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Fungal and parasites of the CNS Flashcards

1
Q

What are the systemic fungal infections that can cause CNS infections? (5)

A 
Histoplasma
Blastomyces
Paracoccidioides
Coccidioides
Cryptococcus
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2
Q

What is the most common fungal cause of meningitis? Second most common?

A
  1. Cryptococcal

2. Coccidiodies

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3
Q

Are the fungi that cause systemic diseases opportunistic?

A

no

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4
Q

How are fungi infections started?

A

Through inhalation

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5
Q

What is the form that coccidioides immitis infects?

A

Yeast

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6
Q

What is the only encapsulated yeast?

A

Cryptococcus neoformans

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7
Q

Where is coccidioides immitis found in the world? Why?

A

Desert southwest d/t drought-rain-drought pattern

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8
Q

What is the morphology of coccidioides immitis?

A

Spherules

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9
Q

What are the symptoms of coccidioidomycosis?

A

Usually asymptomatic

Mild to moderate pulmonary disease

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10
Q

How does coccidial meningitis present, relative to bacterial meningitis?

A

Same symptoms, but much slower onset

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11
Q

How do you diagnose coccidioidomycosis meningitis?

A

Antigen detection

Serology

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12
Q

What is the treatment for coccidioidomycosis meningitis?

A

Amp B

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13
Q

Can you cultivate coccidioidomycosis

A

rarely

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14
Q

Which fungus is NOT dimorphic? Why?

A

Cryptococcus neoformans b/c it is encapsulated

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15
Q

India ink stain?

A

Cryptococcus neoformans

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16
Q

Where is Cryptococcus neoformans found?

A

Bird droppings, soil

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17
Q

What are the symptoms of infx with Cryptococcus neoformans usually? What about for meningeal infections?

A

Mild pulmonary disease (or none)

Slow meningitis symptoms

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18
Q

What population are we concerned about with Cryptococcus neoformans infections (cryptococcosis)?

A

AIDS/ immunosuppressed

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19
Q

How do you diagnose Cryptococcus neoformans? How sensitive is this?

A

India ink stain
Serology

Only 50%

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20
Q

What is the treatment for Cryptococcus neoformans infections of the CNS?

A

Long term Amp B and 5-fluorocytosine

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21
Q

What causes rhinocerebral mucormycosis? Who is usually infected with this?

A

Zygomycetes

DM pts usually get these

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22
Q

What are the symptoms of rhinocerebral mucormycosis?

A

Rhinitis

CNS symptoms

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23
Q

What are the three molds that cause zygomycosis?

A

Rhizopus
Absidia
Mucor

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24
Q

Are zygomycetes septate? Broad or narrow?

A

Broad, aseptate

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25
Q

How do you diagnose zygomycosis?

A

Culture confirmation

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26
Q

What is the treatment for zygomycosis?

A

Amp B

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27
Q

What is the parasite that causes GI symptoms, and can also cause CNS infections?

A

Entamoeba histolytica

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28
Q

What do entamoeba histolytica cause in the brain?

A

Abscesses

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29
Q

What does trypanosoma brucei cause?

A

Sleeping sickness

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30
Q

What does plasmodium falciparum cause?

A

Cerebral malaria

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31
Q

What causes cerebral malaria?

A

Plasmodium falciparum

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32
Q

What causes sleeping sickness?

A

Trypanosoma brucei

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33
Q

What causes neurocysticercosis?

A

Pork tapeworm

Tenia solium

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34
Q

What are the three genera of amoeba that cause infections in man?

A

Acanthamoeba
Naegleria
Balamuthia

35
Q

Where are the opportunistic amoebas found in the environment?

A

Fresh water

36
Q

What is primary cause of primary amebic meningoencephalitis (PAM)?

37
Q

How is Naegleria acquired?

A

Snorting water while swimming

38
Q

What are the symptoms of Naegleria infections?

A

Fever, HA, CNS, death

39
Q

What are the amoebas associated with Neti Pot use?

A

Naegleria fowleri

40
Q

How do you diagnose naegleria fowleri?

A

Trophozoites in CSF

41
Q

True or false: Infection with naegleria fowleri is usually fatal

42
Q

How do you treat naegleria fowleri infections?

A

Amp B… maybe

43
Q

What causes granulomatous amoebic encephalitis (GAE)?

A

Acanthamoeba and balamunthia

44
Q

What is the pathology of acanthamoeba and balamunthia?

A

Amoebas invade the brain, resulting in slow CNS involvement and ulcerative lesions

45
Q

What is acanthamoeba keratitis? What are infections associated with?

A

Chronic infection of the cornea, associated with contact lenses

46
Q

What are the symptoms of acanthamoeba keratitis?

A

Corneal ulceration and ocular pain

47
Q

How does acanhamoeba appear under a microscope?

A

Stop-sign appearance

48
Q

How does toxoplasma gondii move about?

A

Sporozoan (tank tread)

49
Q

Where are toxoplasma cysts found?

A

Cat litter

Garden vegetables

50
Q

What does the TORCH test used on pregnant women screen for?

A 
Toxopalsma
Other
Rubella
CMV
Herpes
51
Q

True or false: infections with toxoplasma gondii are usually fatal?

A

False- usually asymptomatic

52
Q

What can toxoplasma lead to if a pt becomes immunosuppressed?

A

Encephalitis

53
Q

What are the congenital symptoms of toxoplasmosis gondii?

A

Blindness
MR
Neuro disorders

54
Q

What are the ocular signs of toxoplasmosis?

A

Small, asymptomatic scarring

55
Q

What do the toxoplasma lesions look like on a CT?

A

Ring enhanced lesion

56
Q

How does transmission of toxoplasma gondii occur? (2)

A

Ingestion of cysts through meats

Cat litter

57
Q

What are the definitive hosts for toxoplasma gondii?

58
Q

How are cats infected with toxoplasma?

A

Infected rodents

59
Q

When are congential transmission of toxoplasma concerning?

A

When primary infection occurs during pregnancy–later the better

60
Q

What are the symptoms of toxoplasmosis, if it is symptomatic at all?

61
Q

When, besides pregnancy, it toxoplasmosis concerning? What can it cause?

A

Immunosuppression

Encephalitis

62
Q

How do you diagnose toxoplasmosis? (3)

A
  1. PCR testing
  2. IgM or rising IgG in mother
  3. IgM in newborn
63
Q

How do you prevent toxoplasmosis?

A

Cook meat

Avoid cat feces

64
Q

What is the treatment for toxoplasmosis? When?

A

Treat mothers

65
Q

What causes neurocysticercosis?

A

Tenia solium

66
Q

What are the GI symptoms of tenia solium?

67
Q

What is the main pathology with cystercercosis?

A

Lesions in vital organs

68
Q

What are the symptoms of neurocysticercosis?

A

Szs, neuro stuff

69
Q

What population gets neurocysticercosis?

A

immigrants

70
Q

How do you diagnose neurocysticercosis?

A

Serology

MRI

71
Q

What is the main disease that is associated with ascaris lumbricoides?

A

Intestinal disease

72
Q

What causes visceral larval migrans?

A

Ascarid worms (similar to Lumbricoides) from dogs/cats

Toxocara canis/cati

73
Q

What is the mech of transmission of visceral larval migrans?

A

Ingestion of eggs via dog/cat poop contamination

74
Q

What happens in infections with visceral larval migrans?

A

Granulomatous lesions in vital organs d/t larval death

75
Q

What are the symptoms of visceral larval migrans?

A

Depend on location of granuloma development

76
Q

How do you diagnose visceral larval migrans?

A

Eosinophilia

Serology

77
Q

Can you diagnose viceral larval migrans via fecal cysts?

A

No, because there are no cysts

78
Q

What is the treatment for visceral larval migrans?

A

Symptomatic (steroids)

79
Q

Sphereules = ?

A

Coccidioides immitis

80
Q

Broad, aseptate hyphae, branching at 90 degree angles = ?

A

Zygomycoses

81
Q

Septate hyphae, branching at 45 degree angles = ?

A

Aspergillus

82
Q

What two places in the body does acanthamoeba infect?

A

Eye (acanthamoeba keratitis) and brain (GAE)

83
Q

Stop-sign appearing amoeba = ?

A

acanthamoeba

Microbio (50 decks)

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