Sketchy: Coccidioides immitis Flashcards
What are the clinical features of Cocci in healthy people?
- asymptomatic/subclinical
- acute PNA (fever, sweats, arthralgias)
- erythema nodosum
What does the CXR look like in Coccidioides immitis?
either nothing or will have cavities and/or nodules
Cue:
- Presidio San Juaqin
- Presidio = Coccidio; Southwestern USA
- Coccidioides immitis aka San Juaqin Valley Fever (all the dust)
Cue:
- pale pillars of the wall with red spots all over the front of them
- pillars = legs
- red spots = erythema nodosum
How is Coccidioides immitis diagnosed?
- KOH stain
- culture (takes a long time)
- serology (IgM against Cocci)
Cue:
- pinecones and frogs
- tx for Coccidioides immitis:
- cones = -conazole for local
- amphibians = Amphotericin B for systemic
How big are the Coccidioides immitis spherules compared to RBCs?
bigger than an RBC
Cue:
- soldier sitting next to the statue wearing a neck brace and holding his head
- next to statue = disseminated infection
- holding head/neck brace = meningitis
Cue:
- cracks in the ground
earthquakes spread the spores
What are the clinical features of Cocci in immunocompromised people?
invades skin, lung, bone, and meninges (meningitis)
How is Coccidioides immitis transmitted?
spores in dust are inhaled (dust storms, earthquakes)
How is Coccidioides immitis treated?
- -conazole for local
- Amphotericin B for systemic
Cue:
- large tumbleweeds (little circle patches in big spheres) and a small red sombrero blowing in the wind
- tumbleweeds = looks like smears: cocci form spherules filled with endospores inside the lungs
- red sombrero = RBC (smaller than spherules)
Cue:
- butterfly
dimorphism (mold in the cold but SPHERULES OF ENDOSPORES in the heat)
Cue:
- cracks and caved in bricks in the adobe wall
- cracks = shape of lungs
- bricks = nodules, cavities
Cue:
- soldier falling on his knees as he coughs and sweats
- s/s of Coccidioides immitis PNA:
- sweats = fever
- coughing
- hitting knees = arthralgias
Cue:
- cracked statue that has a cane
cracks = cavities in lung, bone (dissemination in immunocompromised pts- cane)