PATH fungi

Question 1

Which fungal infection can you get in neutropenia?

Answer 1

Aspergillus fumigatum

Question 2

What diseases can it cause?

Answer 2

ABPA, invasive aspergillosus, aspigill…

Question 3

What deficiency can give rise to aspergillus?

Answer 3

NADPH oxidase deficiency (lack of free radicals, so lack of oxidative killing of macrophages containing antigens)

Question 4

What two tests can be done to investigate where there is an NADPH deficiency?

Answer 4

Nitro blue tetrazolium test

Dihydrorhodamine flow cytometery

Question 5

What organisms are more likely to infect you if you have NADPH deficiency?

Answer 5

PLACESS

Pseudoamonas
Listeria
Aspergillus
Candida
E coli
Serratia
Staph aureus

Question 6

Mx of NAPDH def

Answer 6

IFN gamma

Question 7

Mx of aspergillus

Answer 7

Voriconazole

Question 8

What does aspergillus look like on CXR?

Answer 8

Halo sign on CXR

Question 9

Halo around yeast cells

Answer 9

India ink stain positive for cryptococcus neoformans

Question 10

Mx of candida, crypto and aspergillus

Answer 10

Mx of candida - fluconazole or amphotericin B for invasive disease

Mx of cryptococcus - amphotericin B

Mx of aspergillus - voriconazole