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34 Cards in this Set

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The molds
aspergillus, mucor/rhizopus, cutaneous mycoses
The yeasts
candida albicans, crypto neoformans, pneumocystis carinii
The dimorphic
sporothrix, coccidio, histoplasmosis, paracoccidio, blastomycosis
Candida infections
thrush in immunocompromised, vulvovaginitis, disseminated candidiasis, chronic mucocutaneous candidiasis, ballanitis, esophagitis, endocarditis, diaper rash
What is seen in diaper rash
irregular border with satellite lesions
Treatment for candida
nystatin or azoles for superficial, Amp B for systemic
Features of thrush
will scrape, will not swab
Aspergillus infections
allergic bronchopulmonary aspergillosis, lung cavity aspergilloma ("fungus ball"), invasive aspergillosis
Aspergillus features
mold with septate hyphae that branch at acute angles
C neoformans infections
cryptococcal meningitis (HIV/AIDS),
C neoformans features
encapsulated yeast, found in soil, pigeon droppings
stains with India ink, urease positive
SNOWMAN
Mucor and rhizopus
branches at wide angles, disease mostly in ketoacidosis diabetes and leukemic patients; can cause infarction, rhinocerebral or frontal lobe abscesses
wide angle branching!
PCP
causes diffuse interstital pneumonia, inhaled, mostly asymptomatic; immunosupressed
dx by lung biospy or lavage
silver stain
tx: tmp-smx, pentamidine, dapsone
prophylaxis when CD4 < 200
sporothrix schenckii
gardening! local pustule or ucler with nodules draining along lymphatics
tx with itraconazole or KI
coccidio
SW US, CA; mold "winebarrels" -arthroconidia; sandstorms
San Joaquin Valley or desert fever
Histoplasmosis
MS and OH river valleys, bird or bat droppings, intracellular tiny yeast inside macrophages
Paracoccidio
Rural Latin America, multiple budding yeast form
Blastomycosis
States E of MS river, Central America- big broad-based budding yeast
Tinea infections caused by...
microsporum, trichophyton, epidermophyton, spidermophyton
infections associated with birds
C neoformans, H capsulatum, C psittaci, West Nile, Avian influenza (H5, N1)
Who binds to ergosterol
Amp B (also pokes holes in the membrane), nystatin
use of Amp B
systemic infections, intrathecally
Amp B toxicities
fever/chills, hypotension, nephro(affinity for cells in the GBM)/hepatotox, arrythmias, anemia, IV phlebitis
nystatin use
too toxic for systemic, use orally or topical
Azole MOA
inhibit fungal steroid (ergosterol) synthesis
Azole uses
systemic mycoses (fluconazole for cryptococcal meningitis in AIDS pts), also hypercortisolism
Azole toxicity
hormone synthesis inhibition (gynecomastia), liver dysfunction (inhibits cyt P 450), fever chills
flucytosine mechanism
inhibits DNA synthesis by conversion to fluorouracil
flucytosine uses
systemic fungal infections
capsofungin uses
invasive aspergillosis (inhibits cell wall synthesis)
terbinafine mechanism
inhibits fungal enzyme squalene epoxidase, used topically or orally
griseofulvin mechanism
interferes with microtubule function, disrupts mitosis, deposits in keratin containing tissues
use of griseo
oral tx of superficial infections, inhibits growth of dermatophytes
Toxicity of griseo
teratogenic, carcinogenic, confusion, headaches, increase P450 met and warfarin metabolism