Fungal Infections Flashcards
What are the key species in common fungal infections?
Aspergillus
Candida
Cryptococcus
Pneumocystis
Which patients are at increased risk of fungal infection?
Impaired immune systems
Chronic lung disease
ICU patients
What are the key causes of immunodeficiency?
HIV/AIDS
Malignancies (neutropenia)
Transplants
Premature neonates
What are the main forms of Candidiasis?
Mucocutaneous
Invasive
What are the risk factors for Mucocutaneous Candidiasis?
Antibiotic use
Moist areas
Inhaled steroids
Neonates
Mucocutaneous Candidiasis is a common presentation in immunodeficiency presenting with what?
Neutropenia
Low CD4+ cells
Impaired IL-17
What are the risk factors for Invasive candidiasis?
Antibiotic use Moist areas Inhaled steroids Premature Neonates Broad spec antibiotics IV catheter Abdominal surgery
How is Invasive candidiasis diagnosed?
Blood culture from sterile site
PCR assay
beta-d-glucan
How is aspergillus fungus transmitted?
Sporulation inhalation
What are the main types of Aspergillus disease?
Acute invasive pulmonary aspergillosis
Chronic pulmonary aspergillosis
Allergic aspergillosis
Acute invasive pulmonary aspergillosis is associated with what?
Neutropenic patients
Post-transplant
Phagocyte defects
Chronic pulmonary aspergillosis is associated with what?
Underlying chronic lung conditions
Greater than 3 months duration
Allergic aspergillosis is associated with what?
CF and Asthma
How does Acute invasive pulmonary aspergillosis typically present?
Neutropenic host
Rapid progression
Thrombosis and haemorrhage
Absent signs and symptoms
Invasive aspergillosis is a typical presenting symptom of what?
Primary immunodeficiency
How does Chronic pulmonary aspergillosis present?
Chronic lung condition Pulmonary exacerbations unresponsive to AntiB Lung function decline Increased pulmonary symptoms Positive Aspergillus sputum cultures
What primary immunodeficiencies typically present with Invasive aspergillosis?
Congenital neutropenia
Chronic granulomatous disease
Job’s Syndrome
CARD-9 deficiency
How is Pulmonary aspergillosis diagnosed?
Non-neutropenic: sputum cultures, Aspergillus IgG/E
Neutropenic: Chest CT, PCR-aspergillus
How does Cryptococcus infection present?
Asymptomatic > Pneumonia
Meningoencephalitis in HIV/AIDS patients
How does Cryptococcus Meningoencephalitis present?
Headache Confusion Altered behaviour Visual disturbances Coma
How is Cryptococcus infection diagnosed?
CSF: Indian ink, culture, high protein low glucose
Blood culture
Cryptococcus antigen
What are the commonly used antifungal groups?
Amphotericin
Azoles
Echinocandins
Flucytosine
How is antifungal resistance monitored?
SCARE-network
