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Infection > Fungal Infections > Flashcards

Fungal Infections Flashcards

1
Q

Number of fungal infections of humans per year

A

1.5 billion fungal infections of humans

> 3 million life-threatening infections per year

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2
Q

Mortality rates of invasive fungal infection

A

> 50%

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3
Q

Number of cases of blindness caused by fungal infections each year

A

> 400,000 per year

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4
Q

Number of exacerbations of asthma and allergies (and other chronic lung disease) caused by fungal pathogens each year

A

> 20 million

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5
Q

Global mortality figures for invasive fungal infections, TB and malaria

A

Invasive fungal infections - 1,350,000
TB - 1,400,000
Malaria - 1,240,000

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6
Q

Common fungal pathogens

A

Aspergillus species
Candida species
Cryptococcus species

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7
Q

What patients are typically affected by fungal infections?

A 
Impaired immune systems e.g. 
HIV
AIDS
Premature neonates
Malignancies 
Transplants
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8
Q

Why do fungal infections affect patients in an ICU setting?

A

Due to use of broad spectrum antibiotics and the need to use intravascular catheters i.e. normal mucosal barriers being compromised

Also due to multi-system disease

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9
Q

What should be considered in a serious fungal infection of an otherwise health individual?

A

Underlying undiagnosed immunodeficiency

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10
Q

Predisposing factors for mucocutaneous candidiasis

A

Can affect both healthy and immunocompromised individuals
Inhalation steroids
Antibiotic treatments

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11
Q

Patients generally affected by mucocutaneous candidiasis

A

Neonates < 3 months
Primary immunodeficiency
Elderly

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12
Q

What is the fourth most common blood stream infection?

A

Invasive candidiasis

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13
Q

When would an anti fungal be given for a blood stream infection?

A

Presentation of fungal BSI is the same as bacterial BSI, so anti fungal would be given at failure to improve on antibiotic

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14
Q

Mortality of invasive candidiasis

A

up to 40%

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15
Q

Risk factors for invasive candidiasis

A

Use of broad spectrum antibiotics
Intravascular catheters
Total parenteral nutrition

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16
Q

Transmission of aspergillus and aspergillosis

A

Transmission by sporulation, airborne, inhalation

17
Q

Patients affected by acute invasive pulmonary aspergillosis

A

Neutropenic patients
Defects in phagocytes
Acquired, congenital or acute diseases with high mortality rates

18
Q

Patients affected by chronic pulmonary aspergillosis (> 3 months)

A

Patients with underlying chronic lung conditions e.g. asthma, COPD

19
Q

What is the difference between acute and chronic pulmonary aspergillosis?

A

Acute is more severe, chronic is milder but will lead to progressive decline in lung function

20
Q

Forms of allergic aspergillosis

A

Allergic bronchopulmonary aspergillosis
Extrinsic allergic bronchoalveolitis
Asthma or CF with fungal sensation

21
Q

Why is allergic aspergillosis a challenge to treat clinically?

A

Have to balance between steroids for the allergy and anti-fungals for the infection

22
Q

Patients affected by acute invasive pulmonary aspergillosis

A

Neutropenic hosts e.g. acute leukaemia, HSCT, post-bone marrow transplant

23
Q

Pathophysiology of acute invasive pulmonary aspergillosis

A

Rapid and extensive hyphal growth
Thrombosis and haemorrhage
Angio-invasion and dissemination

24
Q

Presentation of acute invasive pulmonary aspergillosis

A

Absent or non-specific clinical signs and symptoms

Persistent febrile neutropenia despite broad spectrum antibiotics

25
Q

Mortality rates of acute invasive pulmonary aspergillosis

A

50-90% due to the inability to reverse the causative/predisposing immune deficiency

26
Q

Patients affected by pulmonary aspergilloma

A 
TB 
Sarcoidosis 
Bronchiectasis 
Bronchial cysts and bullae
After pulmonary infections
27
Q

What is pulmonary aspergilloma?

A

A fungal mass, usually grows in lung cavities

28
Q

Transmission of cryptococcus and cryptococcosis

A

Inhalation

Found on bark of trees, in bird faeces and in organic matter

29
Q

What patients are susceptible to cryptococcal meningitis?

A

HIV/AIDS patients

30
Q

When might subacute meningoencephalitis occur?

A

After latent cryptococcal infection

31
Q

Mortality of cryptococcosis in the US and in Africa

A

25% in US

70% in Africa

32
Q

Diagnosis of cryptococcal infection

A

India-ink CSF

33
Q

Anti-fungal treatment for invasive aspergillosis

A

Voriconazole or isavuconazole IV or oral formulation

Liposomal amphotericin B IV only (second line)

34
Q

Anti-fungal treatment for invasive candidiasis

A

Echinocandins IV only

Fluconazole IV or oral formulation (second line)

35
Q

Anti-fungal treatment for cryptococcal meningitis

A

Amphotericin B and Flucytosine followed by fluconazole

36
Q

Resistance of candida auras to fluconazole, echinocandin, amphotericin and multi-drug

A

Fluconazole - 90% resistant
Echinocandin - 30-40% resistant
Amphotericin - 5-15% resistant

50% multi-drug resistant

Infection (14 decks)

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