Fungal (C-H)

Question 1

what is the causing agent for Valley Fever?

Answer 1

fungi Coccidioides immitis;
Coccidioides posadasii

Question 2

what is Valley Fever’s another name?

Answer 2

Coccidioidomycosis

Question 3

how do you get Valley fever?

Answer 3

inhale fungal conidia from the environment;
no person-to-person

Question 4

where is valley fever endemic to?

Answer 4

western US - Arizona & Southern California;
parts of Mexico and Central and South America;

Question 5

how many % of infected valley fever develop symptoms?

Answer 5

40%

Question 6

what is the incubation period of valley fever?

Answer 6

7-21 days

Question 7

what are the most common symptoms of valley fever?

Answer 7

cough, persistent fatigue, 50% have fever;
shortness of breath, headache, joint pain, muscle aches, night sweats, rash;
similar to bacterial pneumonia

Question 8

how to treat coccidioidomycosis?

Answer 8

self-limited - resolve in a few weeks to months;
but 5-10% develop serious or chronic lung disease - bronchiectasis, cavitary pneumonia, pulmonary fibrosis;
1% meningitis - lifelong antifungal tx;
dissemination to bones, joints, and skin also can occur

Question 9

who are at risk of developing severe pulmonary complications due to coccidioidomycosis?

Answer 9

65 and up;
diabetes;
smoker;
people with high inoculum exposure

Question 10

who are at risk of developing disseminated disease from coccidioidomycosis?

Answer 10

with depressed cellular immune function(HIV, organ transplant recipients);
pregnant

Question 11

which ethnicity are at risk of severe illness from coccidioidomycosis?

Answer 11

African American;
Filipino;
Pacific Island descent

Question 12

how to diagnose Valley Fever?

Answer 12

culture, histopathology, molecular techniques, serology

Question 13

when and how to treat Valley Fever?

Answer 13

ppl at high risk for dissemination, ppl with severe acute pulmonary symptoms, chronic pulmonary disease, or disseminated disease;

amphotericin B;
fluconazole (or itraconazole)

Question 14

how to prevent valley fever?/

Answer 14

outdoor dust - wear N95 respirator
stay inside/close windows
no digging, gardening, yard work
air filtration
preventive antifungal meds can be taken in certain circumstances

Question 15

what causes histoplasmosis?

Answer 15

histoplasma capsulatum - thermal-dimorphic fungus that grows as a mold in the environment and as a yeast in animal and human hosts

Question 16

how do you get histoplasmosis?

Answer 16

through inhalation of spores (conidia) from the environment, often soil contaminated with bat guano or bird droppings;
no person-to-person

Question 17

what is incubation time of histoplasmosis?

Answer 17

3-17 days

Question 18

what % of histoplasmosis infection is asymptomatic or mild?

Answer 18

90%

Question 19

what are severe histoplasmosis?

Answer 19

dissemination to CNS and GI tract

Question 20

histoplasmosis might be misdiagnosed as other illnesses, particularly as … ?

Answer 20

tuberculosis

Question 21

how to diagnose histoplasmosis?

Answer 21

culture, histopathologic identification

Question 22

how to treat histoplasmosis?

Answer 22

if extensive or persistent >1 month - azole for mild to moderate;
severe - amphotericin B
acute respiratory distress - steroids + antifungal

Question 23

for which population is chemoprophylaxis indicated for histoplasmosis at certain circumstances? which meds?

Answer 23

HIV, immunosuppressed people - itraconazole