Infections in Immunocomp Host pt 1 Flashcards
What are some factors that lead to a host being immunocompromised?
Defects or injury to physical barrier
Deficiencies in innate immunity
Deficiencies in adaptive immunity
What could a person be at risk for in a burn situation?
Pseudomonas aeruginosa Staphylococcus aureus Staphylococcus epidermidis Streptococcus pyogenes Candida Aspergillus
A gram positive cocci, catalase +, coagulase -
Staph epidermidis
A gram positive cocci, catalase +, coagulase +
Staph aureus
A gram-negative rod, greenish colored colonies on nutrient agar
Pseudomonas aeuginosa
Fungus with branches and septae
Aspergillus
What is likely to be found on the skin?
Staph and Strep
Where would pseudomonas be found in a hospital?
Water, clothing and bedding, improperly sanitized equpitment
Where would aspergillus be found in a hospital?
Air (spores), shower heads, potted plants
What are some characteristics of P. aeruginosa?
Ubiquitous, resistant to some disinfectants, antibiotic resistance common
What diseases could pseudomonas cause?
Pneumonia, UTI, septisemia, wound infections
What is ecthyma gangrenosum and how would you get it?
Hemorrhagic necrosis of skin due to pseudomonas septisemia
What are treatment options for S. aureus (MRSA)?
Vancomycin, Linezolid, streptogramins
What are treatment options for S. aureus (MSSA)?
Anti-staph penicillins (Oxacillin, nafcillin)
1st, 2nd generation cephalosporins
Clindamycin
How would you treat a pseudomonas infection?
Extended spectrum penicillins +/- beta-lactamase inhibitors; carbapemens, azreonam, fluoroquinolones, ceftazidime, cefepime and aminoglycosides
How would an apergillus infection be treated?
Voriconazole, Caspofungin, Amphotericin B
What would you use to treat a listeria infection?
Ampicillin plus gentamicin
What organism is a gram+ bacilli with branching (chain and bead) filaments that is partially acid fast?
Nocardia
What bacterial group is Nocardia a part of?
Actinomycete
Where would Nocardia be found?
In the dirt, transmitted by inhalation
What is a common outcome of having Nocardia?
Lobar pneumonia with abscess
May mimic TB
What is the treatment for Nocardia?
TMP/SMX
What bacteria is associated with HIV?
Mycobacterium avium
What does M. avium cause in immune competent individuals?
Pulmonary disease with lung condition in smokers
How is M. avium treated in ADIS pts?
Clarithromycin or azithromycin plus athambutol
What are some causes of AIDS neurological signs?
Cryptococcal meningitis
Toxoplasma gondii encephalitis
What are the characteristics of JC virus?
Polymavirus
Commonly latent
Causes PML in profoundly T cell suppressed
What are the characteristics of Cryptococal neoformans?
Monomorphic yeast
Thick polysac capsule upon inhalation
Evades phagocytosis and Th1 response
Enters meninges
What should you confirm a finding of Cryptococcal neoformans?
Sabouraud’s agar, heart brain infusion
What should you treat Cryptococcal neoformans with?
Amp-B + flucytosine
Maintain with fluconazole
Where could histoplamsa capuslatum be found?
Ohio, Mississippi, Missouri
Soil with bird and bat droppings
Who is at risk for disseminated histoplasmosis?
Pts with profound T cell immune suppression
What are some of the clinical manifestations of H. capsulatum?
Limited flu-like illness
Chronic pulmonary histoplasmosis
How should H, capsulatum be treated?
Amp-B with itraconazole maintenance
What type of organism if pneumocystis jiroveci?
Fungus possibly acquired by airborn cysts
How is Pneumocystis jiroveci treated?
TMP/SMX
