Clinical Aspects of Respiratory Infection Flashcards

1
Q

What’s the most common, new symptomatic presentation of HIV?

A

Pneumocystis pneumonia

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2
Q

What organism is responsible for Histoplasmosis infection?

A

Histoplasmosis

  • Fungus: Histoplasma capsulatum
  • soil and bat or bird poo -> disrupted soil may release infectious elements that can

be inhaled into the lungs

  • common in immunocompromised patients
    (e. g. HIV)
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3
Q

Pathophysiology of Histoplasmosis

A

When inhaled into the alveoli, they can survive phagocytosis -> in fact the phagocyte (that engulfed fungi) is a place where fungi multiply -> as macrophages travel in lymphatic circulation -> potential to spread to other organs

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4
Q

Symptoms of histoplasmosis

A

A. Acute phase: non-specific respiratory symptoms (cough, flu-like); chest X ray is normal in

40-70% of cases

B. Chronic histoplasmosis -> similar to TB

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5
Q

Possible complications of Histoplasmosis

A

occur if treatment is not provided, especially in immunocompromised patients:

  • recurrent pneumonia
  • respiratory failure
  • fibronising mediastinitis -> serious complication, may be fatal
  • superior vena cava syndrome
  • pulmonary vessel obstruction
  • progressive fibrosis of lymph nodes
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6
Q

Diagnosis of Histoplasmosis

A
  • samples containing fungus taken from sputum, blood or infected organs
  • ELISA or PCR -> detection of antigen in blood or urine samples
  • Blood test -> antibodies against Histoplasma
  • Histoplasma skin tests -> indicate if a person has been exposed (but not able to tell if a person

has the disease)

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7
Q

Treatment of Histoplasmosis

A
  • immunocompetent individuals -> infection resolves on its own
  • severe infection (severe cases of acute histoplasmosis and ALL cases of disseminated histoplasmosis) -> anti-fungal medication: Amphotercin B -> followed by itraconazole

*itraconazole treatment needs to continue for at least a year in severe causes

But in acute pulmonary histomatosis -> 6 - 12 weeks of treatment is usually sufficient

Individuals taking itraconazole should be monitored in view of hepatic function

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8
Q

What is the arrow pointing at?

A
  • the cavity on the top of the lung -> perhaps TB (or other caveating lung infections)
  • (cavity identified as darker spot with white borders -> where the arrow points)
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9
Q

What’s ground glass appearance?

A

‘Grand glass shadowing’ -> multiple flu -> patchy areas = acute inflammation in the lungs -> caused by

infections

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10
Q

Treatment of pulmonary TB

A
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