Fungal infections Flashcards
Tissue phase of Candida
Pseudomycelium
Candida species that accounts for most human infections
Albicans
Candida species that forms a germ tube when incubated with rabbit or human serum for 1-2 hours
Albicans
Tx for Candida that is inactive against approx 20% of C. lusitaniae
Amphotericin B
Tx for Candida that is useful for many infections but is inactive against ALL strains of C. krusei and 5-25% of C. glabrata
Fluconazole
3rd MCC of bloodstream infection in premature infants
Candida species
Significant risk factors for neonatal invasive candidiasis
Prematuriy, LBW, broad-spectrum antibiotics, abdominal surgery, presence of central venous catheter
T/F CNS involvement is common in neonatal candidiasis
T, meningoencephalitis
Thrombocytopenia is sensitive but not specific; it occurs in 80% of preterm infants with ___, 75% with ___, and nearly 50% with ___
Invasive candidiasis, G- sepsis, G+ sepsis
In the absence of systemic manifestations, ___ is the treatment of choice for congenital cutaneous candidiasis in FULL-TERM infants
Topical antifungal therapy
In the absence of systemic manifestations, ___ is the treatment of choice for congenital cutaneous candidiasis in PRETERM infants
Systemic therapy
Systemic antifungal therapy should be administered for how long in neonates
21 days from last positive Candida culture
Mainstay of therapy for systemic candidiasis and is active against both yeast and mycelial forms
Ampho B deoxycholate
T/F Oral thrush/candidiasis is a clue for investigation of immunocompromised condition in newborns
F, affects ~2-5% of normal newborns
MC isolated species in cases of oral thrush
C. albicans
MC prescribed antifungal agent for oral thrush
Nystatin
Treatment for recalcitrant or recurrent oral thrush
Single dose fluco
MC infection caused by Candida among infants
Diaper dermatitis
Presumptively treat any diaper rash present for ___ with topical antifungal therapy such as nystatin, clotrimazole, or miconazole
> 3 days
T/F Candida spp are the most common cause of paronychia and onychomyosis
F, Trichophyton and Epidermophyton
Candida paronychia often respond to treatment consisting of
Keeping hands dry and using topical antifungal agent
More than 80% of cases of vulvovaginitis are caused by
Candida albicans
Candida vulvovaginits is common among what age group
Pubertal and postpubertal females
Candida vulvovaginitis treatment
Vaginal creams or troches of nystatin, clotrimazole, or miconazole
MCC of invasive candidiasis among immunocompromised pediatric patients
Albicans
Candida spp associated with higher rates of mortality and end-organ involvement
Albicans
MC Candida infections in HIV-infected children
Oral thrush and diaper dermatitis
Candida in HIV-infected children: Fiery erythema of the mucosa or loss of papillae of the tongue
Atrophic candidiasis
Candida in HIV-infected children: Oral symmetric white plaques
Chronic hyperplastic candidiasis
Candida in HIV-infected children: Erythema and fissuring of the angles of the mouth
Angular cheilitis
Fungal infections especially Candida and Aspergillus are a significant problem in oncology patients with what hematologic abnormality
Chemo-induced neutropenia
Population of cancer patients with a much higher risk of fungal infections because of dramatically prolonged duration of neutropenia
BM transplant recipients
Decreases incidence of candidemia in BM transplant recipients
Fluconazole prophylaxis
T/F Solid organ transplant patients are at increased risk for superficial and invasive Candida infections
T
Chronic mucocutaneous candidiasis is a group of heterogeneous immune disorders with a primary defect of ___
T-lymphocyte responsiveness to Candida
Conditions associated with chronic mucocutaneous candidiasis
Hypoparathyroidism, hyperimmunoglobulin E syndrome (Job syndrome), autoimmune disorders, HIV, inhaled corticosteroid use
Predominant pathogenic fungal infection among persons infected with HIV
C. neoformans var. neoformans
3rd MC invasive fungal infection after candidiasis and aspergillosis in organ transplant patients
Cryptococcosis
In most cases, C. neoformans is acquired by
Inhalation of fungal spores, <5-10um, which are engulfed by alveolar macrophages
Most important host defense for producing granulomatous inflammation and thus containing cryptococcal infection
Cell-mediated immunity
MC form of cryptococcosis
Pneumonia
MC predisposing factor for disseminated cryptococcosis
Advanced HIV infection
MC clinical manifestation of disseminated cryptococcal infection
Subacute or chronic meningitis
Most useful diagnostic test for C. neoformans
Latex agglutination test that detects cryptococcal antigen in serum and CSF
T/F Immunocompetent patient with asymptomatic or mild cryptococcosis may be closely observed without therapy
T
T/F Immunocompetent patient with asymptomatic or mild cryptococcosis may be treated with oral antifungals
T, fluco or itraconazole
Staged approach for patients with cryptococcemia or severe symptoms and immunocompromised hosts
1) Induction chemotherapy with Amphotericin B + Flucytosine 2) Consolidation therapy with oral Fluconazole or Itraconazole 3) Lifelong maintenance therapy for children who remain immunocompromised
Where are C. neoformans seen in nature
Bird droppings
