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Unit 4: Micro > Opportunistic Mycoses > Flashcards

Opportunistic Mycoses Flashcards

1
Q

In a previously healthy patient, what kind of symptoms do opportunistic fungal pathogens cause?

A

Local symptoms

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2
Q

Typically you need specific predispositions for opportunistic fungal pathogens to be dangerous. What kind of predispositions?

A

Prolonged neutropenia, uncontrolled HIV or diabetes, T-cell suppression

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3
Q

Generally, how do you effectively treat opportunistic fungal infections?

A

Treat the current infection and the underlying problem

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4
Q

What form can candida take?

A

Multimorphic- yeastlike, pseudohyphal, and hyphal forms. All can be present at the same disease site

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5
Q

How does candidiasis present?

A

Thrush, vaginitis, diaper rash, chronic mucocutaneous, disseminated, and more

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6
Q

How do you diagnose candidiasis?

A

Exam, biopsy, and CT

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7
Q

Treatment for candidiasis?

A

azole appropriate to the site. Amphotericin B for a few types

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8
Q

Can candidiasis become drug resistant?

A

Yes

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9
Q

How do you guard against drug resistance in candidiasis?

A

Culture it and check!

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10
Q

Where is cryptococcosis found?

A

It’s a widespread environmental pathogen found worldwide in soil

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11
Q

What predisposes someone to infection by cryptococcosis?

A

A reduced CMI

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12
Q

How does cryptococcosis impact the immune system?

A

It acts as an immune modulator to suppress to the host inflammatory response. Little inflammation is seen!

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13
Q

How does cryptococcosis present?

A

Meningitis, skin nodules, pulmonary symptoms

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14
Q

How do you diagnose cryptococcosis?

A

CSF- India Ink, biopsy, serological test for “crag” (cryptococcal antigen)

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15
Q

Treatment of Cryptococcosis

A

Combination of azoles and amphotericin B

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16
Q

What are the four presentations of aspergillosis?

A

ABPA,, aspergilloma, Chronic necrotizing pulmonary aspergillosis, Invasive aspergillosis

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17
Q

What is ABPA?

A

A hypersensitivity reaction to infection, complicating asthma or CF

18
Q

How do you diagnose ABPA?

A

Exam

19
Q

Treatment of ABPA?

A

Itraconazole, sinus surgery, xolair

20
Q

What is aspergilloma?

A

A fungus ball complicating cavitary lung disease

21
Q

How to diagnose aspergilloma?

A

Look for air crescent on scan. Can see it on xray

22
Q

Treatment for aspergilloma?

A

Itraconazole and/or surgery

23
Q

What does CNPA mimic?

A

Tb

24
Q

How do you diagnose CNPA?

A

Diagnose by air crescent on scan and use a needle biopsy for histology

25
Q

How does invasive aspergillosis present?

A

Respiratory Distress

26
Q

Do you have to be severely immunocompromised to get invasive aspergillosis?

A

Yes

27
Q

How do you diagnose invasive aspergillosis?

A

Look for halo sign on scan, use needle or lung tissue biopsy for histology (Acute angles)

28
Q

How do you treat CNPA and invasive aspergillosis?

A

Voriconazole + Amphotericin B (poor prognosis though)

29
Q

What does mucormycosis infect?

A

Blood vessels- it’s a vasculitis

30
Q

What does mucormycosis arise from?

A

Environmental mold

31
Q

Effects of mucormycosis

A

Causes infarction and necrosis of tissue downstream of blocked vessel- invades brain from sinuses

32
Q

What predisposes someone to get mucormycosis?

A

Uncontrolled diabetes, iron overload, immune suppression

33
Q

How do you diagnose mucormycosis?

A

Biopsy for histology- hyphae branch at right angles

34
Q

How do you treat mucormycosis?

A

Use amphotericin B and surgically remove dead tissue- poor prognosis though

35
Q

Where is fusarium in the environment?

A

A mold

36
Q

In predisposed populations in fusarium fatal?

A

Yes

37
Q

What are the 3 presentations of fusarium?

A

1) Mycotoxicosis- contaminated grain
2) Local infection- burns, implants
3) Disseminated infection- neutropenia

38
Q

How does fusarium enter the body and where does it cause symptoms?

A

Enters through sinus or wound site, circulates in the blood, symptoms in skin, eye, and lung.

39
Q

How do you diagnose fusarium

A

Blood culture and histology

40
Q

How do you treat fusarium?

A

Surgery, amphotericin B, and/or voriconazole- poor prognosis though

Unit 4: Micro (6 decks)

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