Fungal Infections

Question 1

What are the key species in common fungal infections?

Answer 1

Aspergillus
Candida
Cryptococcus
Pneumocystis

Question 2

Which patients are at increased risk of fungal infection?

Answer 2

Impaired immune systems
Chronic lung disease
ICU patients

Question 3

What are the key causes of immunodeficiency?

Answer 3

HIV/AIDS
Malignancies (neutropenia)
Transplants
Premature neonates

Question 4

What are the main forms of Candidiasis?

Answer 4

Mucocutaneous

Invasive

Question 5

What are the risk factors for Mucocutaneous Candidiasis?

Answer 5

Antibiotic use
Moist areas
Inhaled steroids
Neonates

Question 6

Mucocutaneous Candidiasis is a common presentation in immunodeficiency presenting with what?

Answer 6

Neutropenia
Low CD4+ cells
Impaired IL-17

Question 7

What are the risk factors for Invasive candidiasis?

Answer 7

Antibiotic use
Moist areas 
Inhaled steroids 
Premature Neonates
Broad spec antibiotics 
IV catheter
Abdominal surgery

Question 8

How is Invasive candidiasis diagnosed?

Answer 8

Blood culture from sterile site
PCR assay
beta-d-glucan

Question 9

How is aspergillus fungus transmitted?

Answer 9

Sporulation inhalation

Question 10

What are the main types of Aspergillus disease?

Answer 10

Acute invasive pulmonary aspergillosis
Chronic pulmonary aspergillosis
Allergic aspergillosis

Question 11

Acute invasive pulmonary aspergillosis is associated with what?

Answer 11

Neutropenic patients
Post-transplant
Phagocyte defects

Question 12

Chronic pulmonary aspergillosis is associated with what?

Answer 12

Underlying chronic lung conditions

Greater than 3 months duration

Question 13

Allergic aspergillosis is associated with what?

Answer 13

CF and Asthma

Question 14

How does Acute invasive pulmonary aspergillosis typically present?

Answer 14

Neutropenic host
Rapid progression
Thrombosis and haemorrhage
Absent signs and symptoms

Question 15

Invasive aspergillosis is a typical presenting symptom of what?

Answer 15

Primary immunodeficiency

Question 16

How does Chronic pulmonary aspergillosis present?

Answer 16

Chronic lung condition
Pulmonary exacerbations unresponsive to AntiB
Lung function decline 
Increased pulmonary symptoms
Positive Aspergillus sputum cultures

Question 17

What primary immunodeficiencies typically present with Invasive aspergillosis?

Answer 17

Congenital neutropenia
Chronic granulomatous disease
Job’s Syndrome
CARD-9 deficiency

Question 18

How is Pulmonary aspergillosis diagnosed?

Answer 18

Non-neutropenic: sputum cultures, Aspergillus IgG/E

Neutropenic: Chest CT, PCR-aspergillus

Question 19

How does Cryptococcus infection present?

Answer 19

Asymptomatic > Pneumonia

Meningoencephalitis in HIV/AIDS patients

Question 20

How does Cryptococcus Meningoencephalitis present?

Answer 20

Headache 
Confusion
Altered behaviour 
Visual disturbances
Coma

Question 21

How is Cryptococcus infection diagnosed?

Answer 21

CSF: Indian ink, culture, high protein low glucose
Blood culture
Cryptococcus antigen

Question 22

What are the commonly used antifungal groups?

Answer 22

Amphotericin
Azoles
Echinocandins
Flucytosine

Question 23

How is antifungal resistance monitored?

Answer 23

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