically enlarged hilar lymph nodes?
chronic pulmonary form of histoplasmosis
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Which part of the GIT is most often affected with histoplasmosis if they acquire it via ingestion? dogs or cats?
- COLON, small intestine (not stomach)
- -intractable diarrhea and wt loss
- Dogs, not cats
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How do you definitively diagnose histoplasmosis?
ID the organism on histopathology/cytology
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Is antigen or antibody helpful/effective at diagnosising histoplasmosis? What other diagnostic test is highly suggestive?
- antigen (Ab not reliable)
- rads if pulmonary form
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what is tx of choice for mycosis?
itraconazole
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What is tx for fulminate disseminated forms of mycosis?
itraconazole plus amphotericin B
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What form of mycosis is fluconazole often used for?
CNS and eye forms
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Which mycotic agent is easily identified by its psuedocapsule appearance once stained?
histoplasmosis
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what are the clinical forms of blastomycosis? (how does it differ from histo?)
pulmonary and disseminated (no intestinal form like histo)
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Is it likely you will see radiographic evidence in the lungs of a patient with blastomycosis?
yes, very likely (85% of cases)
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what are 4 common sites for disseminated form of blastomycosis?
peripheral lymph nodes, skin, eye, bone
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Would you do an antigen or antibody test to help diagnose blasto? is this definitive?
- antigen titer on urine/serum
- only way to def. diag. is ID the organism on cytology
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What environmental conditions does coccidiomycosis like?
dry desert like Southwest
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compare the incubation time of histo, blasto, and coccidio.
- histo/coccio: 1-3 weeks
- blasto: longer at 1-3 months
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Would you do an antigen or antibody test to help diagnose coccidio?
antibody (do NOT recommend Ag for coccidio)
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What would you tell your client about the patient's prognosis with blasto? what situations are of special concern?
- successful in 75% of cases, esp if they survive the fir 10 days of tx
- -failure more likely if severe hypoxic pulmonary dz, CNS involved, or widespread (3+systems)
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what are 3 forms of coccidiomycosis?
- subclinical
- pulmonary
- disseminated (bone is common)
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which disseminated form of coccidio is common in dogs? in cats?
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What should you tell your client to expect when treating coccidiomycosis?
much longer tx than other mycosis- can be lifelong, esp. difficult if bone involved; 8-12 months of azoles then another 4-6 after clinical resolution
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What are some common non-specific CBC/chem findings that often coincide with mycosis?
- anemia, thrombocytopenia
- leukocytosis
- hypercalcemia, incr. liver enzymes
- hypOalbuminemia (if intestinal, disseminated)
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