Aspergillus And Candidiasis Flashcards by Iseoluwa Ojo

Aspergilli

Ubiquitous in environment (T/F)

Molds or Yeast?

Molds

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Aspergilli

Requires _______ for growth but ______ because of ______

4-5 days

1-3 weeks; sporolation

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Aspergilli

Hyphae are ________ and ———

branching and septate

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Aspergillus

Numerous species but approx ___ implicated in infections

Aspergillus ______
Aspergillus _____
Aspergillus _____
Aspergillus ______

fumigatus
Flavus
Niger
Nidulans

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Aspergillus fumigatus – most common, accounts for ___% of infections in _____

Western world

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Aspergillus flavus – common in _____,_______

India, Nigeria

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Infections caused by Aspergillus

Most often route of transmission is by ______

inhalation

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Infections caused by Aspergillus

Causes infections in only immunosuppressed patients

T/F

Causes infections in both immunocompetent and immunosuppressed.

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aspergilloma (___________)

fungal ball

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Aspergillus has been implicated in are:
________ infections
 _______
 ________ infections
 Sinusitis and rhinosinusitis (most often granulomatous)

Fungal nail

Keratitis

Subcutaneous

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There are three clinical types of pulmonary aspergillosis:
•________-________ to the organism
• _____________
• ________ Or ________

Allergic - hypersensitivity

Aggressive tissue invasion

Fungus ball or Pulmonary Aspergilloma

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There are three clinical types of pulmonary aspergillosis:
•Allergic - hypersensitivity to the organism.

Symptoms may vary from __________ to ________

mild respiratory distress to alveolar fibrosis.

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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.

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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

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In aspergilloma, ________ can sometimes be seen in the sputum.

Chains of conidia

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Yeasts are ______-celled budding organisms.

single

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Yeasts do not produce mycelia

T/F

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We will discuss only the two most significant species of yeast

______ and _______

Candida albicans

Cryptococcus neoformans.

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Candida

Yeast or mold?

Location:part of _____,______, and ______

Yeast

Part of normal flora of skin, GIT and mucocutanous surfaces

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Candida

Commonly causes ________ infections

opportunistic

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Candida

C. albicans accounts for over ____% of infections

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Candida

Resistance to _________ drug due
to _________

fluconazole

overuse

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MOST COMMONLY ISOLATED SPECIES OF CANDIDA
C. ______
C. ______
C. parapsilosis
C. _______
C. glabrata
C._______
C. guillermondii
C. lusitaniae

albicans

tropicalis

kefyr

krusei

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There are many species of the genus Candida that cause disease. The infections caused by all species of Candida are called _________.

candidiasis

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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

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

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