Pathology EMQ

Name: Richard Holder

Theme: Fungal infections

OPTION LIST

A	Histoplasma Capsulatum	I	Pneumocystis jirovecii
B	Microsporum audoni	J	Trichophyton rubrum
C	Cryptococcus neoformans	K	Fusarium spp.
D	Coccoides immitis	L	Candida albicans
E	Malassezia furfur	M	Aspergillus fumigatus
F	Rhizopus arrhizus	N	Blastomyces dermatitidis
G	Aspergillus niger	O	Candida tropicalis
H	Coccidioides immitis	P	Epidermophyton floccosum

For each scenario below, choose the most appropriate answer from the list above. Each option may be used once, more than once or not at all.

1. A 19 year old Afro-Caribbean man presents to the GP with a 6 week history of a rash. Examination reveals patchy hypopigmentation over the arms, trunk and neck.

2. A 45 year old businessman presents with pain and blurred vision in his right eye. He remembers something hitting him in the eye when tending to his uncle’s farm while on holiday in India.

3. A 38 year old HIV-positive woman presents with fever, headache and confusion. Several weeks ago she had a cough. India ink staining of her CSF revealed budding yeast cells surrounded by a wide gelatinous capsule.

4. A 52 year old man with a history of poorly controlled diabetes presents with fever, facial pain and black nasal discharge. He is given amphotericin B and posaconazole, and sent for urgent surgical debridement.

5. A 10 year old girl presents with cough, fever, pleuritic chest pain and haemoptysis 1 month after an allogeneic bone marrow transplant for leukaemia. CXR shows multiple pulmonary nodules. Sputum cultured on Sabouraud’s agar produces green colonies with white periphery.

ANSWERS

1. E

2. K

3. C

4. F

5. M