VII- Fungal and Parasites CNS

Question 1

dimorphic fungi

Answer 1

1. histoplasma capsulatum
2. blastomyces dermatitidis
3. paracoccidioides barsiliensis
4. coccidioides immitis (spherules)

Question 2

encapsulated yeast

Answer 2

cryptococcus neoformans so diagnose with india ink baby

Question 3

coccidioidomycosis prez

Answer 3

1. pulmonary disease- mild to moderate influenza type so fever cough, night sweats, malaise, chest pain
2. meningitis - headache, fever, stiff neck

Question 4

cryptococcosis prez

Answer 4

leading form of fungal meningitis!!
1. pulmonary - flu like but little sputum or damage to lung
2. meningitis - intermittent headaches, irritability, dizziness, esp if immunosup

bird droppings

Question 5

rhinocerebral zygomycosis

Answer 5

primarily diabetic people
-og in sinuses then spread to neighboring tissues
-nasal congestion > blood rhinorrhea > headache, fever

Question 6

entamoeba histolytica

Answer 6

brain abscesses

Question 7

trypanosoma brucei

Answer 7

sleeping sickness

Question 8

plasmodium flaciparum

Answer 8

cerebral malaria

Question 9

opportunistic amoeba genera

Answer 9

1. acanthamoeba
2. naegleria
3. balamuthia

Question 10

opportunisic amoeba epidemiology

Answer 10

fresh water
-for naegleria: swimming in warm water like hot springs, heated pools, hot tubs

Question 11

PAM

Answer 11

primary amebic meningoencephalitis
-caused by naegleria
-fever, headache, vomit, confusion > coma, death

Question 12

GAE

Answer 12

granulomatous amoebic encephalitis
-from acanthamoeba and balamuthia
-ulcerative lesions in brain
-like PAM but slower

Question 13

acanthamoeba keratitis

Answer 13

chronic infection of cornea (ulcers and pain) associated with contacts in homemade solution

Question 14

toxoplasma gondii epidemiology

Answer 14

tissue cysts in prey of cats
-oocyts in cat feces > contaminate litter, grass/soil, veggies/garden
-tissue cysts in livestock
-infest human

Question 15

toxoplasmosis prez

Answer 15

if not asymptomatic then
1. miscarriage, stillbirth or if live then blind, mental retardation, neuro disorders
2. ocular infection lesions
3. encephalitis if immunocomp
4. flu like - fever, headache, chills, lymphadenopathy, muscle aches

Question 16

toxoplasmosis pregnant women

Answer 16

should avoid contact with cats or litter bc
-1st trimester infection = lower chance of fetal infection but more severe
-3rd trimester infection = higher chance of fetal infection but less severe/asymp

Question 17

toxoplasmosis testing

Answer 17

maternal: IgM or rising IgG titer = acute infection
newborn: IgM = congenital infection

Question 18

neurocysticercosis

Answer 18

from taenia solium
-symps: severe and neurologic defects esp recent emigrants from mexico
-dx: with CT scan, MRI

Question 19

visceral larval migrans

Answer 19

infection by ascarid worms (like ascaris lumbricoides) Toxocara canis and T. cati
-normally infect dogs/cats intestines
-humans accidentally ingest eggs > hatch into larvae to spread but NO EGGS IN FECES

Question 20

visceral larval migrans prez

Answer 20

granulomatous lesions @liver, spleen, lung, and eye!!
-if in brain show epilepsy or encephalopathy
-if eye lose visual acuity, retinal scarring
-pt’s show eosinophilia and fever

treat with steroids