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
