Fungal Infections

Question 0

Aspergillus

Answer 0

Ubiquitous, disease if immunocompromised
Sinopulmonary dz, aspergillomas (in pre-existing cavities from CF or TB)
ABPA if severe worsening asthma despite tx
Tx: voriconazole, amphotericin B

Question 1

Candida

Answer 1

Mucocutaneous: oral/pharyngeal or vaginal
Invasive: malignancy, BMT, prolonged steroids, TPN, extensive burns
Tx: topical nystatin, fluconazole/amphotericin B

Question 2

Cryptococcus

Answer 2

Encapsulated yeast&raquo_space; inhaled from soil
Asx or pulmonary dz
Meningitis, disseminated dz if cell-mediated immune deficiency
Tx: amphotericin B + flucytosine

Question 3

Coccidiomycosis

Answer 3

SW U/S, in soil
Asx or flu-like sx
Tx: amphotericin B, fluconazole, ketoconazole if needed

Question 4

Histoplasma

Answer 4

OH, MO, MS river valleys in bird droppings
Asx or resp/flu if immunocompromised
Progressive disseminated possible in healthy infants: fever, HSM, FTT
Tx: amphotericin B, fluconazole, itraconazole if needed

Question 5

Blastomyces

Answer 5

SE U/S, inhaled from soil
Pulmonary (flu-like) 
Cutaneous (subcutaneous abscesses)
Disseminated
Tx: amphotericin B if severe, fluconazole/itraconazole if mild

Question 6

Sporotrichosis schenckii

Answer 6

Rose thorns
Chronic subcutaneous inf&raquo_space; regional lymphatics
Disseminated if immunocompromised
Tx: amphotericin B if systemic, itraconazole for cutaneous