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SS - Exam 1 > Mycology Of CNS > Flashcards

Mycology Of CNS Flashcards

1
Q

Blastomyces dermatitidis

A

Broad based budding yeast
Distributed in eastern US
Likes water

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2
Q

Histioplamsa capsulatum

A

Yeast, capsulated
Likes nitrogen rich soil, commonly found in bat/bird droppings

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3
Q

Cryptococcus neoformans

A

Capsulated narrow based budding, capsule makes it difficult for the immune system to phagocytize the yeast
Found world wide. C. Gattii found in the soil in west US

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4
Q

Coccidioides immitis

A

Endospore
Certain temperatures and dry climate = desert US

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5
Q

Pathogenesis: blasto, histo, cryto

A

General: inhalation, lower airways - @ higher temps it converts forms - stays in lungs or disseminates via blood/lymph

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6
Q

**crypto

A

Can also cause localized disease in nasal cavity - some strains do not do well at internal body temps

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7
Q

Most common signalment for Blastomyces

A

Dogs>cats
1-5 yrs, large breed with outdoor exposure

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8
Q

Signalment for Histoplasmosis

A

Cats>dogs
Can occur even with indoor cats are exposed to potted plants

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9
Q

Signalment of Cryptococcosis

A

Cats > dogs & horses

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10
Q

Signalment for Coccidioimycosis

A

Dogs > cats> horses > zoo animals
Dogs: young, outdoor exposure

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11
Q

Common tissues & organs for Blastomyces

A

BBELLS to a T

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12
Q

Common tissues and organs for histoplasma

A

Cats : hemolymphatic, BM, LN involvement
Dogs: GIT - ingestion of spores

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13
Q

Common tissues and organs for cryptococcosis

A

1 CNS mycosis - nose/nasal cutaneous

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14
Q

Common tissue /organs for coccidioidomycosis

A

Lung and bone

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15
Q

Common clinical signs for Blastomyces

A

depends on organ system affected
B- neuro abnormalities
E - blindness
L - enlargement (lymphoma)
L - chronic cough
S- nodules, masses w draining tracts, ulceration

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16
Q

Common clinical signs for histoplasma

A

Cats - cytopenia, 2nd IMHA, LA enlargement
Dogs - chronic diarrhea

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17
Q

Common clinical signs for cryptococcus

A

Cats- Roman nose (nasal crypto)
CNS vary dependent on location

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18
Q

Common clinical signs for coddidiodis

A

Dogs - chronic cough, lameness

19
Q

Cryptococcosis:Nasal

A

Roman nose - swelling on nose & bridge due to inflammation and fugal infection
Ulceration and draining tracts

20
Q

Granulomatous inflammation

A

Expect to see macrophages as the cell to respond to this kind of inflammation

21
Q

Feline cryptococcus CNS

A

Acute or chronic neurological signs
Behavior changes (40%)
Gait abnormalities (32%)
Seizures (32%)
Other (<20%)

22
Q

Route of infection for cryptococcus

A

Local extension from nose, transverse Cribriform plate and straight to the brain
Hematogenous

23
Q

Cutaneous form of cryptococcus

A

Includes nodules and masses, ulcerated with draining tracts
Naso-cutaneous form - prefers lower temperatures near nose and pinnae of ears

24
Q

Ocular form of cryptococcus

A

Uveitis - granuloma inside the eye, can progress & lead to blindness

25
Q

Diagnosing histoplasma

A

Can be seen in blood smear

26
Q

Cytology for diagnosis

A

Lung: BAL, FNA
Lymph node: FNA
Skin: draining tract, impression smear

27
Q

Problems with culturing

A

Dangerous bc fungi is zoonotic
Better route is antigen / antibody detection

28
Q

Antigen/antibody detection

A

Antigen detection is better than measuring antibody

29
Q

Antigen test for what bacteria

A

Blastomyces and histoplasmosis - galactomannan
Will cross test - Blastomyces will test positive for histo and vice versa. Cant tell them apart

30
Q

Samples for antigen testing

A

Urine - highest sensitivity for Blastomyces/histoplasmosis
Serum or CSF for crypto

31
Q

Serum antibody titers

A

Coccidioides
Available for histo & blasto but pair with antigen testing if used
Limited number of labs perform these tests

32
Q

Titer

A

Allow you to know the relative quantitity of antigen or antibody present
Highest dilution that will produce a positive test result (highest value)

33
Q

Management for mycolic diseases

A

Baseline data - CBC, chem, UA, imaging, Ag/Ab titers
± surgical debulking - granulomas, non visual eye
Antifungal drugs - azole drugs, Amphotericin B, Flucytosine(crypto)
Monitor - drugs aren’t super safe, CBC, chem, UA, imaging, titers, treatment duration is 3-6 months, monitor antigen titers to guide therapy

34
Q

Use for Amphotericin B

A

Used when rapid response to therapy is needed
Good CNS penetration
- nephrotoxic

35
Q

Use for ampB + flucytosine

A

Refractory cryptococcus CNS infections
Good CNS penetration
Flu: hepatic, drug induced dermatitis, BM toxicity

36
Q

Azole drugs
Side effects
CNS penetration
Use

A

Hepatoxicity - dont give to cats
Only fluconazole & voriconazole have CNS pen
Itraconazole - blasto, histo, cocci $$$
Fluconazole - crypto, cocci $
Keto - NA $$
Voriconazole - only in Itra & flu fail $$$$

37
Q

Azoles with good CNS penetration

A

Fluconazole & voriconazole

38
Q

Azoles go to

A

Itraconazole - can treat 3/4 blasto, histo, cocci
Fluconazole - treats crypto, cocci

39
Q

Surgical treatment for cryptococcus

A

Nasal flap surgery to remove granuloma - horses, good prognosis

40
Q

Prognosis for Dimorphic fungal infection

A

Good EXCEPT for
CNS involvement
Severe pneumonia
Canine cryptococcus
Disseminated coccidioides
Non-nasal crypto in horses
20-30% of cases relapse

41
Q

Fungi that effect dogs more

A

Blastomyces & coccidiodes

42
Q

Fungi that affect cats more

A

Histoplasma & cryptococcus

43
Q

Fungi with enlarged LN

A

Blasto & histo

44
Q

Fungi that present as chronic cough

A

Blasto and coccidioides

SS - Exam 1 (33 decks)

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