Fungal Infection

Question 1

Histoplasmosis

Answer 1

A fungus found in soil contaminated with bird and bat droppings

• Ohio and Mississippi river valley
• causes hepatosplenomegaly

Question 2

how to dx histoplasmosis?

Answer 2

urine antigen assay

Question 3

tx of histoplasmosis?

Answer 3

• itraconazole

- amphotericin B for HIV/immunocompromised

Question 4

coccidiomycosis

Answer 4

• causes eosinophilia

- erythema nodosum

Question 5

how to dx coccidomycosis?

Answer 5

C. immitis spherules visualized in sputum, pleural fluid, cerebrospinal fluid or exudates from draining lesions

Question 6

tx of coccidomycosis?

Answer 6

itrakonazole

Question 7

cryptococcosis

Answer 7

• involves the brain, meningitis in 50% of cases

- seen mainly in immunocompromised

Question 8

crytpococcus dx?

Answer 8

Cerebrospinal fluid with C neoformans, India ink stain. Budding yeast indicated by arrow.

Question 9

tx of cryptococcus?

Answer 9

amphotericin B

Question 10

blastomycosis

Answer 10

Disseminated disease is seen M/C with lesions at the skin, bone and urogenital tract

Question 11

aspergillosis and tx

Answer 11

Septate, hyaline hyphae with 45° ramifications

-voriconazole

Question 12

invasive aspergillosis

Answer 12

low immunity

Question 13

chronic aspergillosis

Answer 13

aspergilloma of lung causes hemoptysis

Question 14

allergic aspergillosis

Answer 14

allergic bronchopulmonary/sinusitus

Question 15

dx of aspergillosis

Answer 15

Galactomannan (GM)

Question 16

Pneumocystis (Carinii) Jiroveci (PCP)

Answer 16

Opportunistic infection and a late complication of HIV
Opportunistic infections are the leading cause of death in HIV pt’ s
Pt’s with a CD4 <200
increased LDH

Question 17

Pneumocystis (Carinii) Jiroveci (PCP) tx?

Answer 17

TMP/SMX (Bactrim) x 21 days or Prednisone for 21 days if pt is hypoxic