Infections in Immunocomp Host pt 2

Question 1

If you have neutropenia less than 7 days what bacteria could you suspect?

Answer 1

Staph, Strep, Pseudomonas, E. coli and Klebsiella

Question 2

If you have neutropenia greater than 10 days what fungi might accompany the bacteria?

Answer 2

Aspergillus and Candida sp.

Question 3

What can cause neutrophil count to fall?

Answer 3

Cancer medications

Question 4

What could be used to prevent opportunistic fungi?

Answer 4

Candida or aspergillus

Question 5

What are some broad spectrum IV antibiotics?

Answer 5

Ceftazidime, cefepime

Carbapenem if beta-lactamase needed

Question 6

What drug would be used for prevention of opportunistic fungi?

Answer 6

Caspofungin

Question 7

What could Sabourauds agar be used to indentify?

Answer 7

Candida

Question 8

What diseases does Candida cause?

Answer 8

Thrush
Vagina yeast infections 
Esophagitis
Candidemia
Hepatospenic candidasis

Question 9

What is the treatment for Candida?

Answer 9

Echiocandins (caspofungin)
Fluconazole
Voriconazole
Amphotericin B

Question 10

What are some causes of neurological symptoms in AIDS patients?

Answer 10

CNS lymphoma
AIDS dementia complex
Cryptococcal meningitis
Toxoplasma gondii encephalitis 
Progressive multifactorial leukoencephalitis 
CMV encephalitis

Question 11

What are ring-enhancing lesions in the brain associated with?

Answer 11

Lymphoma
Toxoplasmosis
Cryptococcosis

Question 12

How is Toxoplasma gondii treated?

Answer 12

Pyrimethamine (inhibitor of folate synth)
Sulfadiazine (inhibitor of folate synth)
Leukovorin (folinic acids to overcome bone marrow suppressive effects of folic acid antagonists
If intolerant of sulfa drugs Clindamycin + pyrimethamine

Question 13

How do you prevent Toxoplasma gondii in AIDS patients?

Answer 13

TMP/SMX (CD4 count below 200)

Question 14

In healthy people what does Toxoplasma gondii cause?

Answer 14

Mono like symptoms

Question 15

If an infant is born while the mother is infected what could it lead to?

Answer 15

Hydrocephalus, microephaly, intercranial calcification

Classic triad - chorioretinitis, hydrocephalus, calcification

Question 16

What are the long term manifestations of congenital toxoplasmosis?

Answer 16

Deafness
Visual impairment
Learning disabilities

Question 17

What organism will cause profuse, non-bloody, watery diarrhea with nausea, vomiting and lower ab cramping?

Answer 17

Cryptosporidium

Question 18

What are the characteristics of Crypto hominis?

Answer 18

Sporozoite that follows the ingestion of contaminated food or water (like pools)

Question 19

Where does the parasite of Cryptosporidium replicated in the host?

Answer 19

Ingested as oocyst
Replicates under brush border of intestine
Male and female gametes formed
Zygote to oocyst shed in feces

Question 20

What is the treatment for Crytospotidiosis?

Answer 20

Nitazoxanide in normal infection

Question 21

Where will you find the larvae of Strongyloides stercoralis?

Answer 21

CNS, heart, urinary tract, endocrine glands

Question 22

What organism is associated with corticosteroid treatments?

Answer 22

Strongylodies stercoralis

Question 23

How would you treat Strongylodies stercoralis?

Answer 23

Thiabendazole