Opportunistic Infections Flashcards
Opportunistic infections are always considered?
chronic (>21 days)
7 days = acute
7-21= subacute
What are the factors that ↑ risk for fungal infection?
- Severity of impairment of cell-mediated immunity
- Recent current use of anti fungal medication
- Risk of exposure
- Neutropenia (invasive candidiasis and aspergillosis)
What is the ideal number for count of CD4+ T helper cells ?
650
What are the two forms of Criptococcus that often cause infection in humans?
C. neoformans and C. gattii
Transmission of Criptococcus is via?
What happens to the spores once they enter the body?
air droplets and bird droppings
spores are inhaled, lodged into the lung alveoli then disseminate hematogenouly and cause infection
The most common manifestation of cryptococcal infection is ?
meningitis
What are the main characteristics of criptococcus infection ?
What is the test of choice to diagnose a Criptococcous infection?
- Malaise (76%)
- Headache** (73%)
- Fever
- N/V
- Cough/SOB (31%)
- Altered Mental Status
Cryptococcal antigen in CSF
Criptococcous infection has more tropism to affect what part of the body?
How do you treat a Criptococcous infection?
the brain
amphotericin B 80%
fluconazole 50%
Histoplasmosis infection occurs by?
- inhalation
- exposure to chicken coops
How long does it take to see symptoms in Histoplasmosis infection?
What are those symptoms?
1-3 months after exposure
main characteristics:
- fever, weight loss, skin ulcers,
- hepato-splenomegaly, lymphadenopathy
Histoplasmosis infection likes to affect what areas
LUNGS first then connective tissue
What test would you use to diagnose a Histoplasmosis infection?
Urine: H Capsulatum antigen
→ sensitivity 95%
How do you treat Histoplasmosis infection
-Amphotericin B
→ very nephrotoxic (hypokalemia/magnesia)
→ use central line b/c it can damage peripheral system
Oral Candidiasis is more common with a CD4 below?
What can you contract if your CD4 is below 100?
Oral Candidiasis is more common with a CD4 below?
→ 300
What can you contract if your CD4 is below 100?
→ Esophagitis
In most cases of oral candidiasis the strain causing the disease is derived from… ?
the patients own flora
The 4 types of Oral Candidiasis are?
“HEAP”
-Hyperplastic -raised hard lesion “bump” on tongue
- Erythematous (distinct redness on hard palate)- may have white spots
- Angular Cheilitis (confused w/ Pseudomembranous, if you try to remove the spots the it won’t go anywhere)
- Pseudomembranous
How do you treat Oral Candidiasis ?
Itraconazole or
Fluconazole (DOC)
- Avoid topical treatments
- avoid drug (NYSTATIN)
What are the signs you should listen for when taken a patient hx when trying to diagnose Oral Candidiasis ?
solids feel like it doesn’t advance and when it does advance its painful
Most patients with Oral Candidiasis and esophageal symptoms have ?
Esophageal candidiasis but not all patients with esophageal candidiasis have Oral Candidiasis
Esophageal Candidiasis is the most common cause of ?
dysphagia and odynophagia in AIDS
The best test for the detection of Oral Candidiasis is ?
How do you treat Oral Candidiasis?
- EGD- upper GI endoscopy he upper GI tract includes your food pipe (esophagus), stomach, and the first part of your small intestine (the duodenum).
- Treatment: Fluconazole DOC (use drug via IV if pt is unable to swallow)
HIV copies about what number makes it transmittable ?
20 copies
What is Pneumocystis Jirovecii?
its a fungus (NOT PARASITE) with unique tropism for the lung and rarely invading the host by attaching to the alveolar epithelium
What are the signs and symptoms of Pneumocystis Jirovecii?
- inflammation in lung → fever (IL-6)
- interstitial edema → non productive cough
- diffuse alveolar damage→ SOB (dyspnea)
