Fungal Meningitis

Question 1

Fungal meningitis is rare except in?

Answer 1

immunocompromised pts

Question 2

How are cases confirmed

Answer 2

• microscopic observation of yeast forms in CSF samples
• Culture CSF for fungi
• Antigen detection for fungi such as : Cryptococcus

Question 3

Treat fungal meningits with

Answer 3

AMPHOTERICIN B often in combo with flucytosine

Question 4

Most common fungal agent in IC pts is

Answer 4

cryptococcus neoformas

Question 5

C. Neoformans found where

Answer 5

pigeon dropings

Question 6

85% of crypto infections occur in who?

Answer 6

HIV pts

Question 7

Where is cryptococcus found

Answer 7

tropical regions, west coast, AUSTRALIA

Question 8

steroid injection fungus

Answer 8

exserohilum rostratum

Question 9

Which cryptococcus is seen most often in healthy individuals

Answer 9

Cryptococcus gatti

Question 10

Cryptococus are ALWAYS ENCAPSULATED

Answer 10

KNOW

The capsule is a polysaccharide, is anti-phagocytic and blocks opsonization

Question 11

Initital crypto infection is what

Answer 11

asymptomatic pulmonary infection

Question 12

Diagnosis of Crypto

Answer 12

yeast with halos in INDIA INK stained CSF of meningitis pts.

Question 13

exsorhilum rostratum

Answer 13

common environmentalblack mold that rarely causes infection

not previously linked to meningitis

Question 14

Treatment of exsorhilum

Answer 14

voriconazole IV for 3 mos or more

severe cases gt ampho B for 3 months or more

Question 15

If CSF contains 5 or more WBCs

Answer 15

start voriconazole