Fungal Pneumonia and Antifungals Flashcards
what type of patients usually suffer from fungal infections?
immunocompromised
name three types of acquired immunodeficiencies that predispose to fungals
HIV
Cancer
Transplant
what are the three respiratory pathogenic yeasts?
candida
cryptococcus
pneumocystis
what are the three respiratory pathogenic molds?
aspergillus
Mucor
rhizopus
what are the three respiratory dimorphics that are pathogenic?
histoplasma
blastomyces
coccidioides
what is the key pearl on candida albicans?
germ tube formation
what type of disorder leads to risk for candida albican pneumonia?
neutropenic patients
which two antifungals are used for treating candida respiratory infections?
echinocandins and amphotericin B
what type of cell is cryptococcus?
encapsulated yeast
where are the two common sites for cryptococcus infection?
meningitis and respiratory (pneumonia)
what two drugs to treat cryptococcal infection?
amphotericin B and flucytosine
with PCP or PJP what is the characteristic shape that forms as yeast?
cyst like yeast forms…looks like hamburger
what type of pneumonia do you see with PJP on Xray?
interstitial pneumo with ground glass infiltrates
where does PJP usually occur as infection?
mainly in lungs…outside if super immunocomp like AIDS
what are the two drugs used to treat PJP usually? why these?
sulfamethoxazole and trimethoprim
antibiotics because resistant to antifungals
is aspergillus septate or aseptate hyphae?
septate hyphae!
what is a disease that aspergillus is commonly seen with?
hematologic malignancies
what is the best drug to treat aspergillus?
voricanizole
are mucor/rhizopus septate or aseptate?
aseptate
what is the best drug to treat mucor/rhizopus?
amphotericin B
what is the stain used to see cryptococcus?
india pink stain
what is the buzz word that describes how candida grows?
budding yeast or pseudohyphae
what must you get to treat a candida pneumonia?
a tissue biopsy
what stain is commonly used to see PJP?
silver stain
what three laboratory techniques are used to see PJP?
direct visualization in lung tissue
BAL
induced sputum
describe how aspergillus grows in the lungs
it makes fungal balls that are called aspergillomas…they reside in the cavities of the lungs
how do you visualize aspergillus for diagnosis?
direct observation in tissue
how do you visualize mucor and rhizopus for diagnosis?
direct observation in tissue
describe how histoplasma capsulatum looks by shape in a patient and where they reside?
oval cells inside tissue macrophages
when do you treat histoplasma and with what?
itraconazole and amphotericin B only when symptoms are really bad
describe what happens when histoplasma is grown in lab and what is the shape of it?
taken from patient as yeast and allowed to grow in lab it will become a mold…the mold looks like a ships wheel
describe the shape of blastomyces
thick walled yeast with broad based budding
what is tricky about pneumonia with blastomyces?
it originally appears to be bacterial but does not respond to any antibiotics
what is treatment for blastomyces?
amphotericin B and itraconazole
where is coccidioides immitis most common?
in the SW USA
describe the shape of coccidioides
circular with endospored when in tissue, but in environment it is barrel shaped
what does coccidioides form in the lung (2)
cavity or nodules
which of the dimorphic organisms is associated with desert bumps or erythema nodosum?
coccidioides
what is the treatment for coccidioides?
amphotericin B or fluconzole
what is nocardia asteroides?
this is a branching bacteria that can cause pneumonia
how do you describe Nocardia asteroides?
beaded filaments that are weakly acid fast
how to treat nocardia asteroides?
SMX/TMP
what is actinomyces israelii?
a branching bacteria that can cause pneumonia
what symptom do people with actinomyces israelii normally have?
oral/facial abscesses
how to treat actinomyces israelli?
penicillin
what is the shape of actinomyces israelii and is it acid fast?
filamentous…not acid fast, unlike nocardia
what two aspects of fungi are usually targeted with antigen detection tests?
mannoproteins and beta glucans
what three bugs have good fungal antigen detection tests?
cryptococcus
aspergillus
histoplasma
