Dr. Ana Velez’s “Art In Infectious Diseases”

April 10th, 2018

 

Dr. Ana Velez is an accomplished artist and University of South Florida Associate Professor and Infectious Diseases physician who has practiced at Moffitt Cancer Center among immunocompromised patients since 2007.  Although she paints in many different styles, among her favorite subjects are the microorganisms she confronts everyday as a health care provider.  With her art, she conveys the complexity and beauty present in even some of the most challenging pathogens.  Her paintings mix bright colors and subtle shades to capture the simple yet elegant nature of fungi, bacteria, and viruses. Below is some of her artwork each with an accompanying legend. Please click each picture to link to a larger version.

 

Aspergillus

Aspergillus is a fungus found throughout the world that can cause infection in primarily immunocompromised hosts and individuals with the underlying pulmonary disease. There most important types of respiratory tract infections caused by aspergillus include: invasive aspergillosis, and allergic bronchopulmonary aspergillosis. Aspergillosis infection can also manifest as sinus disease in immunocompromised hosts and cutaneous disease after traumatic inoculation.

The treatment of choice is Voriconazole. Isavuconazole, Posaconazole and Amphotericin also have activity.

The painting below illustrate aspergillus with its septate acute angle hyphae (white arrow) a vesicle (blue arrow) with phialides (orange arrow) and sporulating conidia (red arrow).

 

 

Dengue Virus

The dengue virus is a single positive-stranded RNA virus of the family Flaviviridae. It is transmitted by the Aedes aegypti female mosquito. The clinical presentations include dengue fever, dengue hemorrhagic fever and dengue shock syndrome.

The painting below illustrates the main parts of the virus including the E protein (white arrow), the M protein (black arrow), the capsid protein (red arrow) and the genomic RNA (blue arrow)

 

 

Fusarium

Fusarium is a hyaline mold that can cause severe invasive infections in neutropenic and transplant patients. The most common type of infections in this population includes invasive nodular pneumonia, sinusitis and necrotizing cutanous infections from traumatic inoculation.

This mold is angioinvasive, but can also cause disseminated disease from metastatic conidias that travel distally from the initial site of inoculation thru the bloodstream.

The treatment is Voriconazole orAmphotericin depending on the subspecies and suceptibilities of fusarium.

The painting below illustrates septated hyphae (green arrow) and banana shape conidia (black arrow).

 

 

Actinomycetes

Actinomycetes are acid-fast gram positive bacilli that are sometimes branching depending of the species.

The Actinomycetes sppinclude Mycobacterium spp, Corynebacterium spp, Nocardia spp, Actinomyces spp, Rhodococcus spp, Tsukumurella spp, Gordona spp, Actinomadura spp, Streptomyces spp, and Tropheryma wippelii.

The painting below illustrates Nocardia, Actinomyces and Rhodococcus.

Nocardia spp(black arrow) are aerobic filamentous branching beaded, gram positive rod, that stain acid-fast positive given its mycolic content of the cell wall.

Actinomyces spp(white arrow) are anaerobic branching gram positive rods that can be differentiated from Nocardia because they are acid-fast negative.

Rhodococcus spp(yellow arrow) are aerobic gram positive rod non branching acid-fast positive.

 

Chikungunya

Chikungunya virus is an RNA alphavirus transmitted by Aedes mosquitoes in the tropical and subtropical areas.

It causes acute febrile illness with polyarthralgia, arthritis and occasionally headache, rash and periarticular edema.

The painting below illustrates the structure of the Chikungunya virus with the E proteins (yellow arrow) Membrane (white arrow) capsid (red arrow) and the genomic structure (black arrow).

 

 

Herpes Simplex Virus

HSV is an enveloped double stranded DNA virus that belongs to alpha herpes virus.

There are 2 types of herpes virus (HSV): herpes virus type 1 (HSV-1) and herpes virus type 2 (HSV-2). Both are closely related.  HSV1 is more commonly associated with orofacial disease whereas HSV2 is more commonly associated with genital disease.

Medications to treat HSV infections include acyclovir, valacyclovir, and famciclovir.

The painting below illustrates the HSV virus. It has the DNA gene (white arrow), nucleocapsid (black arrow) the tegument (blue arrow), the lipid envelop (orange arrow), and the envelope proteins (red arrow).

 

 

Polymicrobial abscess

The painting below illustrates the polymicrobial purulent and bloody fluid from an abscess. The gram positive cocci in chains are Streptococcus spp (orange arrow), the gram positive cocci in clusters are Staphylococcus aureus (blue arrow) and the gram negative rods are Pseudomonas spp (white arrow).

 

 

Scedosporium

Scedosporium is a filamentous mold present in soil, sewage, and polluted water. It has two main species: Scedosporium apiospermum(and its sexual form Pseudallescheria boydii) and Scedosporium prolificans. Scedosporium spp may colonize transitory previously damaged airways, but can also cause severe respiratory infections in near-drowning and immunosuppressed patients. The infection may spread locally by angioinvasion or hematogenously to distant organs (lung and brain are common organs). Scedosporium spp are often resistant to several antifungals. Voriconazole can be used to treat infections by Sedosporium angiospermum. Scedosporium prolificans is often multi-drug resistant.

The painting below illustrates Scedosporium spp with broad hyphae (blue arrow) and Pseudallescheria boydii (red arrow) with fully developed and ruptured cleistothecium, the typical form of the sexual stage of Scedosporium apiospermum.

 

 

Zygomyces

Zygomyces is hyaline fungus that causes severe invasive infections in transplant and neutropenic patients. It can also cause severe infections in poorly controlled diabetic patients.

The most common type of infections includes invasive necrotizing nodular pneumonia, severe sinusitis with peri-orbital cellulitis, and cutaneous infections  from traumatic inoculation.

The treatment of choice is Amphotericin. Isavuconazole and Posaconazole are also effective but are often used as an alternative to Amphotericin.

The painting below illustrates different Zygomyeces spp with the typical large ribbon like non septate 90 degree angle hyphae (green arrow).

 

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