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
Treatent for cryptococcal meningitis
Amphotericin B with flucytosine and serial lumbar punctures followed by fluconazole alone
Trichostrongyloides effect
large losses in livestock
like hookworm in human
Unique organ affected by histo
Adrenal
Valley fever, Desert rheumatism
Coccidiomycoses
What percent of PJP CXR are abnormal
75%
What percent of PJP CXR are abnormal
75%
White peidra
Trichosporon
white nodules- more facial and oubic
shave, topical ketoconazole
