Aspergillus And Candidiasis Flashcards
Aspergilli
Ubiquitous in environment (T/F)
Molds or Yeast?
T
Molds
Aspergilli
Requires _______ for growth but ______ because of ______
4-5 days
1-3 weeks; sporolation
Aspergilli
Hyphae are ________ and ———
branching and septate
Aspergillus
Numerous species but approx ___ implicated in infections
Aspergillus ______
Aspergillus _____
Aspergillus _____
Aspergillus ______
10
fumigatus
Flavus
Niger
Nidulans
Aspergillus fumigatus – most common, accounts for ___% of infections in _____
95
Western world
Aspergillus flavus – common in _____,_______
India, Nigeria
Infections caused by Aspergillus
Most often route of transmission is by ______
inhalation
Infections caused by Aspergillus
Causes infections in only immunosuppressed patients
T/F
F
Causes infections in both immunocompetent and immunosuppressed.
aspergilloma (___________)
fungal ball
Aspergillus has been implicated in are:
________ infections
_______
________ infections
Sinusitis and rhinosinusitis (most often granulomatous)
Fungal nail
Keratitis
Subcutaneous
There are three clinical types of pulmonary aspergillosis:
•________-________ to the organism
• _____________
• ________ Or ________
Allergic - hypersensitivity
Aggressive tissue invasion
Fungus ball or Pulmonary Aspergilloma
There are three clinical types of pulmonary aspergillosis:
•Allergic - hypersensitivity to the organism.
Symptoms may vary from __________ to ________
mild respiratory distress to alveolar fibrosis.
There are three clinical types of pulmonary aspergillosis:
•Aggressive tissue invasion. Primarily a pulmonary disease, but the aspergilli may ___________
They may cause endocarditis, osteomyelitis, otomycosis and cutaneous lesions.
disseminate to any organ.
There are three clinical types of pulmonary aspergillosis:
•Fungus ball or Pulmonary Aspergilloma which is characteristically seen in the ________ of ______ patients.
This is easily recognized by x-ray, because the lesion (actually a _________ in the cavity) is shaped like a _______ (______ growth).
The patients may cough up the fungus elements because ______________.
old cavities of TB
colony of mold growing
half-moon ; semi-lunar
the organism frequently invades the bronchus
In aspergilloma, ________ can sometimes be seen in the sputum.
Chains of conidia
Yeasts are ______-celled budding organisms.
single
Yeasts do not produce mycelia
T/F
T
We will discuss only the two most significant species of yeast
______ and _______
Candida albicans
Cryptococcus neoformans.
Candida
Yeast or mold?
Location:part of _____,______, and ______
Yeast
Part of normal flora of skin, GIT and mucocutanous surfaces
Candida
Commonly causes ________ infections
opportunistic
Candida
C. albicans accounts for over ____% of infections
50
Candida
Resistance to _________ drug due
to _________
fluconazole
overuse
MOST COMMONLY ISOLATED SPECIES OF CANDIDA
C. ______
C. ______
C. parapsilosis
C. _______
C. glabrata
C._______
C. guillermondii
C. lusitaniae
albicans
tropicalis
kefyr
krusei
There are many species of the genus Candida that cause disease. The infections caused by all species of Candida are called _________.
candidiasis
CANDIDIASIS (Candida albicans)
Candida albicans is a/an (Endo or Exo?) genous organism.
It can be found in ___-___% of normal human beings.
It is present in the ____,______, and ______
Endo
40-80
mouth, gut, and vagina.
CANDIDIASIS (Candida albicans)
It may be present as a ______ or a ______ organism.
commensal
pathogenic
CANDIDIASIS (Candida albicans)
Infections with Candida usually occur when a patient has _________,________, or ________.
some alteration in cellular immunity, normal flora or normal physiology
most common fungal pathogen worldwide is
Candidiasis
Candidiasis
Is the _____ leading causes of nosocomial infections, with ____% mortality
4th
40
Candidiasis
Frequency
- significant mortality and morbidity in ___________ infants
- affects ____% women, ____% experience recurrenceA
low birth-weight
75; 45
Candidiasis is classified as a STD
T/F
T
Candidiasis
Immunocompromised
-_____ and ______ patientsC
- most commonly manifested in patients with ____ or ______ infections.
cancer and HIV-AIDs
leukemia
HIV-AIDs
Candidiasis
Oral candidiasis is often a clue to ___________
acute primary infectionC
Candidiasis
Public Concerns
- increasing ______ to ______ due to antibiotics and antifungals
resistance
drug therapies
Biology of Candida albicans
Can be a ____ or a ____
A (thin or thick?) -walled ______ fungus
Pathogen; Commensal
Thin ; dimorphic
Biology of Candida albicans
Morphogenesis
__________ (harmeless)
________ (pathogenic)
Unicellular yeast
Filamentous
Biology of Candida albicans
Principal Cell Wall Polymers
————-
____________
Gluccan
Mannan
Biology of Candida albicans
(Facultative or Strict?) ( aerobe or anaerobe?)
favors (dry or moist ?) surfaces
Temp ____o C
______ pH
Strict aerobe
Moist
37; neutral
Biology of Candida albicans
(Slow or Rapid?) Multiplication & Spread
Rapid
Patients with decreased _______ have decreased resistance to fungal infections.
cellular immunity
Prolonged antibiotic or steroid therapy destroys the __________________ allowing the ______________ to ________ the host.
balance of normal flora in the intestine
endogenous Candida
overcome
Invasive procedures, such as cardiac surgery and indwelling catheters, produce ______ in host physiology and some of these patients develop Candida infections
alterations
Diseases by Candida albicans
List 5
Thrush
Esophagitis
Cutaneous Candidiasis
Genital Yeast Infections
Deep Candidiasis
Oropharyngeal Thrush
Symptoms :
*__________
* _______
* __________
Pseudomembranous
Atrophic
Angular chelitis
Oropharyngeal Thrush
Risk factor: _____
Treatment: ___________
HIV
topical antifungals
Genital Yeast Candidiasis
Risk Factors
-_____________
disruption of normal
microbiota
Genital Yeast Candidiasis
Treatment
-___________ administration
- _____,______,______
direct genital
tablets, suppositories, creams
Forms of invasive candidiasis
In order: from candidemia to organ involvement
Catheter related candidemia
Acute disseminated candidiasis
Chronic disseminated candidiasis
Deep organ candidiasis
Candida
The yeast form is 10-12 microns in diameter, gram _____
it grows _____ on most __________.
positive
overnight
bacterial and fungal media
Candida
It produces _____, and ____ may be formed from budding yeast cells that remain attached to each other.
germ tubes
pseudohyphae
Candida
_____ may be formed on the ______.
These are called _______ and they can be used to _____________
Spores
pseudomycelium
chlamydospores
identify different species of Candida.
CULTURE OF Candida
______ agar, _____ agar , _____ agar – creamy moist colonies
Candida – ______ agar for presumptive identification of 4 species
Blood; sabourose dextrose; chocolate
chromogenic
CULTURE OF Candida
Grows in ______ time
24-48hrs
CULTURE OF Candida
Stains gram _______
_______ test to speciate as C.albicans or non- C.albicans.
positive
Germ tube
Treatment of candidiasis
Depending on _____ of infection
_______ is drug of first choice
site
Fluconazole
Treatment of candidiasis
Dosage dependent on _____ and _____ of infection
______ are generally effective
type and site
Azoles
Treatment of candidiasis
2nd line drugs – ______,_______
echinocardins, polyenes
cryptococcus
The source of human infection is __________.
The portal of entry is the ______ system.
not clear
respiratory
cryptococcus
Evidence is developing which indicates that the initial exposure may be _______________
The organism can be ______ for this time.
many years prior to the manifestation of disease.
sequestered
cryptococcus
Infection may be ______ or _______.
subacute or chronic
cryptococcus
The highly fatal ________ caused by C. neoformans has a prolonged evolution of several months.
meningoencephalitis
In cryptococcus neoformans
The patients symptoms may begin with ______ problems and headache, which then progress to _____,_______ leading to _____ and death
vision
delirium, nuchal rigidity
coma
In cryptococcus neoformans
The _____ is examined for its characteristic chemistry ) of elevated _____ and decreased ______, cells ( ________ ), and evidence of the organism.
CSF
protein
glucose
usually monocytes
In cryptococcus neoformans
The CSF is examined for its characteristic chemistry ) elevated protein and decreased glucose(, cells (usually monocytes), and evidence of the organism. diagnosis
The latter is measured by the visual demonstration of the organism ( ________ preparation) or by a _______ for the antigen of C. neoformans.
India Ink
serologic assay
Cryptococcus neoformans
The India Ink test, which demonstrates the ______ of this yeast, is supplemented by the ________ test for _____ which is more sensitive and more specific.
capsule
latex agglutination ; antigen
The Latex Agglutination test measures _____, NOT ______.
antigen
antibody
The Latex Agglutination test
A decreasing titer indicates a _____ prognosis, while an increasing titer has a ____ prognosis.
good
poor
When you consider Cryptococcosis, think of ________ and _______ disease.
Capsules and CNS
In addition to causing _____, C. neoformans may also infect ____ and _____ .
meningitis
lungs and skin
Cryptococcosis
The disease in the lungs and skin is characterized by the formation of a ________ reaction with ______ cells.
granulomatous
giant
Cryptococcus neoformans
The organism is a ____ shaped , single cell, ____ surrounded by a ______. Identification is based on physiological reactions.
round
yeast
Capsule
Cryptococcus neoformans
Pathologists use a ______ stain, which stains the capsule, to identify the organism in tissue sections.
There is usually _______ inflammatory response.
muci-carmine
little or no
Cryptococcus neoformans
The Direct Fluorescent Antibody test identifies the organism in culture or tissue section specifically, by causing the yeast cell wall to stain ____.
green
To test the patient’s serum for cryptococcus neoformans there are 3 serologic tests:
1-The ________________ test
2- the _________ test for ________
3- the _______ test for ______.
Indirect Fluorescent Antibody
Tube Agglutination; antibody
Latex Agglutination; Antigen
The latex agglutination test can be used as a prognostic test.
T/F
T
The drugs of choice to treat cryptococcus infection are _______ and _________.
amphotericin B and 5- Fluorocytosine (5-FC)
5-FC is an (oral or IV?) drug.
Oral
5-FC
If it is given as the only treatment to cryptococcus neoformans, there are ______ so most physicians use _________ .
relapses
both drugs simultaneously
