fungal + protozoa + helminths Flashcards
endocarditis in IVDU
candida albicans
s. aureus
treatment of superficial c. albicans infection
topical: nystatin -azole: clotrimazole oral: -azole: fluconazole
treatment of disseminated c. albicans infection
if immunocompetent: fluconazole
if immuncompromised: amphotericin B or echinocandin
AIDS patient with meningitis
cryptococcus neoformans meningitis
soap bubble image in brain
crytptococcal meningitis
treatment of cryptococcal meningitis
initially: IV amphotericin B + flucytosine
followed by: fluconazole
causes of diffuse interstitial pneumonia
mycoplasma (bacteria)
pneumocystis jirovecii pneumonia (PCP)
treatment of PCP
TMP-SMX: begin IV, then oral if sulfa allergy: pentamidine or clindamycin + primaquine TMP-SMX prophylaxis: CD4
treatment for aspergillus
voriconazole or
lipid formulation of amphotericin B
treatment of rhinocerebral mucormycosis
amphotericin B
treatment of dermatophyte infection
1) simple skin infection:
topical terbinafine or -azole
2) extensive skin infection or scalp/hair:
oral terbinafine or -azole
3) onychomycosis (tinea unguium, nail infection):
oral terbinafine or itraconazole or fluconazole
4) tinea versicolor:
topical azole or topical selenium sulfide or
oral azole
spaghetti and meatball on KOH
Malassezi furfur causing tinea versicolor
opportunistic fungal infections (infect those who are immunocompromised)
c. albicans aspergillus cryptococcus neoformans pneumocysitis jirovecii mucor + rhizopus species
treatment of giardia lamblia
metronidazole or
tinidazole
treatment of entamoeba histolytica
kill trophozoites: metronidazole or tinidazole
kill cysts in intestine: iodoquinol or paromomycin
common causes of dystentery (blood diarrhea)
bacteria:
shigella
protozoa:
entamoeba histolytica
metronidazole uses
GET GAP on the Metro Giardia Eentamoeba Trichomonas Gardnerella vaginalis Anaerobic bacteria Pylori (H. pylori)
treatment for trichomonas vaginalis
metronidazole (flagyl)
most common protozoal infection in US
trichomonas vaginalis
treatment of toxoplasma gondii
sulfadiazine + pyrimethamine + folinic acid
treatment of naegleria fowleri
amphotericin B
treatment for chagas disease
benznidazole or
nifurtimox
treatment of visceral leishmaniasis
liposomal amphotericin B
treatment of cutaneous leishmaniasis
sodium stibogluconate
treatment of p. vivax or p. ovale dormant malarial infection in liver
chloroquine + primaquine
treatment of malaria
if p. vivax or p. ovale: chloroquine + primaquine (eradicate latent liver stage) if chloroquine-resistant: quinine + doxycycline atovaquone-proguanil artemether-lumefantrine mefloquine
treatment of babesiosis
quinine + clindamycin
most common helminth in US
enterobius vermicularis
intestinal nematodes (roundworm)
ingest organism: EAT
Enterobius vermicularis (eggs: fecal-oral)
Ascaris lumbricoides (eggs: fecal-oral: swallow → intestine)
Trichinella spiralis (larvae: undercooked meat)
enter through skin (feet → swallow → intestines): SAND
Strongyloides stercoralis
Ancylostoma and Necator (hookworms)
D
treatment of hookworm, pinworm, roundworm
1) benzimidazoles:
albendazole (worms are bendy = BEND)
mebendazole
2) OR pyrantel pamoate
treatment of strongyloides stercoralis
ivermectin or
albendazole
cestodes (tapeworms)
taenia solium
diphyllobothrium latum
echinococcus granulosus
treatment of taenia solium
albendazole or
praziquantel
ADD: dexamethasone (prevent worsening CNS symptoms from dying larvae in brain)
trematodes (flukes)
schistosoma
paragonimus westermani
clonorchis sinesis
chronic infection with schistosoma haematobium associated with
squamous cell carcinoma of bladder!!
egyptian immigrant with hematuria
squamous cell carcinoma of bladder from schistosoma haematobium
treatment of schistosomiasis, paragonimus westermani, clonorchis
praziquantel
ectoparasites: live on surface of hosts body
lice
scabies
bedbugs
attach ova on hair shaft close to scalp (can see ova, not adult lice)
head lice
scalp pruritis (ears, nape of neck)
head lice
treatment of head lice (pediculosis capitus) or pubic lice (pediculosis pubis)
topical:
permethrin
pyrethrin
not lindane (neurotoxic + resistance)
spread by sexual contact
(STD)
screen for OTHER STDS!
pruritic
pubic lice
scabies mite
burrows under human skin - reproduces here
transmitted by sexual contact with infected person
WEBBING b/t fingers, WRISTS, ANKLES, PERIUMBILICAL, PENIS
severe pruritis
papules + linear burrows
dx: mites, egss, feces on skin scraping
scabies
treatment of scabies
topical:
permethrin 5% cream
ivermectin
on mattresses: can go months without eating
travel 100 feet in night
pruritis → superinfection
bedbugs
treatment for giardia, entamoeba, trichomonas
metronidazole or tinidazole
