Infections of Immunocompromised Host Flashcards
Top Opportunistic Infections (5 total)
Nocardia Strongyloides M. tuberculosis CMV Polyoma virus (JC & BK) Parvo B19
Corticosteroid use makes you more prone to what opportunistic infections
Nocardia
Strongyloides
*also Listeria and fungi
TNF antagonists and Rituximab/Natalizumab use makes you more prone to what opportunistic infections
M. tuberculosis
Hep B virus
Polyoma virus (JC & BK)
*also fungi
SLE makes you more prone to what opportunistic infection and why?
Parvo; low complement and neutropenia/lymphopenia
Examples of Gram-positive branching bacteria
Actinomyces
Nocardia
Gram-positive/acid fast BRANCHING bacteria with a “beaded” appearance; AEROBIC; lives in the soil; results in Pneumonia, Lung and Brain abscesses; diagnose with sputum or BAL; treat with TMP-SMX
Nocardia
Clinical Manifestations of Nocardia
Pneumonia
Lung/Brain/Skin abscesses
Cellulitis
Staining properties of Nocardia
Gram +
Acid fast
Branching and “beaded”
Treatment for Nocardia
TMP-SMX
*maybe Ceftriaxone
Herpes virus (ds DNA); transmitted via blood, sexual contact, ORGAN TRANSPLANTS and possible TORCH infection; seen in AIDS patients with CD4 <50; can cause retinitis, encephalitis, pneumonitis and myelosuppression; diagnose with PCR, biospy (“owls-eyes”) and Serology; treat with Ganciclovir, Valganciclovir or Foscarnet/Cidofovir
CMV
AIDS patients are prone to CMV infection with a CD4 below _______
50
Clinical manifestations of CMV
Retinitis
Encephalitis
Pneumonitis
Myelosuppression
*usually only immunocompromised hosts
Diagnostic tests for CMV
PCR
Biopsy (“Owls-eyes”)
CMV IgM (acute) and IgG (past)
CMV (IgM/IgG) indicates as acute or reactivated infection
IgM
CMV (IgM/IgG) indicates a previous infection
IgG
Treatment for CMV
1st line: Ganciclovir/Valganciclovir
2nd line: Foscarnet/Cidofovir
Acyclovir is effective against CMV (True or False)
False (HSV, but not CMV)
ssDNA virus that infects ERYTHROBLASTS; transmitted via respiratory droplets or TORCH infection; can result in Hydrops fetalis, Erythema infectiosum (“slapped cheek rash”) or aplastic crisis; treat with transfusions (aplastic crisis) or IVIg (chronic anemia)
Parvo B19
Clinical Manifestations of Parvo
Hydrops fetalis
Erythema infectiosum ("slapped cheek rash")
Aplastic Crisis (sickle cell anemia)Treatments for Parvo
NO effective antivirals (no polymerase)
Transfusions (aplastic crisis)
IVIg (chronic anemia)
Polyomavirus; associated with HIV/AIDS patients or those who take Natalizumab; causes Progressive Multifocal Leukoencephalopathy
JC virus
Clinical Manifestations of JC virus
Progressive Multifocal Leukoencephalopathy
Polyomavirus; associated with Kidney & Bone marrow transplant patients; causes nephropathy, hemorrhagic cystitis and graft dysfunction
BK virus
Clinical Manifestations of BK virus
Nephropathy
Hemorrhagic cystitis
Graft dysfunction
Intestinal nematode (round worm); transmitted by skin penetration (bare feet) and autoinfection; can cause abdominal pain, diarrhea, eosinophilia and pulmonary complications and MENINGITIS; treatment is Ivermectin and Albendazole
Strongyloides
Clinical Manifestations of Strongyloides
Asymptomatic Abdominal pain/Diarrhea Eosinophilia Pulmonary complications MENINGITIS
Treatments for Strongyloides
Ivermectin
Albednazole
