Fungal Infections Flashcards
Which patients are affected by fungal infections?
Opportunistic =>
Impaired immune system
Chronic lung diseases (pulmonary aspergillosis and other moulds)
In ICU settings
Mucocutaneous candidiasis optimimum conditions
Antibiotic use
Moist areas
Inhalation steroids
Neonates < 3 months
How does mucocutaneous candidiasis present?
Primary immunodeficiency disorder
What are the characteristics of immunodeficiency disorders?
Neutropenia
Low CD4+ T-cells
Impaired IL-17 immunity
How does invasive candidiasis arise?
Gut commensal
Mostly endogenous
Broad spectrum antibiotics/intravascular catheters => risk factors
Diagnosis of invasive candidiasis
Blood culture or culture from normally sterile site
Transmission of aspergillus and aspergillosis
Sporulation
Hydrophobic conidia
Airborne/inhalation
Classification of pulmonary aspergillus disease
Acute invasive (neutropenic patients)
Chronic (underlying chronic lung conditions)
Allergic
Acute invasive pulmonary aspergillosis
Rapid and extensive hyphal growth
Thrombosis and haemorrhage
Angio-invasive and dissemination
Absent or non-specific clinical signs and symptoms
Persistent febrile neutropenia despite broad-spectrum antibiotics
Mortality rates around 50%
Subacute invasive pulmonary aspergillosis
Non-neutropenic host Non-angioinvasive Limited fungal growth Pyogranulomatous infiltrates Tissue necrosis Excessive inflammation Non-specific clinical signs and symptoms Mild to moderate systemic illness Mortality 20-50%
Invasive aspergillosis as presenting symptom of primary immunodeficiency
Congenital neutropenia
Chronic granulomatous disease
Hyper IgE syndrome (Job’s syndrome)
CARD-9 deficiency
Symptoms of chronic pulmonary aspergillosis
Increased respiratory symptoms such as cough, decreased exercise tolerance and dyspnoea
What is pulmonary aspergilloma?
A fungal mass that usually grows in lung cavities Tuberculosis Sarcoidosis Bronchiectasis Bronchial cysts and bullae After pulmonary infections
