Fungal and Parasitic infections I

Question 1

What organism is responsible for the majority of fungal CNS infections?

Answer 1

Cryptococcal meningitis.

Question 2

What classical symptom do all clinical fungal infections first present with?

Answer 2

All clinical fungal CNS infections begin as a pulmonary infection.

Question 3

Where is coccidios immitis indigenous to?

Answer 3

This organism is mostly found in the San Joaquin Valley of California or Southern Arizona and follows a rain-drought pattern.

Question 4

Following inhalation, coccidios immitis transforms into what sort of structure

Answer 4

Coccidios will transform into a spherule, a multinucleated structure.

Question 5

What is the treatment plan for coccidiomycosis?

Answer 5

Amphotericin B regiment works well.

Question 6

Is cryptococcus neoformans Dimorphic?

Answer 6

It is NOT dimorphic and appears as an encapsulated yeast that is view able with the india ink stain.

Question 7

Where is cryptococcus neoformans most typically found in the environment?

Answer 7

It is commonly found in the soil, and especially in pidgeon droppings/ other bird droppings.

Question 8

What is the treatment regimen for Cryptococcosis?

Answer 8

Longterm 6-10 week treatment of amphotericin B combined with fluorocytosine or fluconazole.

Question 9

If there is a recurring fungal meningitis infection in an AIDS pt it is most likely what fungus?

Answer 9

Cryptococcus neoformans.

Question 10

What are the predisposing factors for contracting an infection by a zygomycoses

Answer 10

Predisposing factors include immunosupression, diabetes, and burns.

Question 11

Rhinocerebral zygomycosis is most commonly seen in what demographic of people?

Answer 11

Most commonly seen in diabetic patients with the infection originating in the sinuses and then invading into neighboring tissues.

Question 12

What are the clinical/observable characteristics of zygoycete species?

Answer 12

Non-septate broad hyphae branching in 90 degree patterns.

Sporangia bearing sporangiospores.

Question 13

What is the treatment plan for a patient with zygomycosis?

Answer 13

Amphotericin B

Question 14

What sort of CNS infection does entamoeba histolytica cause?

Answer 14

Typically will cause brain abscesses.

Question 15

What sort of CNS infection does Trypanosoma brucei cause?

Answer 15

Sleeping sickness.

Question 16

What sort of CNS infection does Plasmodium falciparum cause?

Answer 16

Cerebral malaria.

Question 17

Acanthamoeba, Naelgleria, and Balamuthia are what sort of organism commonly found in what environment?

Answer 17

These are all opportunistic or accidental parasites of man (amoeba) and are found in fresh water. Thought to be accidental infections of man.

Question 18

What microbe would you most likely contract through use of a neti pot?

Answer 18

Naelgleria fowleri, This is the most common cause of amebic meningoencephalitis (PAM)

Question 19

A patient who ends up with meningitis shortly after swimming in warm water is likely to have caught what bug?
What would you treat this pt with?

Answer 19

Naelgleria fowleri.

Treat with Amphotericin B!

Question 20

How is Primary amebic meningoencephalitis and Granuomatous amoebic encephalitis differentiated?

Answer 20

GAE is typically seen as a slowly developing ulcerative lesion in the brain (1-2 weeks longer than PAM)

Question 21

What buggers cause Granulomatous amoebic encephalitis?

Answer 21

Acanthamoeba and Balamuthia

Question 22

How do congenital Toxoplasmosis infections differ in the first trimester vs the third trimester?

Answer 22

During the First trimester of pregnancy the pt only has a 25% chance of fetal infection however it will be much more sever.

During the Third trimester there is a 65% chance of contracting Toxoplasmosis but it will be far less severe and possibly even asymptomatic.

Question 23

What serological test results would display an acute infection in a mother by toxoplasmosis?

Answer 23

IgM or rising IgG titer would indicate an acute infection.

Question 24

What antibodies would be serologically observed in an infant that received a congenital infection with toxoplasmosis?

Answer 24

Newborn IgM would indicate congenital infection however, not all infected newborns are IgM positive.

Question 25

What specific version of a microbe is ingested leading to cysticercosis of Taenia solium?

Answer 25

When the embryonated eggs are ingested systemic infection occurs in comparison to ingestion of encysted larvae leading to intestinal disease.

Question 26

If you have an immigrant who came from mexico and is frequently around pigs what sort of infection would you suspect is causing meningitis presenting with seizures.

Answer 26

Infection by ingestion of Taenium soleus eggs.

Question 27

Toxocara canis and T. cati are most often aquired through what vector?

Answer 27

Dogs in the US that shed eggs in stool.

Humans then accidentally ingest the eggs within the stool leading to Toxocara.

Question 28

What symptoms do visceral larval migrans cause?

Answer 28

These are shed by dogs and cats and the eggs are ingested.

The larvae will then migrate forming granulamatous lesions in the liver, spleen, lung, and eyes. Presenting with eosinophilia.