Immunocompromised HPR Flashcards
cough in M. tuberculosis vs. Pneumocystis jiroveci
Tub–> PRODUCTIVE cough;
P. jiroveci–> non-productive
Clinical signs of pneumonia are usually absent despite infiltrates on x-ray
Pneumocystis jiroveci
septate hyphae and conidia on the conidiophore
aspergillus fumigatus
pts with asthma and allergies–>
aspergillus fumigatus
Eosinophila and allergic aspergillosis (pulmonary infiltrates)
aspergillus fumigatus
fungus ball seen on xray–>mycelial masses
aspergillus fumigatus
hemoptysis due to FISTULAS
aspergillus fumigatus
Filamentous fungus; Normal flora of rice, bean
Fusarium solani
Medication-related Immunodeficiency
Corticosteroids–> bacteria
All bacteria, particularly M. tuberculosis
Medication-related Immunodeficiency
Corticosteroids–>Fungi
Pneumocystis jiroveci, Aspergillus f, Fusarium solani
Medication-related Immunodeficiency
Corticosteroids–> parasite
Strongyloides stercoralis
Medication-related Immunodeficiency:
TNF-α inhibitors
Listeria monocytogenes
Medication-related Immunodeficiency:
Rituximab (mAb to CD20)
Babesia microti
pulmonary and peripheral eosinophilia
Strongyloides stercoralis
transient, raised, red, serpiginous lesions over buttocks and lower back
Strongyloides stercoralis
HBV reactivation
Rituximab
TB reactivation
TNF-α inhibitors
pate, contaminated milk, soft cheeses, coleslaw
Listeria monocytogenes
- Internalin
- Listerolysin O (LLO)
- Propels through cytosol via actin polymerization
Listeria monocytogenes
Clay-colored bowel movements;
Dark urine
Hepatitis B Virus
Asplenic patients
Encapsulated (S. pneumo; H. influ; N. menin)
Babesia!!
Capnocytophaga canimorsus
Streptococcus pneumoniae
Haemophilus influenzae
Neisseria meningitidis
Encapsulated;
Asplenic Patient;
Humoral Immunodeficiency
Capnocytophaga canimorsus found in what patient pop?
asplenic
alpha-hemolysis (green zone around colonies)
Streptococcus pneumoniae
Viridans Streptococci
Capsule is anti-phagocytic
• IgA protease
Streptococcus pneumoniae
Meningitis in very young (
Streptococcus pneumoniae
causes MOPS: Meningitis, otitis media,pneumonia and sinusitis
Haemphilus influenzae
hocolate agar containing hematin (factor X) and NAD (factor V)
Haemphilus influenzae
Gun metal gray, hemorrhagic, necrotic patches
Neisseria meningitidis
Erythematous macules initially
Petechiae and purpura
Neisseria meningitidis
Culture on Thayer-Martin or chocolate agar
Neisseria meningitidis
Digital necrosis
Capnocytophaga canimorsus
Gram-negative of oropharynx of canines
Capnocytophaga canimorsus
Early post-transplant period (2 and 6 months):
Opportunistic pathogens:
Pneumocystis jiroveci,
Aspergillus fumigatus
Cryptococcus neoformans
Early post-transplant period (2 and 6 months):
Reactivation of latent pathogens:
CMV;
Varicella zoster virus;
BK virus;
Toxoplasma gondii
> 6 months post-transplant:
encapsulated bacteria.
Encapsulated yeast-like fungus
Cryptococcus neoformans
Meningitis in immunocompromised patients (e.g. early post transplant)
Cryptococcus neoformans
Bone marrow transplants = interstitial pneumonia leading cause of death
Cytomegalovirus
low birth weight, microcephaly, chorioretinitis
• Fetal damage most likely in 1st trimester
Cytomegalovirus
Hemorrhagic cystitis in bone marrow transplants
BK Virus
Polyomavirus family
• Small double-stranded DNA virus with icosahedral capsid
BK Virus
Virus to kidneys and UT - persists for the life
BK Virus
Consuming raw or undercooked, contaminated meat
Toxoplasma gondii
Ingesting water, soil, vegetables, or anything contaminated with feces of an infected animal (particularly cats)
Toxoplasma gondii
Pseudomonas aeruginosa desc.
- Aerobic, Gram-negative bacillus
* Polar flagella for motility
Widespread in moist environments
Pseudomonas aeruginosa
Grows as golden, β-hemolytic colonies on blood agar
Staphylococcus aureus
Coagulase-negative gram-positive cocci that Forms biofilms on catheters and indwelling devices
Staphylococcus epidermidis
White piedra – soft, pale
nodules on hairs of scalp and body
Trichosporon asahii
Subcutaneous lesions from injury following “traumatic implantation” by contaminated splinters or plant thorns
Scedosporium prolificans
Thin, pleomorphic, Gram-negative bacillus
Legionella pneumophila
WATER SOURCES such lakes, riverbanks
Legionella pneumophila
Herpesviridae, dsDNA
Varicella & shingles
VZV
a-hemolytic gram + cocci in chains Dental carries Subacute endocarditis
Viridans Streptococci
Anamorphic yeast
White piedra
Invasive infection (lung, kidneys, spleen)
Trichosporon Asahii
Filamentous fungus
SubQ lesions after implantations – thorns/splinters
Scedosproium prolificans
Dimorphic fungus, no yeast phase-barrel hyphae
Harsh environments
Chronic pulmonary form – cavity + relapse
Coccidioides Immitus
Progressive pulmonary disease similar to that of pulmonary TB starts off w/ dyspnea and non-productive cough, eventually moving to productive cough
Histoplasma Capsulatum