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foundations ii (cholley) > HistoCocci > Flashcards

HistoCocci Flashcards

1
Q

What are lab findings/dx tests in coccidioidomycosis?

A
  • Eosinophilia, leukocytosis
  • Serology: IgM, IgG antibodies
  • Culture
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2
Q

What populations are at an increased risk for complications of coccidioidomycosis?

A
  • HIV
  • African Americans & Asians
  • 3rd trimester
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3
Q

What is the px of coccidiodomycosis?

A
  • Limited disease = good (fatigue may persist)

- Disseminated & meningeal = High mortality

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4
Q

Is coccidioidomycosis reportable?

A

YES!

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5
Q

Where is histoplasmosis common?

A

Midwestern states, in Ohio & Mississippi river valleys

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6
Q

Histoplasmosis infection is secondary to what?

A

Inhalation of fungal spores

–> proliferation in lungs –> spreads to other organs via blood

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7
Q

What is histoplasma capsulatum isolated from?

A

soil contaminated w/ bird/bat droppings

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8
Q

What is the most common form of histoplasmosis in otherwise healthy people?

A

Asx primary histoplasmosis

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9
Q

In asx primary histoplasmosis, what can you see on CXR?

A

Residual granuloma

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10
Q

Describe diffuse pulmonary disease

A
  • Form of histoplasmosis

- Can occur in healthy people w/ intense exposure (inhalation of many spores)

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11
Q

How does diffuse pulmonary disease present?

A
  • Fever, fatigue
  • Pulmonary complaints
  • Lasts 1wk-6mos
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12
Q

Describe acute localized pulmonary disease

A
  • Form of histoplasmosis
  • Presents like pneumo
  • local infiltrates
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13
Q

Describe chronic cavitary pulmonary histoplasmosis

A
  • Occurs in older COPD pts

- Lungs show progressive changes (apical cavities)

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14
Q

Describe disseminated histoplasmosis

A
  • Rare in immunocompetent host

- Multiple organ involvement, often fatal

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15
Q

How does disseminated histoplasmosis present?

A
  • Fever, fatigue
  • Cough, dyspnea
  • Wt loss
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16
Q

What do you need to distinguish histoplasmosis from?

A
  • Sarcoidosis*
  • TB
  • Malignancy
17
Q

What type of imaging can you use for dx of histoplasmosis?

A
  • CXR: hilar adenopathy, patchy or nodular infiltrates in lower lung
18
Q

What labs are used for dx of histoplasmosis?

A
  • Antigen detection
  • Serology
  • Biopsy
  • Cultures (useful in chronic dz only)
19
Q

How do you tx histoplasmosis in asx pts?

A

None!

20
Q

How do you tx acute histoplasmosis?

A
  • Often don’t need tx

- Can use itraconazole

21
Q

How do you tx severe histoplasmosis?

A

Amphotericin B IV

22
Q

How do you tx chronic histoplasmosis?

A

Amphotericin B or itraconazole

23
Q

How do you tx histoplasmosis in AIDS pts?

A

Amphotericin B & maintain w/ intraconazole

24
Q

What organisms cause coccidioidomycosis? Where are they found?

A
  • Coccidioides immitis
  • Coccidioides posadasii
  • In soil, semiarid areas
25
Q

Coccidioidomycosis infection is secondary to what?

A

Inhalation of spores

26
Q

What is the incubation period for coccidioidomycosis?

A

7-21 days

27
Q

What % of people experience sx of coccidioidomycosis? What is the usual manifestation?

A
  • 40%

- Pneumo

28
Q

What sx/characteristics does coccidioidomycosis share w/ histoplasmosis?

A
  • HA, arthralgias
  • Fatigue
  • Disseminated extrapulmonary infection
  • Granuloma on CXR
29
Q

What sx is unique to coccidioidomycosis?

A

Rash (erythema multiforme), erythema nodosum

30
Q

What complications are seen in the disseminated form of coccidioidomycosis?

A
  • More pronounced lung findings (abscess, miliary infiltrates)
  • Lymphadenitis, meningitis
  • Bone lesions
31
Q

What type of immunocompromised pts are affected by coccidioidomycosis?

A
  • Pts w/ organ transplant
  • Pts taking glucocorticoids or immunosuppressant meds
  • Chemo pts
  • Those w/ pre-existing cardiopulmonary conditions
  • Elderly
32
Q

What type of imaging is used to dx coccidioidomycosis?

A

CXR

  • hilar adenopathy
  • patchy, nodular infiltrates
  • thin walled cavities
33
Q

What warrants tx for coccidioidomycosis?

A
  • 10% wt loss
  • Night sweats > 3wks
  • Infiltrates involving > 1/2 of a lung
  • Hilar adenopathy
  • Inability to work
  • Sx > 2 months
34
Q

How do you tx coccidioidomycosis?

A
  • Fluconazole 3-6mos
  • Thoracic surgery
  • Monitor for 1 yr, initially every 2-4 wks

foundations ii (cholley) (25 decks)

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