Opportunistic Pulmonary Fungal Infections Flashcards
when are opportunistic fungal pathogens dangerous?
prolonged neutropenia, uncontrolled HIV or diabetes or profound T cell suppression
what does effective treatment for opportunistic fungal infection entail?
treatment addresses both infection and underlying immunocompromise
where do cryptococci reside? what enables infection?
environmental throughout the world
enabled by reduced CMI and it suppresses the host inflammatory response
what does late cryptococcosis present as?
meningitis and skin nodules or pulmonary symptoms
how is cryptococcosis diagnosed?
by biopsy, CSF and the crag serological antigen test
how is cryptococcosis treated?
with a combination of azoles and Amphotericin B
what are the four presentations of aspergillosis?
Allergic bronchopulmonary aspergillosis, aspergilloma, chronic necrotizing pulmonary aspergillosis and invasive aspergillois
what is allergic bronchopulmonary aspergillosis?
hypersensitivity reaction to infection complicating asthma or cystic fibrosis
how is allergic bronchopulmonary aspergillosis diagnosed? treated?
diagnose with exam
treat with itraconazole, sinus surgery and xolair
what is aspergilloma?
a fungus ball that takes the space of cavitary lung disease
how is aspergilloma diagnosed? treated?
air crescent on scan
treat with itraconazole and surgery
what does chronic necrotizing pulmonary aspergillosis resemble? how is it diagnosed?
mimics TB
diagnose with air crescent on scan and do a needle aspirate of lung fluid for microscopy
how does invasive aspergillosis present?
respiratory distress with history of profound immunosuppression
how is invasive aspergillosis diagnosed?
halo sign on scan
needle or tissue biopsy for histology
how is chronic necrotizing pulmonary aspergillosis treated?
with voriconazole and amphotericin b with poor prognosis
what causes mucormycosis?
mucor or rhizopus
what is mucormycosis?
rare deadly invasive vasculitis by environmental mold
what does mucormycosis cause?
causes infarction distal to infected vessels and may invade brain from sinuses
how is mucormycosis diagnosed? treated?
with biopsy for histology. treat with amphotericin B and surgical removal of diseased tissue (poor prognosis)
what is fusarium? how common is infection?
it is an environmental mold that is ubiquitous. infection is rare but may be fatal
what are the presentations of fusarium infection?
mycotoxicosis from ingestion of contaminated grain, local infection or deadly disseminated infection
what types of local infection does fusarium cause?
infection of burns and prosthetic implants. also may infect cornea from contaminated contact lens solution or lung infection
what predisposes to disseminated fusarium infection?
prolonged neutropenia and recipients of hematopoietic stem cell transplants
how is fusarium diagnosed? treated?
blood culture and histology
treat with surgery, amphotericin B and voriconazole with poor prognosis
