Fungal infections Flashcards
What type of infections are fungal infections?
Opportunistic
Who do opportunistic infections affect?
Impaired immune system- HIV/AIDS, malignancies and transplants, primary immunodeficiencies
CF, asthma
ICU setting
What are the types of candidiasis?
Mucocutaneous candidiasis
Invasive candidiasis
What are the risk factors for mucocutaneous candidiasis?
Antibiotic use
Moist areas
Inhalation steroids
Neonates <3 months
What are the risk factors for invasive candidiasis?
Broad spec antibiotics
Intravascular catheters
Total parenteral nutrition
Abdo surgery
What is the clinical presentation of invasive candidiasis>
Bacterial bloodstream infection
How is invasive candidiasis diagnosed?
Blood culture or culture from normally sterile site
PCR assay
How is aspergillosis transmitted?
Sporulation
Hydrophobic conidia
Airborne/inhalation
What are the types of pulmonary aspergillosis?
Acute invasive pulmonary aspergillosis Subacute invasive pulmonary aspergillosis Chronic pulmonary aspergillosis Allergic aspergillosis Pulmonary aspergilloma
What are the risk factors of acute invasive pulmonary aspergillosis?
Neutropenic patients
Post transplant
Phagocyte defects
What are the clinical features of acute invasive pulmonary aspergillosis?
Angioinvasive
Absent or non specific S+S
Persistent febrile neutropenia, despite broad spec antibiotics
What are the clinical features of subacute invasive pulmonary aspergillosis?
Non angioinvasive
Limited fungal growth
Excessive inflammation
Mild to moderate systemic non specific S+S
At what time period is pulmonary aspergillosis considered chronic?
3 months
What is chronic pulmonary aspergillosis?
Underlying chronic lung condition
What are the clinical features of chronic pulmonary aspergillosis?
Pulmonary exacerbations not responding to antibiotics
Increasing respiratory symptoms
Who gets allergic aspergillosis?
Those with asthma or CF
What is a pulmonary aspergilloma?
Fungal mass that usually grows in lung cavities
What can pulmonary aspergilloma occur with?
TB Sarcoidosis Bronchiectasis Bronchial cysts and bull After pulmonary infections
How is pulmonary aspergillosis diagnosed in non-neutropenic patients?
Culture sputum and/or bronchoalveolar lavage and/or biopsy
Aspergillus specific IgG and IgE in chronic and allergic pulmonary aspergillosis
How is pulmonary aspergillosis diagnosed in neutropenic patients?
High resolution CT chest
Molecular markers
BAL and biopsies of clinical condition allows
How is cryptococcosis transmitted?
Via inhalation
How can cryptococcus spread within the body within HIV/AIDS?
Can disseminate from lungs to braun and cause cryptococcal meningitis
What is the clinical presentation of cryptococcal meningitis?
Headache COnfusion Altered behaviour Visual disturbances Coma
How is cryptococcosis diagnosed?
CSF- indian ink, culture, high protein, low glucose
Bloods- culture, cryptococcus antigen
What is the mortality of cryptococcal meningitis?
25% in USA
70% in Africa
What are the types of anti fungal agents?
Amphotericin B
Azoles
Echinocandins
FLucytosine
What do amphotericin B drugs act on and how are they given?
Acts on ergosterol
IV
What do azole drugs act on and how are they given?
Inhibits ergosterol synthesis
IV, oral
What do echinocandin drugs act on and how are they given?
Inhibit gluten synthesis
IV
What do flu cytosine drugs act on and how are they given?
Inhibit fungal DNA synthesis
IV, oral
