Opportunistic Fungal Infections Flashcards

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1
Q

properties of Candida albicans

A
  • alba = white
  • dimorphic
    • forms pseudohyphae and budding yeasts at 20 deg C
    • germ tubes at 37 deg C
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2
Q

what does Candida albicans cause?

A
  • systemic or superficial fungal infections
    • causes oral and esophageal thrush in immunocompromised (neonates, steroids, diabetes, AIDS)
    • vulvovaginitis (diabetes, use of antibiotics)
    • diaper rash
    • endocarditis (IV drug users)
    • disseminated candidiasis (to any organ)
    • chronic mucocutaneous candidiasis
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3
Q

Candida albicans–treatment

A
  • topical azole for vaginal
  • nystatin, fluconazole, or caspofungin for oral/esophageal
  • fluconazole, caspofungin, or amphotericin B for systemic
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4
Q

properties of Aspergillus fumigatus

A
  • septate hyphae that branch at 45 deg Acute Angle
  • produces conidia in radiating chains at end of conidiophore
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5
Q

what can Aspergillus fumigatus cause?

A
  • causes invasive asperillosis–especially immunocompromised and those with chronic granulomatous disease
  • can cause aspergillomas in pre-existin lung cavities, especially after TB infection
  • som species of Aspergillus produce Aflatoxins–associated with hepatocellular carcinoma
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6
Q

Allergic bronchopulmonary aspergillosis (ABPA)

A
  • hypersensitivity response associated with asthma and cystic fibrosis
  • may cause bronchiectasis and eosinophilia
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7
Q

properties of Cryptococcus neoformans

A
  • 5-10 micrometers with narrow budding
  • heavily encapsulated yeast
  • not dimorphic
  • culture on Sabourand agar
    • highlighted with India Ink (clear halo) and mucicarmine (red inner capsule)
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8
Q

Cryptococcus neoformans:

where is it found

how is it acquired

A
  • found in soil, pigeon droppings
  • acquired thru inhalation with hematogenous dissemination to meninges
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9
Q

Cryptococcus neoformans–detection in lab

A
  • latex agglutination test detects polysaccharide capsular antigen and is more specific
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10
Q

what does Cryptococcus neoformans cause?

A
  • cryptococcosis
  • cryptococcal meningitis
  • cryptococcal encephalitis–soap bubble lesions in brain
    • primarily in immunocompromised
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11
Q

properties of Mucor & Rhizopus spp.

A
  • irregular, broad, nonseptate hyphae branching at wide angles
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12
Q

what does Mucor & Rhizopus spp. cause? How does it proliferate?

A
  • Mucormycosis
    • causes disease mostly in ketoacidotic diabetic and/or neutropenic patients (ie. leukemia)
    • fungi proliferate in blood vessel walls, penetrate cribriform plate, and enters brain
    • rhinocerebral, frontal lobe abscess
    • cavernous sinus thrombosis
    • headache, facial pain, black necrotic eschar on face
      • may have cranial N involvement
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13
Q

Mucor & Rhizopus spp.–treatment

A
  • surgical debridement
  • amphotericin B
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14
Q

properties of Pneumocystis jirovecii

A
  • yeast like fungus
  • inhaled
  • most infections are asymptomatic
  • diffuse bilateral ground glass opacities on CXR/CT
  • disc shaped yeast seen on methenamine silver stain of lung tissue
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15
Q

what does Pneumocystis jirovecii cause?

A
  • causes Pneumocystis pneumonia (PCP)–a difuse interstitial pneumonia
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16
Q

what predisposes you to Pneumocystis jirovecii infection?

A
  • immunosuppression like AIDS
17
Q

Pneumocystis jirovecii–treatment/prophylaxis

A
  • TMP-SMX
  • pentamidine
  • dapsone (prophylaxis only)
  • atovaquone
18
Q

when to start prophylaxis for possible Pneumocystic jirovecii infection?

A
  • start prophylaxis when CD4+ count drops to < 200 cells/mm3 in HIV patients
19
Q

properties of Sporothrix schenckii

A
  • Sporotrichosis
  • dimorphic
  • cigar shaped budding yeast that grows in branching hyphae with rosettes of conidia
    • lives on vegetation
20
Q

what does Sporothrix schenckii cause?

A
  • when spores are traumatically introduced into the skin, typically by a thorn (“rose gardener’s disease”), cause local pustule or ulcer with nodules along draining lymphatics (ascending lymphangitis)
  • disseminated disease possible in immunocompromised host
21
Q

Sporothrix schenckii–treatment

A
  • itraconazole
  • potassium iodide
    • “Plant a rose in the pot.”