7 - Mycotic Diseases Flashcards
Mycotic diseases include:
Endemic mycotic mycotic illness - blastomycocsis - coccidioidomycosis - histoplasmosis Cryptococcosis Candiadiasis - superficial fungal - systemic infections
Mycoses are?
Fungal infections
Mycoses transmission?
No evidence of transmission among humans or animals
Where is blastomycosis found
North America
- mississippi and ohio rivers
- midwest
- great lakes
- new york/canada
Who gets blasto (MC)
Males - “because they hunt and fish”
Environments where blasto is found?
Occupational and recreational activities
Along streams or rivers
Moist soil enriched w decaying vegetation
Blasto types of infection?
Asymptomatic (50%)
Primary - inhalation (pneumonia)
Cutaneous
Primary blastomycosis phases
Acute: similar to bacterial pneumonia
Chronic: looks like TB
Can resolve spontaneously
Cutaneous blasto presentation?
Verrucous, nodular, or ulcerative lesions
Face>extremities>neck>scalp
What organs/systems are involved with blastomycosis?
Almost any organ can be involved
- Osteoarticular
- Genitourinary
- CNS
Test/studies for blasto?
Microscopic
- KOH
- culture
Serology
- immunodiffusion test
- ELISA
Skin test
- blastomycin antigen (useless)
Preferred blasto test?
Immunodiffusion test
ELISA
Temperatures for growing blastomyces?
Mold: 77*F
Yeast 98.6*F
Treatment modalities for blastomycosis?
Liposomal amphotericin B - life threatening Itraconazol (sporanox) - mild-moderate Fluconazole (diflucan)(6-12 mo)
Coccidiomycosis aka?
San Joaquine valley fever
Valley fever
Coccidioides immitis
Where do you find coccidiomycosis?
Arizona
Central cali
Southern NM
West Texas
Lab nerd concerns for coccidiomycosis?
It is highly infectious
- Hazard for the lab folks
Who is at the highest risk for coccidiomycosis?
Filipinos
Pregnant
CAP in arizona?
Coccidiomycosis accounts for 15-29% of cases of CAP in arizona
- put it in your differential
Presentations for coccidiomycosis?
Pulmonary disease
- 60% asymptomatic
- acute pneumona - look like pneumonia
Cnronic pneumona
Chronic pneumonia for coccidioidomycosis presentation?
TB-like disease
Thin walled cavities
Nodules
Disseminated/secondary coccidioidomycosis?
Fulminant disease Skin Bone Vertebrae Meningeal
MC pts who get secondary/disseminated coccidiomycosis?
Immunocompromised
High risk
- filipino
- preggo
- AA)
Coccidioidomycosis test and diagnostic procedures?
Direct - smear, tissue
Culture (biohazard)
Serology
- complement fixation
- IgG/IgM
Acute pulmonary vs severe/disseminated treatments?
Acute:
- No antifungal therapy required
- Symptomatic therapy only
Other/disseminated
- severe - ampothericin B
- fluconazole or itraconazole
Meningeal treatment?
Life-long fluconazole (not a long life though)
Intraventricular amphotericin B
Histoplasmosis aka??
Darling’s disease
Histoplasma capsulatum
Where do you find histoplasma capsulatum?
What spreads it?
World wide (molstly ohio/mississippi river valley)
Bats, chickens, birds
Who is at a higher risk for histoplasmosis?
Smokers