ID Flashcards
Histoplasmosis
Pulmonary/systemic dimorphic fungi
Mississippi/Ohio River valleys, bird/bat droppings
Path: Survives in M-Phages (smaller than RBC)
Tx: fluconazole/itraconazole
Histo lives in histiocytes
Blastomycosis
Pulmonary/systemic dimorphic fungi: inflammatory lung dz, broad dissemination. granulomatous nodules
East of mississippi, central Am
Path: broad-based budding (same size as RBC)
Tx: fluconazole/itraconazole
BBBB
Blast Broad based bud
Coccidioidomycosis
Pulmonary/systemic dimorphic fungi (NB is spherule, not yeast, in tissue): PNA and meningitis
SW, California, incr after earthquake
Path: spherule filled with endospores (larger than RBC)
Tx: fluconazole/itraconazole
I bruised my Coccyx after a Cali Earthquake and had to wear a Sphere cast
Paracoccidioidomycosis
Pulmonary/systemic dimorphic fungi
Latin America
Path: budding yeast with “captains wheel” formation. (much larger than RBC)
Tx: fluconazole/itraconazole
Captain Parasailed to Latin America
Tinea versicolor
Cutaneous mycoses caused by Malassezia furfur hot/humid weather damage to melanocytes Path: "spaghetti and meatball" on KOH Tx: topical miconazole, selenium sulfide
Candida albicans
Opportunistic infection (superficial or systemic)
thrush, vulvovaginitis, chronic mucocutaneous candidiasis
Path: dimorphic yeast. pseudohyphae and budding yeasts at 20C, germ tubes at 37C
Tx: topical azole for vag. fluc or caspo for oral/esophageal. Fluc, ampho, or caspo for systemic
Aspirgillus
Invasive, especially in immunocomporomised and chronic granulomatous dz
ABPA: asthma/CF, post-TB aspergilloma
Some produce aflatoxins –> HCC
Acute angles, septate hyphae. non-dymorphic. Can form conidophore with spores
Cryptococcus
Opportunistic. Meningitis, cryptococcosis
Soil, pigeon droppings.
Path: Sabouraud’s agar, India ink. Latex agglutination. “soap bubbles” in brain
Tx: ampho/flucytosine
Mucor/rhizopus
Opportunistic: DKA, leukemia
Rhinocerebral, frontal lobe abscesses
Headache, facial pain, black necrotic exchar, CN
Path: irregular, broad, nonseptate hyphae at wide angles
Pneumocystis jirovecii
Opportunistic: PCP in AIDS at CD4< 200
Path: disc-shaped yeast on methenamine silver stain
Tx: TMPSMX, pentamidine, dapsone.
PPx at CD4< 200
Sporothrix schenkii
Sporotrichosis. Rose gardener’s dz. Local pustule with nodules along lymphatics.
Path: cigar-shaped budding yeast
Tx: itraconazole or potassium iodide
Giardia
Bloating, flatulance, foul-smelling diarrhea in campers/hikers. Transmitted by cysts in water
Path: trophozoites or cysts in water
Tx: metronidazole
Entamoeba histolica
Amebiasis: bloody diarrhea (dysentery), liver abscess (anchovy paste exudate), RUQ pain. Flask-shaped ulcer if submucosal colonic abscess ruptures
Path: trophozoite (with intracellular RBCs) or multi-nucleated cysts in stool
Tx: metronidazole, iodoquinol for asymptomatic cyst passers
Don’t dys EntaAnchovy, he drinks from a flask, gobbles RBCs, but hates iodine and flagyl.
Cryptosporidium
Severe diarrhea in AIDS
Mild watery diarrhea in noncompromised
Path: cysts on acid fast stain
Tx: filtered water, nitazoxanide in AIDS
Toxoplasma
Protozoa -CNS
Brain abscesses in HIV (ring enhancing)
Triad: chorioretinitis, hydrocephalus, intracranial calcification
Transmitted by cysts in meat or cat feces
Dx: serology, bx
Tx: sulfadiazine, pyrimethamine
Naegleria fowleri
Protozoa - CNS Rapidly fatal meningoencephalitis Freshwater lakes (Nalgene): enters via cribiform plate Dx: amoebas in spinal fluid Tx: Ampho but not usually efective
Trypanosoma brucei, gambiense, rhodesiense
Protozoa -CNS
African sleeping sickness
LAD, recurring fever (antigenic variation), somnolence, coma
vector: tsetse fly (painful bite)
Dx: smear
Tx: Suramin for blood, melarsopol for CNS
“sure is nice to go to sleep. melatonin is helpful”
Plasmodium Vivax/Ovale
Malaria: fever, headache, anemia, splenomegaly
Path: smear. Trophozoite ring, RBC schizont with merozoites
48 hr cycle !!!
dominant form (hypnozoite) in liver
Tx: chloroquine (mefloquin if resistant) add primaquine (test for G6PD)
48 hypnotism? PROVe it to me
Plasmodium falciparum
Malaria: fever, headache, anemia, splenomegaly
Path: smear. Trophozoite ring, RBC schizont with merozoites
Severe, irregular fever patterns, parasitized RBCs occlude capillaries in brain (cerebral malaria), kidneys, lung
Tx: chloroquine (mefloquin if resistant) use IV quinidine in life-threatening (test for G6PD)
Plasmodium malariae
Malaria: fever, headache, anemia, splenomegaly
Path: smear. Trophozoite ring, RBC schizont with merozoites
72 hr cycle (quartan)
Tx: chloroquine (mefloquin if resistant) use IV quinidine in life-threatening (test for G6PD)
Babesia
Protozoa -- heme babesiosis: fever and hemolytic anemia NE USA Asplenia inc risk of severe dz vector: ixodes tick (same as borrelia burgdorferi) Smear: ring form, maltese cross PCR Tx: atovaqone + Azithro
Babes like Limes in Church where they Atone under the Cross.
Trypanosoma cruzi
Protozoa
Chagas dz: dilated cardiomyopathy, megacolon, megaesophagus.
South america
Vector: reduviid bug (kissing): painless bite
dx: smear
Tx: nifurtimox
I took a Tryp to mexico and Kissed a girl, now i’m blowing up and am Furtive
Leishmania donovani
Protozoa visceral leishmaniasis (kala-azar) spiking fever, HSM, pancytopenia vector: sandfly dx: mphages containing amastigotes Tx: sodium stibogluconate
the Goats on a Leash travel in Flies and live in macrophages, but hate Sties
Enterobius vermicularis
pinworm (nematode)
Eggs in food
anal pruritus (scotch tape test)
Tx: bendazoles or pyrantel pamoate
Ascaris lumbridoides
giant roundworm (nematode
fecal-oral
intestinal infection
Tx: bendazoles or pyrantel pamoate
Strongyloides stercoralis
nematode
larvae in soil penetrate skin
Intestinal infection: V/D anemia
Tx: ivermectin or albendazole
Strong: penetrate skin and keep up strength by eating RBCs
Ancylostoma duodenale, necator americanus
hookworms (nematodes)
Larvae penetrate skin
Intestinal infxn –> anemia from sucking blood
Tx: bendazoles or pyrantel pamoate
Treat worms with BEND with bendazoles
Dracunculus medinesnsis
guinea worm – nematode
drinking water
skin inflammation and ulceration
Tx: slow extraction of worm
Onchocerca volvulus
nematode
vector: female blackfly
hyperpigmented skin and river blindness
Tx: ivermectin
Niver get bit by the blackfly down by the river while looking for Chonch; you’ll go blind.
Loa loa
nematode
swelling in skin, worm in conjunctiva
vector: deer, horse, mango fly
Tx: diethylcarbamazine
wo-ah wo-ah there’s a worm in your eye
Wuchereria bancrofti
elephantiasis: blocked lymphatics (9mos- 1 yr)
vector: mosquito
tx: diethylcarbamazine
Bankrupt elephants hate CARBon taxing mosquitos
toxocara canis
visceral larva migrans
Roundworm. From dogs. hepatomegaly, eye dz, blindness, myocarditis
eggs
tx: albendazole or mebendazole
Nematode routes of infxn mnemonic
You’ll get sick if you EAT these. These get into your feet from the SANd
ingested – Enterobius, Ascaris, Trichinella
Cutaneous – Strongyloides, Ancylostoma, Necator
Taenia solium
Cestodes (tapeworm)
Ingestion of larvae encysted in undercooked pork.
Dz: intestinal infxn, cysticercosis, neurocysticercosis
Tx: Praziquantel; bendazoles for neurocysteicercosis
if you PIG out in the sun you will get TAN, then turn into a PRAZin, get the BENDs, and fry your brain
Diphyllobathrium latum
Cestode (tapeworm)
Ingestion from raw freshwater fish
Dz: B12 deficiency –> anemia
Tx: praziquantel
get BLASTED with fishy BATHwater (megaloblastic anemia, BATHrium)
Echinococcus granulosus
cestode (tapeworm)
ingestion of eggs from dog feces
Liver cysts, anaphylaxis if antigens released (preinject with ethanol)
tx: bendazoles
Buy EchCANococcus some EtOH before you take it out
Schistosoma
trematode (fluke) liver and spleen granulomas, fibrosis, inflammation Chronic infection --> SCC of bladder vector: snails Tx: praziquantel
if you eat SNAIL SHIT with your Prazins you’ll be PEEING BLOOD
Clonorchis sinensis
Trematode (fluke)
undercooked fish
biliary tract inflamm –> pigmented gallstones, cholangiocarcinoma
Tx: praziquantel
It’s a SIN to eat BLACK (pigment stones) FISH with Prazins
Paragonimus westermani
Trematode (fluke)
undercooked crab meat
Lung inflammation and secondary bacterial infxn, with hemoptysis
Tx: praziquantel
Western man likes to cough blood onto his crab
most common bug prostatitis
E Coli!
