Fungal infections Flashcards
Main three pathogens
Aspergillus fumifatus
Candida albicans
Crytococcus neoformans
Mucocutaneous candidiasis risks (4)
Antibiotic use
Moist areas
Inhaled steroids
Neonates- nappy rash
Primary immunodeficiency disorder presentation
Neutropenia (low neutrophils)
Low CD4+ T cells
Impaired IL-17 immunity
Invasive candidiasis risks
Broad spectrum antibs Intravasuclar catheters Total parenteral nutrition Abdo surgery Premature neonates
Invasive candida found
Found in the gut commensal
Diagnose invasive candidiasis
Blood cultures or culture from normally sterile site
PCR assays
Beta-d-glucan high NPV can exclude
Aspergillus and aspergillosis transmission
Sporulation
Hydrophobic conidia
2-3 microns
Airborne/inhaled
Acute invasive pulmonary aspirgillosis
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
Chronic pulmonary aspirgillosis
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
Allergic aspergillosis
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
Pulmonary aspergilloma
Fungal mass growing in lung cavities
Can be linked to TB, sarcoidosis, bronchiectasis or post infective
Diagnose pulmonary aspergillosis non neutropenic
Culture sputum
Bronchoalveolar lavage
Biopsy
Aspergillus specific IgE and IgG in chronic/allergic
Diagnose pulmonary aspergillosis neutropenic
High resolution CT chest- halo sign
Molecular markers in blood- galactomannan and PCR-aspergillus
BAL and biopsies
Cryptococcus and cryptococcosis
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%)
Cryptococcus and cryptococcosis presents
Presents w headache, confusion, altered behaviour, visual disturbances, coma (inc ICP)