Fungal Infections Flashcards
Who does Allergic BronchoPulmonary Aspergillosis occur in?
How does it present
What are common lab abnormalities (2)
Usually occurs in the setting of Asthma or CF
Presents as difficult to control asthma and recurrent pulmonary infiltrates
Will see a positive skin test, elevated IgE, Eosinophilia
How does a Aspergilloma present, who does it occur in
Presents as cough, Hemoptysis, dyspnea, weight loss , fever and chest pain
Occurs in pre-existing pulmonary cavities or cysts or in areas of devitalized lung
How does invasive Aspergillosis present on imaging and what kind of patient is it most common in?
CT shows halo sign, a target lesion with surrounding ground glass attenuation ( hemorrhage)
Occurs in immunocompromised hosts
What is the gold standard test for Aspergilloma
Deep body culture
Serum galactomannan will support the diagnosis and can be trended
What is the treatment for Aspergillosis
Voriconazole is the treatment for invasive aspergillosis
Surgical resection is indicated for Aspergilloma and hemoptysis ( considered definitive treatment) Asymptomatic Aspergilloma with stable XRAY does not require treatment
Oral Glucocorticoids is the treatement for Allergic Bronchopulmonary Aspergillosis
True or False: Candida in a blood culture is never a contaminant
True, should be treated with anidulafungin, caspogungin or micafungin
How does Cryptococcus present
What population is it the most common type of meningitis in?
The least severe cryptococcal syndrome is characterized by pulmonary involvement without dissemination
Disseminated disease may include fungemia and meningitis
This is the most common form of meningitis in AIDs patients and they will present with irritability, headache and nausea.
How is Crytptococcus treated
Amphotericin B and Flucytosine for induction treatment of meningitis followed by fluconazole maintenance therapy ( indicated for AIDS patients and meningitis until CD4 count is > 100 for 3 months)
Where is Blastomycosis endemic?
Midwestern/ South Eastern and South Central US (Mississippi, Missouri and Ohio River Valley)
How does Blastomycosis present
Presents 4-6 weeks after exposure
PRIMARY skin lesion and concurrent pulmonary/ skin / bone findings
Consider in patients being evaluated for TB/ malignancy
Where is Coccidiomycosis endemic
Southern Arizona, South Central California, Southwestern New Mexico, West Texas
How does Coccidiomycosis present
Symptoms 1-3 weeks after exposure
Consider in patient with Pulmonary Sx and Erythema Nodosum or Erythema Multiforme
Consider in patients with pulmonary sx and prolonged constitutional sx or meningitis
Where is Histoplasmosis endemic
Midwestern states in the Ohio and Mississippi River Valley regions
How does Histoplasmosis present
Sx onset 2-3 weeks after exposure
consider in a patient with complex pulmonary disease ( nodular/cavitary/lymphadenopathy)
Consider patients being evaluated for sarcoidosis TB or malignancy
Where is Sporotrichosis endemic
Occurs exclusively in persons who engage in landscaping or gardening
