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Microbiology · USMLE Step 1

USMLE Microbiology: Clinical Fungal Infections

Opportunistic fungal infection presentations in immunocompromised patients tested on USMLE Step 1, distinct from the classification focus of the fungi and parasites deck.

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What fungal infection causes white plaques in the mouth of HIV patients?
Oral candidiasis (thrush)
Esophageal candidiasis (an AIDS-defining illness) typically occurs below what CD4 count?
Below 100 cells/microL
What symptom is classic for Candida esophagitis?
Odynophagia (painful swallowing)
Endoscopy in Candida esophagitis classically shows what finding?
White, adherent plaques on the esophageal mucosa
Cryptococcus neoformans is acquired by inhaling spores from soil contaminated with ____.
pigeon droppings
What CNS infection does Cryptococcus neoformans commonly cause in AIDS patients?
Cryptococcal meningitis
What CSF stain reveals Cryptococcus as a yeast with a clear halo around it?
India ink stain
What rapid test, more sensitive than India ink, is used to diagnose cryptococcal infection?
Cryptococcal antigen (CrAg) test
What special histologic stain highlights Cryptococcus's capsule in tissue sections?
Mucicarmine stain
What is the first-line induction therapy for cryptococcal meningitis?
Amphotericin B plus flucytosine
What polysaccharide makes up the Cryptococcus neoformans capsule?
Glucuronoxylomannan
What opportunistic mold causes invasive infection in neutropenic and transplant patients?
Aspergillus fumigatus
On histology, Aspergillus hyphae are septate and branch at what characteristic angle?
Acute angles, about 45 degrees
A fungus ball that colonizes a pre-existing lung cavity, such as an old TB cavity, is called what?
An aspergilloma
What allergic lung condition, seen in asthma and cystic fibrosis patients, is caused by hypersensitivity to Aspergillus?
Allergic bronchopulmonary aspergillosis (ABPA)

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