MI: Fungal Infections Pt.2 Flashcards

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1
Q

List the aetiological agents that can cause Aspergillus infection.

A
  • Aspergillus fumigatus
  • Aspergillus flavus
  • Aspergillus niger
  • Aspergillus niduland
  • Aspergillus terreus
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2
Q

What is the mainstay of diagnosis of Aspergillus infection?

A

Microscopy - looking at fungal spores

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3
Q

List some investigations used in the diagnosis of Aspergillus infection.

A
  • Blood test
    • Beta-D glucan
    • Serology
      • Check IgE for allergic response in ABPA
      • Aspergillus IgG for invasive disease
    • Antigen detection (galactomannan) - in blood and BAL
    • PCR
  • Blood/tissue culture
  • Imaging (CXR/CT for ABPA and aspergilloma)
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4
Q

What is the treatment for aspergillosis?

A
  • ABPA - itraconazole plus steroids
  • Aspergilloma - surgery plus itraconazole
  • Invasive aspergillosis - voriconazole (amphotericin B second line)
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5
Q

List some examples of dermatophyte infections.

A
  • Ringworm
  • Tinea
  • Nail infections
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6
Q

What is tinea pedis caused by?

A
  • Tricophyton rubrum
  • Tricophyton interdigitale
  • Epidermophyton floccosum
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7
Q

What is tinea cruris caused by?

A
  • Tricophyton rubrum
  • Epidermophyton floccosum
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8
Q

What is tinea corporis caused by?

A
  • Tricophyton rubrum
  • Tricophyton tonsurans
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9
Q

What is onychomycosis caused by?

A
  • Tricophyton spp.
  • Epidermophyton spp.
  • Microsporum spp.
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10
Q

How is onychomycosis treated?

A
  • Nail lacquers
  • If unsuccessful, systemic treatment with terbinafine
  • Itraconazole is also an option
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11
Q

How are dermatophyte infections diagnosed?

A

Skin scarpings and microscopy

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12
Q

What is pityriasis versicolor caused by?

A

Malassezia furfur

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13
Q

What is mucormycosis?

A

Group of moulds that cause very severe and invasive disease

transmitted by direct inoculation or inhalation

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14
Q

Which groups of patients are affected by mucormycosis?

A
  • Immunocompromised patients
  • Patients with poorly controlled diabetes
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15
Q

What is the characteristic clinical manifestation of mucormycosis?

A

Cellulitis of the orbit and face which progresses with discharge and black pus from the palate and nose

NOTE: black eschars may be seen as the fungus destroys the tissues

can also cause pulmonary/cutaneous manifestations

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16
Q

What can retro-orbital extension of mucormycosis lead to?

A

Proptosis, ophthalmoplegia and blindness

17
Q

What is the term used to describe the invasion of the brain by mucormycosis?

A

Rhinocerebral mucormycosis

18
Q

List three aetiological agents that can cause mucormyocosis.

A
  • Rhizopus spp.
  • Rhizomucor spp.
  • Mucor spp.
19
Q

How is mucormycosis managed?

A
  • SURGICAL EMERGENCY
  • Refer to ENT for debridement
  • May need high-dose amphotericin
20
Q

What are the three targets of antifungals?

A
  • Cell membrane
  • DNA/RNA synthesis
  • Cell wall