15- Deep Mycoses Flashcards

1
Q

Flulike illness
Lung changes on CXR- hilar adenopathy, infiltrate
Generalized maculopapular eruption

Pulmo sx subside within a few weeks
Erythema nodosum over shins then disappear after 3 weeks

A

Coccidiodomycosis (primary pulmonary)

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2
Q

Treatment for coccidiomycosis

A

Fluconazole 400-800mg/day
Itraconazole 200mg TID

X 12-18 months

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3
Q

Inhalation of airborne spores
Asymptomatic or limited lung disease

Immunocompromised/ systemic steroids

Ulcerations/ granulomas of the oronasopharynx

A

Histoplasmosis

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4
Q

Painless, slightly pruritic dome shaped nodular granulomas
Erythema nodosum

Organism found in bat and bird feces

A

African histoplasmosis

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5
Q

Treatment of choice for histoplasmosis

A

Amphotericin B

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6
Q

Begins as a pulmonary infection and remains localized to the lung in 90% of cases

10%- disseminate to CNS and skin
Immunocompromised

Molluscum contagiosum like lesions-50% of px with HIV and disseminated

A

Cryptococcosis

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7
Q

Most common cause of mycotic meningitis

A

Cryptococcosis

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8
Q

4th leading cause of opportunistic infection and 2nd most common fungal opportunist

A

Cryptococcosis

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9
Q

Treatment of cryptococcosis

A

Amphotericin B IV + oral fluconazole - seriously ill

Fluconazole 400-600mg/day x 8-10 weeks- less severely ill non -AIDS

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10
Q

Result from dissemination from a primary pulmonary focus

Multiple Verrucous, granulomatous lesions with thick crusts, warty vegetations on exposed skin
-thick dirty brown or gray crusts

A

Blastomycosis (North American)

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11
Q

Treatment of choice for North

American blastomycosis

A

Itraconazole 200-400mg/day x 6 months

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12
Q

Blastomycosis with mucocutaneous involvement

Armadillos may harbor the disease

A
South American 
(Paracoccidiodomycosis)
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13
Q

Treatment for south American blastomycosis

A

Itraconazole 200mg/day x 12 months

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14
Q

Usually from direct inoculation by a thorn, cat’s claw

Small nodule that disappear before onset of other lesions

After few weeks- painless firm nodules along draining lymphatics

A

Sporotrichosis

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15
Q

Treatment of sporotrichosis

A

Itraconazole 200mg/day x 2-4 weeks

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16
Q

Affects one lower extremity
Occurs in farmers 75%
Direct inoculation
Small pink scaly papules or warty growth and soread through direct extension

A

Chromoblastomycosis

17
Q

Treatment for chromoblastomycosis

A

Small lesions- excision

Itraconazole 200-400mg/day x 6-12months

18
Q

Chronic, granulomatous, subcutaneous inflammatory disease

Triad: progressive subcutaneous swelling
Sinus tracts that discharge grains

Begin in instep or toe webs- nontender firm
Bone and fascia involved also

A

Mycetoma

Madura foot/maduromycosis

19
Q

Mycetoma triad

A

Tumefaction
Sinuses
Granules

20
Q

Treatment of mycetoma (maduromycosis)

A

Early stage- surgical removal

Penicillin- A.israelli
Sulfonamides- nocardia spp
Voriconazole- P. boydii

21
Q

Acute rapidly developing fatal infection

Infarction, gangrene, necrotic abscess
Black, necrotic purulent debris

Common in soil, decomposing plant and animal matter

A

Mucormycosis

22
Q

Treatment of mucormycosis

A

Excision + amphotericin B

23
Q

2nd to candidiasis
Opportunistic fungal disease in px with leukemia and other hema neoplasias

Neutropenia- risk factor
Pulmo involvement- invasive disease
Hemorrhagic bullae/ necrotic ulcers

A

Aspergillosis

24
Q

Treatment of choice for invasive aspergillosis

A

Voriconazole