Fungal Infection Flashcards
What puts you at risk of fungal infections
Immunocompromised Neutropenia Chronic lung - asthma / CF / COPD Previous TB Chemo Post-transplant ICU HIV Broad spec Ax
What do azole anti-fungals do
Block ergosterol synthesis
p450 inhibitor
Liver toxic
What does Amphotericin B do
Acts on ergosterol causing lysis
Very broad spec
Systemic fungal infections / meningitis
IV only
SE of amphotericin B
Nephrotoxic
Flu
Hypo K and glucose
What can aspergillus cause
Aspergillosis
Aspergilloma
Allergic bronchopulmonary aspergillosis
How does fungal transmit
Spores
Airborne
Inhalation
What does Aspergillosis cause
SOB Cough Wheeze Fever Weight loss
What is leading cause of death in neutropenic patients
Acute invasive aspergillosis
Who is at risk
HIV
Leukaemia
Broad spec Ax
Post transplant
What happens
Fungus destroys lung Dissemination Thrombosis Haemorrhage Persistent febrile neutropenia despite Ax 50% mortality
When does sub-acute occur
Non-neutropenic host
Limited fungal growth but tissue necrosis due to inflammation
What is Chronic
> 3 months
Who is at risk of chronic
Chronic lung
Leads to lung function decline
Pulmonary exacerbations which don’t respond to Rx
How do you Dx non-neutropenic aspergillosis
Culture of sputum
Aspergillis IgG and IgE
Biopsy
Bronchoscopy
How do you Dx neutropenic
No sputum as no inflammation CT PCR Biopsy Bronchoscopy
