Fungal infections 2 Flashcards

1
Q

Other medically important fungi include

A
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2
Q

Aspergillus found/important

A

found throughout the world

Ecologically important saprophytic cycle (biomass recycling)

Expert in making and secreting compounds! (many are toins; used to breakdown biomass)

Adapted to high temperature - very hot in compost

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3
Q

Why Aspergillus Problematic treatment

A

acquired resistance to antifungals

and formation of biofilms

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4
Q

Aspergillus entry route into body

A

inhale spores into lungs and paranasal sinuses

Is a mold → hyphal grow will traverse cellular barriers!

is an angioinvasive pathogen → looks for blood vessles to grow inside → will destroy blood vessels

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5
Q

Aspergillus CNS infection

A

Relatively infrequent opportunistic

Brain parenchymal aspergillosis may cause stroke-like syndromes, mycotic aneurysms, or hemorrhage [massive strokes - growing inside vessels]

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6
Q

most common pathogenic species of Aspergillus

A

A. fumigatus

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7
Q

Aspergillus morbidity

A

very high

asthma, cystic fibrosis, toxicoses → produces several mycotoxins; most common aflatoxin

also high burden in food industry - exposure to toxins

Will form biofilms → harder to treat
Problem when requiring catheterization (chemo, dialysis) → catheter becomes source

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8
Q

Aspergillus diagnosis

A

direct microscopy (preferably using optical brighteners) and microbiological culture

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9
Q

Aspergillus treatment

A

For CNS infection: Voriconazole

Azole-resistant → AmpB (not as effective, and many side effects)

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10
Q

Biofilms

A

makes everything more resistant to anything

is an assemblage of surface-associated microbial cells that is enclosed in an extracellular polymeric substance [EPS] matrix.

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11
Q

Blastomyces spp cause

A

blastomycosis, generally a lung and skin
infection, but can disseminate

Mostly B. dermatitidis

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12
Q

Blastomyces Niche

A

Environmental fungi, but has restricted niches

moist soil and in decomposing organic matter such as wood and leaves in humid areas

Most cases occur in the endemic areas - area expanding

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13
Q

Blastomyces are ___ dynamic

A

Thermally dimorphic fungi

Mold in environment → yeast inside hosts

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14
Q

Blastomyces cycle

A
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15
Q

Blastomyces risk groups

A

Is a primary pathogen but at risk:

Live in an endemic area

Participate in outdoor activities that expose them to wooded areas

Have weakened immune systems

It is a veterinary problem, particularly for dogs - but not continuous, cannot spread from pets, need to inhale spores from environment

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16
Q

Blastomyces CNS

A

Untreated symptoms can develop into disseminated blastomycosis (20% in pediatric and 40% in AIDS)

[~50% of infected people will show symptoms]

17
Q

Blastomyces diagnosis

A

growth from patient sample - lung culture

Broad neck is strong indicator
Serology not accurate
CNS infection must have CSF positive sample

18
Q

Blastomyces treatment

A

AmB for severe infection,
followed by prolonged azole regimen

can progress to acute respiratory distress
syndrome (ARDS) - when it comes back more leathal - not very well understood

19
Q

most common invasive fungal pathogen

A

Candida

20
Q

Candida is

A

A dimorphic fungus, some species part of microflora - NOT ALL are dimporphic

Yeast form → commensal
Hyphal form → pathogen

21
Q

most common cause of Candida disease

A

C. albicans

Makes diagnostic difficult - is part of normal flora!

Mostly an “endogenous” infection

22
Q

C. albicans common cause of ___ infections

A

Common HAI [hospital aquired infections]: bloodstream; cathether-associated; various organs (kidney, eye, brain)

CNS = very rare - usually terminal stage of AIDS

23
Q

Invasive candidiasis

A

internal orgon
blood, heart, brain, eyes, bones, kidney, etc.

24
Q

Source of candidiasis

A

breach on normal cellular barriers (surgery, catheter, etc.)

Commonly categorized as a contaminant – challenging diagnosis!

25
Q

Candida spp risk

A

long-term antibiotic usage, GI-UT (urinary tract) surgery, medical immunosuppression

26
Q

Candida diagnosis

A

is based on the identification of Candida spp. in the CSF culture

Brain imaging helpful to determine the clinical manifestation

27
Q

Candida treatment

A

If CNS

liposomal AmB with or without flucytosine initially, followed by maintenance therapy with fluconazole

Antifungal resistance a concern - C. auris currently a superbug

Other antifungals (Echinocandins/NEW) won’t go inside CNS

If suspected endogenous infection, removal of prosthetic material needed

28
Q

The rise of Candida auris

A

Very likely due to climate change

29
Q

Why mycoses are so hard to treat

A
  1. Delayed diagnosis
  2. Few antifungals
  3. Toxic side effects

New oputuntites - medical intervention ex. cathatory

New platforms and niches! Appearance of superbugs! - special adhesions - bind to surfeces

New land! Ease of travel, climate change, etc.

30
Q

WHO first ever list of fungal pathogens

A