L60 Flashcards
Which 3 fungi should you be thinking about for opportunistic mycoses due to altered T cell fxn?
- MUCOCUT candidasis
- Cryptococcosis
- Pneumocystosis
What are the 3 AIDs defining illnesses?
Cryptococcosis
Pneumocystosis
Esophageal candidasis
What 3 fungi should you be thinking about for opportunistic mycoses due to altered phagocytic activity?
INVASIVE candidiasis
Aspergillosis
Zygomycosis
Why must you be immune compromised to get a candida infection?
B/c part of normal flora otherwise!
What are some examples of mucocutaneous candidasis infections? (Aka these are how you should be thinking of these infections presenting in the ED)
Oral thrush Esophageal Epiglottis Onychomycosis Vulvovaginal
Who are some patients that would develop mucocutaneous candidasis?
Those w/ defective T cells:
- Corticoidsteroids (inhaler)
- AIDs
- Women on birth control
- Diabetes
- Babies
- Antibiotics
- Elderly
What are some examples of systemic/deep candida infections?
Candidemia
Endocarditis
Heptosplenic
Which patients are at risk for systemic candida infections?
Leukemia/lymphoma (neutropenic) \+ Catheter to ICU pt Trauma, burns Transplant pts EYES!
What will you see on scraping sample for candida infections?
All 3!
Hyphae
Pseudohyphae
Budding cells
What inherited condition would present with skin candida infections?
APECED - recessive
- Polyendocrinopathy
- Candidosis
- Ectodermal dystrophy
Treat mucocutaneous candidiasis
Topical clotrimazole
Severe: PO fluconazole
Treat systemic candidiasis
Echinocandins - big guns!!
Candida VFs
Surface receptors = adhesion
Enzymes
Host mimcry
Dimorphism - opposite of usual!
What toxin does aspergillus produce? Why is this so concerning?
Aflatoxin
Liver toxic/carcogenic!
Where in the environment would you find aspergillus/its toxin?
Peanut or grain plants
Talk through the pathogenesis of aspergillosis invasion and infection in the LUNG
Inhale conidia
Impaired immune host - alveolar macrophages don’t kill the inhaled fungus
Germinate
Hyphae invade lung parenchyma
Angioinvasion b/c defective neutrophils
- Infarction
May or may not spread throughout vasculature
Shape and classification of aspergillus
Angular Dichotomous (Y) Branching Septate W/ hyphae
What is the difference between the pathogenesis for aspergillus infection in neurtopenic vs immune suppressed patients?
Neutropenia:
- Coag necrosis
- Dissemination (nothing to fight it leaving site of infection)
Immune suppression
- Inflam necrosis
- Local invasion
What are the 2 lung lesions you might see with aspergillus infection?
Halo sign
Crescent sign
Treat aspergillosis
Voriconazole
