Invasive Aspergillosis (IA) - Fungal Infection Flashcards
1
Q
What are the risk factors of IA?
A
- Drugs
- Diseases
2
Q
What drugs could contribute to a risk?
A
- High dose corticosteroids
- Immunosuppressants
- Cytotoxic agents
- Receiving multiple antibiotics
3
Q
What diseases could contribute to a risk?
A
- Leukopenia (< 1000 cell/mm^3)
- Alcoholism
- Lymphoma or leukemia
- DM
- Immunodeficiency disease
- Chronic granulomatous disease
- Chronic hepatitis
4
Q
Describe clinical presentation of IA?
A
- Lung, liver, CNS, spleen are the most common sites for infection
- Pulmonary IA leads to fever, hemoptysis, chest pain, cough
- Presents late after infection - after dissemination sometimes
5
Q
If vascular invasion occurs from IA - could that lead to other health conditions?
A
- Thrombosis
- Infarction
- Necrosis
- Dissemination
6
Q
What best ways are to diagnose IA?
A
- Galactomannam (cell wall component of aspergillus) antigen
- Cultures of the respiratory tract
- Histological evidence from a tissue biopsy
- Chest radiographs and CT scans
7
Q
How is IA in the lungs treated?
A
Voriconazole 6 mg/kg IV q12h x 1 day then 4 mg/kg IV q12h
8
Q
How is IA in the lungs treated as a maintenance therapy?
A
Voriconazole 200-300 mg PO q12h or weight-based
9
Q
What is the general recommendation of duration of therapy for IA?
A
Minimum 6-12 weeks
10
Q
Is prophylaxis recommended in patients who had IA?
A
Yes
11
Q
Prophylaxis is recommended in:
A
- Prolonged neutropenia
- High risk for IA
- Patients who successfully treated pulmonary IA who require subsequent immunosuppression
- To prevent recurrence
12
Q
What medication would be used for prophylaxis?
A
- Posaconazole (more recommended) AND/OR
- Voriconazole AND/OR
- Micafungin
