Chapter·MicrobiologyDimorphic fungi

Paracoccidioides brasiliensisDownloads

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1

A 34-year-old woman presents with multiple round, scaly patches on her chest and back. The lesions are hypopigmented and slightly pruritic. KOH preparation of skin scrapings shows short, angular hyphae. Which of the following best describes the causative organism's morphology in culture?

ABranching, septate hyphae with characteristic 'spaghetti and meatballs' appearance

BNon-septate hyphae with sporangiospores

CBranching, septate hyphae with tear-drop microconidia

DPseudohyphae with blastoconidia

2

A 29-year-old woman comes to the military physician because of a 2-day history of fever, joint pain, dry cough, chest pain, and a painful red rash on her lower legs. Two weeks ago, she returned from military training in Southern California. She appears ill. Her temperature is 39°C (102.1°F). Physical examination shows diffuse inspiratory crackles over all lung fields and multiple tender erythematous nodules over the anterior aspect of both legs. A biopsy specimen of this patient's lungs is most likely to show which of the following?

ASeptate hyphae with acute-angle branching

BSpherules filled with endospores

CBroad-based budding yeast

DEncapsulated yeast with narrow-based budding

EOval, budding yeast with pseudohyphae

3

A 73-year-old man presents to the office, complaining of “weird blisters” on his right hand, which appeared 2 weeks ago. The patient says that he initially had a rash, which progressed to blisters. He denies any trauma or known contact with sick people. He is worried because he hasn’t been able to garden since the rash appeared, and he was planning on entering his roses into an annual competition this month. His vital signs are stable. On physical exam, the patient has multiple bullae accompanied by red, papular lesions on his right hand, which progress to his forearm. The right axillary lymph nodes are swollen and tender. What is the treatment for the most likely diagnosis of this patient?

AItraconazole

BAzithromycin

CTopical corticosteroids

DDoxycycline

EPotassium iodide solution

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