Fungal infections Flashcards

1
Q

Main three pathogens

A

Aspergillus fumifatus
Candida albicans
Crytococcus neoformans

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2
Q

Mucocutaneous candidiasis risks (4)

A

Antibiotic use
Moist areas
Inhaled steroids
Neonates- nappy rash

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3
Q

Primary immunodeficiency disorder presentation

A

Neutropenia (low neutrophils)
Low CD4+ T cells
Impaired IL-17 immunity

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4
Q

Invasive candidiasis risks

A
Broad spectrum antibs
Intravasuclar catheters
Total parenteral nutrition
Abdo surgery
Premature neonates
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5
Q

Invasive candida found

A

Found in the gut commensal

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6
Q

Diagnose invasive candidiasis

A

Blood cultures or culture from normally sterile site
PCR assays
Beta-d-glucan high NPV can exclude

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7
Q

Aspergillus and aspergillosis transmission

A

Sporulation
Hydrophobic conidia
2-3 microns
Airborne/inhaled

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8
Q

Acute invasive pulmonary aspirgillosis

A

Neutropenic host (acute leukemia)
Post transplant patients- stem cell mroe than solid organ
Patients w defects in phagocytes
Rapid and causes thrombosis and haemorrhage
Persistent febrile neutropenia despite broad spectrum antibs

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9
Q

Chronic pulmonary aspirgillosis

A

Patients w underlying chronic lung conditions
More than 3 months
Lung function decline
Pulmonary exacerbations not responding to antibs
Incr resp symptoms
Positive sputum cultures for aspergillus

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10
Q

Allergic aspergillosis

A

Allergic broncopulmonary aspergillosis in CF and asthma
Asthma or CF with fungal senstitisations
Acute or subacute deterioration of lung function and resp symptoms
Abnormal chest imaging
Elevated IgE
Positive aspergillus IgG

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11
Q

Pulmonary aspergilloma

A

Fungal mass growing in lung cavities

Can be linked to TB, sarcoidosis, bronchiectasis or post infective

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12
Q

Diagnose pulmonary aspergillosis non neutropenic

A

Culture sputum
Bronchoalveolar lavage
Biopsy
Aspergillus specific IgE and IgG in chronic/allergic

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13
Q

Diagnose pulmonary aspergillosis neutropenic

A

High resolution CT chest- halo sign
Molecular markers in blood- galactomannan and PCR-aspergillus
BAL and biopsies

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14
Q

Cryptococcus and cryptococcosis

A

Transmission by inhalation
Can be found on bark of some trees, bird faeces and organic matter
Pulm infection from asymp to pneumonia
Dissemination to brain- meningoecephalitis in HIV/AIDs patients
high mortality in africa (20%)

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15
Q

Cryptococcus and cryptococcosis presents

A

Presents w headache, confusion, altered behaviour, visual disturbances, coma (inc ICP)

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16
Q

Daignosis crytptococcal disease

A

CSF fluid- indian ink preparation, culture, high protein and low glucose, cryptoccus antigen
Blood culture and cyptoccus antigen

17
Q

Antifungal treatment

A

Amphotericin B fromulation
Azoles
Echinocandins
Flucytosine

18
Q

Amphotericin B

A

Broad spectrum

19
Q

Echocandins and fluconazole

A

Invasive candidasis

20
Q

Voriconazole and isavuconazole

A

Acute invasive aspergillosis

21
Q

Itraconzole and posaconzole

A

Antifunga; prophylaxis

22
Q

AmB and flucytosine followed by fluconazole paintances

A

Cryptococcal meningitis