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9. Infection (Medical Knowledge) > 8.Fungal Infections > Flashcards

8.Fungal Infections Flashcards

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USMLE® Step 1 flashcards
1
Q

What is the mortality rate of invasive Mycological Disease?

A

> 50% - about 1,350,000

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2
Q

Who do Fungal Pathogens affect?

A

They are Opportunistic Infections:
1. Patients with an Impaired Immune System (Primary imunodeficiencies, HIV/AIDS, Malignancies etc)
2. Patients with Chronic Lung Diseases (Asthma, Cystic Fibrosis)
3. Patients in ICU Settings

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3
Q

What are the “Big 3” Fungal Pathogens?

A
  1. Candida Species (Albicans) - Yeast
  2. Aspergillus Species (Fumigatus) - Spores in the Air
  3. Cryptococcus Species (Neoformans) - Yeast
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4
Q

What is the most common type of Candida Species infection?

A

Mucocutaneous Candidiasis (Nappy Rash, Thrush)
Note - it can cause a lot of different diseases

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5
Q

When / Where does Candida Species infection occur?

A

Candida Species are a commensal (on the Skin) and is found:
1. When the patient is on Antibiotics
2. When the patient is on Inhaled Steroids
3. When the patient has a Primary immunodeficiency disorder
4. When the patient is a Neonate (< 3 months)
5. Moist Areas of the Skin

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6
Q

What is the Pathology of Invasive Candidiasis?

A
  1. Candida Species are a Gut commensal (infections mostly Endogenous origin)
  2. If the patient is immunocompromised, the Candida may become more aggressive
  3. Same clinical course as bacterial infection in Sepsis
    Note - Candida Species are the 4th most common Bloodstream Infection
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7
Q

How is Aspergillosis transmitted from person to person?

A

Sporulation, when the spores are then dispensed into the air where they are inhaled
Note - pulmonary infections are common
Note - If the immune system is in tact, there will be no problem

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8
Q

What are the 3 classifications of Pulmonary Aspergillus Disease?

A
  1. Acute Invasive Pulmonary Aspergillosis
  2. Chronic Invasive Pulmonary Aspergillosis
  3. Allergic Aspergillosis
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9
Q

What predisposes patients to Acute Invasive Pulmonary Aspergillosis?

A
  1. Neutropenic Patients
  2. Patients with defects in Phagocytes
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10
Q

What predisposes patients to Chronic Invasive Pulmonary Aspergillosis?

A

Patients with underlying chronic lung conditions

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11
Q

What predisposes patients to Allergic Aspergillosis?

A
  1. Allergic Bronchopulmonary Aspergillosis in Cystic Fibrosis and Asthma
  2. Extrinsic Allergic (Broncho)Alveolitis
  3. Asthma or Cystic Fibrosis with Fungal Sensitisation
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12
Q

What causes Acute Invasive Pulmonary Aspergillosis?

A

Rapid and Exensive Hyphal (Aspercillus) Growth - Spores cause the infection and these will just grow through any body wall

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13
Q

What are the Clinical Signs / Symptoms of Acute Invasive Pulmonary Aspergillosis?

A
  1. Thrombosis and Haemorrhage
  2. Persistent Febrile Neutropenia, despite broad-spectrum antibiotics
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14
Q

What is the definition of a Pulmonary Aspergilloma?

A

A Fungal Mass that grows in Lung Cavitiy
Note - As long as it is within the cavity it isnt a problem, but it can go through and cause bleeding

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15
Q

What are some common Pulmonary Aspergilloma?

A
  1. Tuberculosis
  2. Sarcoidosis
  3. Bronchiectasis
  4. Bronchial Cysts and Bullae
  5. After Pulmonary infections
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16
Q

How is Cryptococcosis transmitted from person to person?

A

Inhalation

17
Q

Where can Cryptococcal Species be found?

A
  1. On the bark of trees
  2. Bird faeces
  3. Organic matter
18
Q

Which Cryptococcosis is the most concerning, in patients with HIV / AIDS?

A

Cryptococcal Meningitis:
Subacute meningoencephalitis after a latent infection

19
Q

How is Cryptococcal Meningitis diagnosed?

A

Indian-Ink CSF

20
Q

What are the 3 classes of Anti-Fungals?

A
  1. Polyenes
  2. Azoles
  3. Echinocandins
21
Q

What are the most common Polyene Antifingual Drug?

A
  1. Amphotericin B
  2. Griseofulvin
  3. Nystatin
22
Q

What are the most common Azole Antifungal Drugs?

A
  1. Fluconazole
  2. Voriconaxole (more recently developed)
  3. Posaconazole (more recently developed)
23
Q

What are the most common Echinocandin Antifungal Drugs?

A
  1. Anidulafungin
  2. Caspofungin
  3. Micafungin
24
Q

How is Invasive Aspergillosis treated?

A
  1. I.V. and Oral Azoles (Voriconazole / Isavuconazole)
    OR
    I.V. Polyene (Liposomal Amphotericin B) if serious infection occurs
25
Q

How is Invasive Candidasis treated?

A
  1. I.V. Echinocandins
  2. I.V. and Oral Fluconazole (Azole)
    Note - Fluconazole is a good step-down medication
26
Q

How is Cryptococcal Meningitis treated?

A
  1. I.V. Polyene (Amphotericin B)
  2. Flucytosine (Followed by Fluconazole)
27
Q

What are the main problems with Antifungal Therpaies?

A
  1. Toxicity
  2. Antifungal Resistance

9. Infection (Medical Knowledge) (29 decks)

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