Fungal Infections

Question 1

What does imipenem NOT cover?

Answer 1

G+
- MRSA
- Coag-neg staph
- Enterococus - VRE
G - 
- Pseudomonas 
- Acinetobacter 
FUNGI

Question 2

Drugs to cover Candida

Answer 2

Echinocandins (micafungin)

Question 3

Which fungus is associated with the US Southwest? What structure do these form in the body?

Answer 3

Coccidioides immitis
- Coccidioidomycosis
Form spherule

Question 4

What clinical disease will coccidioidomycosis present as?

Answer 4

Pneumonia

CXR - diffuse infiltrates

Question 5

What fungi can cause pna?

Answer 5

Cocci - southwest 
Histoplasma - midwest 
Blasto - midatlantic 
Cryptococcal pna (Egypt micro)
Pneumocystis - AIDS

Question 6

Which type of pna is most likely to follow the flu?

Answer 6

SA

Question 7

Treat cocci pna

Answer 7

Do nothing! Likely resolve on own
Worsened: azoles
Severe: ampho B

Question 8

What fungi is going to cause sinusitis progressing to orbital cellulitis?

Answer 8

Rhinocerebral zygomycosis
(Mucormycosis)
Directly invades eye BVs

Question 9

How do you treat rhinocerebral zygomycosis?

Answer 9

Ampho B ASAP!

Question 10

Describe the histo of muromycosis

Answer 10

Broad
Angle branching
Hyphae
No septa

Question 11

Which bug is most likely fungal cause of meningitis

Answer 11

Cryptococcus

Question 12

Tests for crypto

Answer 12

CSF crypto antigen - fast & accurate
- Tests for its thick capsule!
CSF India Ink

Question 13

Treat crypto meningitis

Answer 13

Ampho + 5 FC

Progress to fluconazole