Fungal Meningitis

Question 1

fungal meningitis usually occurs in

Answer 1

ImmunoC pt.’s

rare overall

from bStream to CNS

requires dissemination

Question 2

are fungal infections contagious

Answer 2

no

Question 3

antigen detection test available for which agent

Answer 3

Cryptococcus

Question 4

most common agent for fungal meningitis

Answer 4

cryptoccus neoformans

Question 5

name the agents that can cause meningities

Answer 5

candida-nosocomial
aspergillus
coccidiodes
histoplasma
blasotmyces
zygomyces

recently
Exserohilum rostratum-contaminated steroid preps-BLACK MOLD

Question 6

Cryptococcosis most commonly in what patients base

Answer 6

HIV/AIDS-75% of cases

C neoformans most common-OPPORTUNISTIC

c gaddi-most in otherwise healthy individuals

Question 7

Cryptococcus neformans found in

Answer 7

pidgeon droppings

transfer via inhalation

Question 8

non opportunistic cryptococcus that infects healthy hosts

Answer 8

c. gaddi

Question 9

is c neoformans dimorphic

Answer 9

no-it is always in the encapsulated yeast

Question 10

most important virulence factor for c neoformans

Answer 10

capsule- antiphagocytic

these capsular antigens are used to diagnose

Question 11

initial infection of c neoformans

Answer 11

pulmonary and usually asymptomatic

only in immuno c will it go critical and become meningitis

almost certainly fatal in untreated

Question 12

diagnose c neoformans by

Answer 12

sampling csf and staining with india ink

Question 13

india ink halos

Answer 13

diagnostic for c neoformans via the thick capsule preventing the india ink from invading the encapsulated yeast

Question 14

most sensitive method of c neoformans dx

Answer 14

rapid antigen testing of csf

Question 15

tx of c neoformans

Answer 15

ampho b and flucytosine

Question 16

systemic tx of c neoformans

Answer 16

ampho b will be effective but ot cross BBB

Question 17

cns infectiion of c neoformans requires what drug

Answer 17

flucytosine-this one can cross BBB, ampho B cannot

Question 18

steroid associated meningitis caused by

Answer 18

Exserohilum rostratum

Question 19

Exserohilum rostratum dx via

Answer 19

analysis of CSF

PCR (CDC only)
and culture

Question 20

tx of Exserohilum rostratum meningitis

Answer 20

voriconazole IV for 3 months

severe- ampho B for 3 months

injected but asymptomatic should be observed only

Question 21

meningitis cases of Exserohilum rostratum are from ….

Answer 21

epidural injections

if in a joint will only cause local infection

Question 22

injection patient with contamination by Exserohilum rostratum what is the protocol

Answer 22

monitor very closely for ANY meningitis symptoms

be quick to take CSF sample

if there is 5 or more WBC’s in the sample–> they get ampho B as well