Fungal Flashcards
Anaplasma phagocytophilum- vector, Sx, labs, Tx
within 3 weeks of a tick bite
fever/rigors, headache, myalgia, V, possible neurologic
low PLT, low WBC, elevated LFT empiric
treatment with doxycycline
Aspergillosis- micro, Tx
dichotamous branching
surgical excision
Black Peidra- Sx, Tx
Black nodules on hairs
breakage
Blastomycosis- geo, Sx, Dx, Tx
Midwest, Africa 50%
Sx- pulmonary, skin, multiorgan
broad based budding
itraconazole, ampho B
Chromomycosis- micro, Sx, DDx
coffee bean
skin lesions with black dots
psoriasis, SCC
itracon plus flucytosone; terbinafine, ampho B, local Tx
Chronic paracoccidiomycosis- age, Sx
Adult
Chronic pneumonia with painful skin lesions
CNS fungal with high opening pressure
Cryptococcal
Coccidiomycoses- source, geo, Sx, Dx, Tx
inhaled soil
Americas
bag of marbles
none 60%, flu, pulmonary, erythema nodosum
ampho B
Cryptococcus- agents, geo, Sx, Tx
C. neoformans and C. gatii
worldwide
pneumonia, menigitis, molluscum-like rash
amphoB+ flucytosine 6 wks, then PO fluconazole
Histo finding not seen with blasto
hilar LAD
Histoplasmosis- agent, source, Sx, Dx, DDx, Tx
H. capsulatum
soil- bird, bats
acute lung, chronic lung, dissem in HIV (LAD, HSM, wt loss, mulloscum like rash, skin abscess, ulcers
Ag or Cx, serology (only 1% in endemic)
DDx sarcoid
ampho B, itraconazole
Lobomycosis- geo, clinical, reservoir, micro, Tx, severity
South America and Central America (high Brazil)
minor skin trauma -> promoting scar-like lesions
Dolphin-to-human transmission reported
Dx- KOH, PAS and silver positive- rosary chain
Tx: surgery, clofazamine +/- itraconazole No deaths from lobomycosis have occurred.
MAC Sx
fever, weight loss, LAD, HSM, cytopenias
looks like TB but clear lungs
Madura foot- causes, Tx
mycetoma due to fungal (eumycetes) or bacteria (actinomyces, Nocardia)
amputation may be needed for fungal
streptomycin or rifampicin for bacterial
Malarone can be used down to ___ kg
5
Mycetoma- location, 2 types and Tx
esp feet (Madura foot) can spread deeper, sinus tract
eumycetoma (fungal)- septate hyphae PAS pos and gram neg; Tx Itraconazole, surgical excision actinomycemtoma
(bacterial- most)- branching filaments PAS neg and gram pos; Tx Streptomycin and cotrimoxazole
Paracoccidiomycoses- geo, micro, Sx (acute, chronic), Tx
Central and South Amercia
pilot wheel
acute in 10% but 11% mortality
LAD, HSM, aplastic anemia
Chronic- lung, oral, skin, adrenal, CNS, bone…
ampho B, itraconazole
Penicillinosis reservior
rat
Penicilliosis- agent, geo, Sx, Dx, Tx
Penicillium marneffei
Asia
umbilicated papular rash (DDx molluscum) intra and extra cellular yeast on Bx
ampho B -> intraconazole
Pneumocystic jirovecii- Sx, Dx, Tx (4), proph
slow onset dry cough, malaise, hypoxia
BAL better than sputum- immunofluor or silver stain
25% have nl CXR
steroids for severe, bactrim (primaquin, clinda, malarone)
proph bactrim CD4
Sporothrichosis- agent, source, Sx (3), Tx
dimorphic fungus
moss, hay, soil
skin, lymphocutaneous, pulmonary, arthritic
Skin- saturated solution of potassium iodide, itraconazole, ampho, surgery
Sx and age of acute paracoccidiomycosis
Children
lymphadenitis, abscesses with sinus tracts
fevers, HSM and weight loss
Majocchi’s grauloma- agent, patient, Sx, Tx
T. rubrum
immunocompromised
red perifollicular
PO
Tinea nigra- agent, DDx, Tx
Hortaeo werneckii
melanoma
salicyclate, tretenoin, azoles
