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34 Cards in this Set
- Front
- Back
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Systemic Mycoses
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ALL Systemic Mycoses can cause Pneumonia
They can ALL MIMIC Tuberculosis (Granulomas) ALL Systemic Mycoses are caused by Dimorphic Fungi o Cold = Mold (20oC) and Heat = Yeast (37o) Coccidiodomycosis is the EXCEPTION b/c it becomes a SPHERULE in Tissue and NOT Yeast TREATMENT Local Infection: Fluconazole or Ketoconazole Systemic Infection: Amphotericin B |
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Histoplasmosis
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Histoplasmosis – oHio and Mississippi River Valleys
Transmission: Bird/Bat droppings Cause: Fever + Productive Cough + Tongue Ulcer + Hepatosplenomegaly in AIDS HIsto: Macrophages/Granulomas filled with Histoplasmosis |
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Blastomycosis
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AlaBama is East of Mississippi River
Broad Based Budding yeast Causes: Inflammatory Lung Disease that DISSEMINATES to Skin and Bone Histo: Broad-based budding + Multi-nucleated cells with Refractile Walls |
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Coccidiodomycosis
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San Joaquin Valley of Cali
a. Causes: Pneumonia and Meningitis Transmission: Storms ==> Spores in Dust are THROWN UP into Air ==> INHALED ==> become Spherules in Lung Histo: Spherules FILLED with Endospores |
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Paracoccidiomycosis
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Occurs in Latin America
HIsto: Budding Yeast with “Captain’s Wheel” appearance |
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Chromoblastomycosis
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South America and Africa
Traumatic Inoculation/Injury ==> Verrucous Plaque-like Skin Lesions Histo: Thick-walled Cigar-Colored Sclerotic Cells |
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Tinea Versiclor
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Tx: Miconazole
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Tinea Pedis, Tinea Cruris, Tinea Corporis, Tinea Capitis
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Cruris = Groin Corporis = Ringworm on Body
Cause: Trichophytons Presentation: Pruritic Rash with Central Clearing RING Lesion |
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Opportunistic Fungal Infections
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Sporothrix schenckii
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Rose Is a Thorn in my side and Loves Cigars but is an Ascending star in this Sport
AKA: Sporotrichosis or Rose Gardener’s Disease Transmission: When a Thorn is TRAUMATICALLY Introduced INTO Skin Presentation: i. Initially presents as a Ulcerating Papule AT SITE of Inoculation/ Papule that will BREAK OPEN ii. Ascending Lymphangitis Nodular Pustules/Ulcers will form along Lymphatic Drainage Histo: Dimorphic Cigar-shaped Budding Yeast TreatmebtL Itraconazole |
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Pneumocystis jiroveci
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Yeast that are INHALED to cause a Diffuse Interstitial
Pneumonia Risk Factors: ONLY found in Immunosuppressed pts (AIDS) CXR Findings: Diffuse B/L Infiltrate Histo Feat: Disc-shaped Yeast on a Silver Stain Treatment: TMP-SMX PROPHYLACTIC Treatment should START at CD4 < 200 |
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Candida Albicans
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Histo: Dimorphic Yeast – Budding Yeasts and Pseudohyphae at 20C / Germ Tubes at 37
Presentation: i. Oral Thrush ii. Esophageal Thrush in Immunocompromised pts (Neonates, Steroids, Diabetes, AIDS) iii. IV Drug Users – Endocarditis iv. Vulvovaginitis v. Disseminated Candidiasis Treatment: i. Vulvovaginitis – Topical Azole (Miconazole) ii. Oral/Esophageal Thrush – Fluconazole iii. Systemic Candidiasis – Amphotericin B iv. Serious Oral Candidiasis/Vaginal Candidiasis/Diaper Rash – Nystatin |
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Aspergillus
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a. Histo: Septate Hyphae that BRANCH at 45o Angles
b. Cause: i. Immunocomp pts: Invasive Aspergillosis ii. Pre-existing Asthma or Cystic Fibrosis: Allergic Bronchopulmonary Aspergillosis iii. After Tuberculosis Infection: Aspergillomas in Lung Cavities c. Bottom Line: Invasive Aspergillosis (Immunocomp) + ABPA (Asthma/CF) + Aspergilloma in Lung Cavity (TB) |
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Cryptococcus neoformans
**Histoplasmosis, Coccidio, Cryptococcus have Uniqe transmissions** |
Causes: Cryptococcal Meningitis
HIsto: Yeasts with Wide Capsular Halos on India Ink Stain i. HEAVILY Capsulated Yeast Transmission: Pigeon Droppings in Soil (Inhalation) Findings: Soap Bubble Lesions in Brain Diagnosis: Latex Agglutination Test to DETECT Polysaccharide Capsular Antigen |
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Mucor / Rhizopus
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Histo: NON-septate Hyphae BRANCHING at WIDE
Angles Causes – Mucormycosis In Diabetic Ketoacidosis and Leukemic Patients Findings: Rhinocerebral and Frontal Lobe Abscesses Presentation: HA + Facial Pain + Necrotic Eschar on Face + CN Involvement |
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Protozoan GI Infections
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Entamoeba Histolytica
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Presentation: Bloody Diarrhea + Liver/Lung Abscess +
RUQ Pain + Flask-shaped Ulcer Transmission: Contaminated Water Diagnosis: Trophozoites in Stool |
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Giardia lamblia
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Bloating + Flatulence + Abdominal Cramps + Foul-smelling Diarrhea
**Eating Ghirardelli chocolate ==> Sugar ==> Foul-Smelling Diarrhea** Transmission: Hikers/Campers drinking Contaminated Diagnosis: Trophozoites in Stool Water |
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Cryptosporidium
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SEVERE Watery Diarrhea in AIDS
Mild Watery Diarrhea in NON-immunocomp Transmission: Contaminated Water Diagnosis: Cysts on ACID-FAST Stain |
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Protozoan CNS Infections
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Toxoplasma Gondii
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Trypanosoma bruciee, gambiense
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Transmission: Tsetse Fly ==> PAINFUL Bite
Presentation: African Sleeping Sickness i. ENLARGED Lymph Nodes + Recurring Fever + Somnolence + Coma Diagnosis: Blood Smear Treatment: Suramin + Melarsoprol i. It SURe is nice to SLEEP; thanks MELAtonin |
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Naegleria fowleri
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Transmission: Swimming in Freshwater Lakes
Presentation: RAPIDLY Fatal Meningoencephalitis Diagnosis: Amoebas in Spinal Fluid Treatment: Amphotericin-B (only works sometimes) |
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Protozoans - Hematologic Infections
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Plasmodium
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Plasmodium Dr Quine the Medicine woman
Transmission: Anopheles Mosquito Pathogenesis: Mosquito INJECTS Sporozoites into Blood Sporozoites travel to Liver and REPLICATE in Hepatocytes MATURE into Schizont Schizont RUPTURE and RELEASE Merozoites into Blood Merozoites ENTER Erythrocytes and turn into Trophozoite Rings i. Mosquito Sporozoite Schizont Merozoite Trophozoite Ring Presentation: Fever + Chills + HA+ Anemia + Abdominal Pain + Hepatomegaly Diagnosis: Blood Smear ==> Trophozoite Ring Form OR Schizont with Merozoites Treatment: Chloroquine/Mefloquine if RESISTANT i. BLOCKS Plasmodium Heme Polymerase |
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Plasmodium subtypes
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Plasmodium Vivax/Ovale
a. Presentation: Fever Cycle of 72 hrs recurring EVERY 3 days (Tertian Malaria) b. Pathogenesis: Vivax and Ovale have Dormant forms in the Liver = Hypnozoites c. Treatment: Primaquine for the Dormant Form Plasmodium Malariae a. Presentation: Fever Cycle of 72 hrs recurring EVERY 4 days (Quartian Malaria) Plasmodium Falciparum a. FATAL FORM with Irregular Fever Patterns where Infected RBCs will OCCLUDE Capillaries in Brain, Kidney and Lungs i. Brain: Cerebral Malaria ii. Kidney: Blackwater Fever + Hemoglobinuria (d/t Hemolysis) |
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Babesia
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a. Transmission: Ixodes Tick (also carries Borrelia burgdorferi) Northeast US
b. Presentation: i. Fever + Hemolytic Anemia c. Diagnosis: Blood Smear showing Maltese Cross d. Treatment: Quinine / Clindamycin |
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Trypanosoma cruzii
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Tramission: Reduviid Bug ==> Painless Bite
Causes: Chagas Disease (commin in South America) Presentation: Dilated CM + Megacolon + Megaesophagus (Dysphagia) Diagnosis: Blood Smear Treatment: NIFURTIMOX |
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Leishmania donovani
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Leishmaniasis = Iraq + Sandly + Spiking Fever +
Sodium Stibogluconate + amaStigotes Transmission: Sandfly i. COMMON in Middle East/Iraq Presentation: SPIKING FEVER + Hepatosplenomegaly + Pancytopenia Diagnosis: Macrophages containing Amastigotes Treatment: Sodium Stibogluconate |
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Trichomonas Vaginalis
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Presentation: Foul-smelling Green Vaginal Discharge
Itching / Burning Vagina Diagnosis: MOTILE Trophozoites on Wet Mount |
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Roundworms / Nematodes
Mnemonic = NEMATTODS |
Mnemonic: You’ll get sick if you EAT these Eggs vs. These worms get into your feet from the SANd
EAT = Enterobias, Ascaris, Trichonella SANd = Strongyloides/Anylostoma / Necator EAT SANd = ALL treated with Mebendazole Enterobias Food contaminated with Eggs Anal Pruritis Scotch Tape Test Ascariasis Fecal/Oral Route Dx: Eggs that are visible in Feces Trichinella Undercooked Pork PERIORBITAL EDEMA + Muscle Inflammation Strongyloides Larvae penetrate Feet Vomiting + Diarrhea + Anemia Ancylostoma duodenale/ Necator Larvae Penetrate Feet Intestinal Infection ==> Microcytic/Iron Def Anemia Worms suck BLOOD from Intestine ______________________________________________________ |
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Roundworms/Nematodes
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Toxic Worms DO Loa Loa = T W D O Loa Loa
ALL Treated with Diethylcarbamazine EXCEPT Onchocerca Toxocara canis Food contaminated with Eggs Granulomas + Visceral Larva ==> Blindness Wuchereria bancrofti = M Female Mosquite Elephantiasis ==> d/t BLOCKAGE of Mosquito Drancunculus Dracula Drinks til you get Skin Ulcer a. Transmission: Drinking Water b. Presentation: Skin Ulcers Onchocerca Blackflies Hypopigmented Skin + River Blindness Treatment Ivermectin Loa Loa Transmission: Deer Fly / Horsefly / Mango fly i. ONLY seen in Africa Presentation Transient Migratory Angioedema/Skin Swelling + Pruritis + Localized Urticaria in Wrists/Ankles ==> Ocular Sx (Pruritis of Eye + Periorbital Edema) i. You can see worm CRAWLING in Conjunctiva |
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Tapeworms
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TED Taping Scherbotzky Wanking a Cock is a Fluke
ALL Treated with Praziquental except Echinococcus **Tenia Solium** Ingestion of Undercooked Pork (Larvae/Eggs) Ingestion of Larvae ==> Intestinal Tapeworms Ingestion of Eggs ==> Cysticercosis and Neurocysticercosis Mass Lesions in Brain ==> Swiss Cheese Brain Tx is Bendazole for Neurocysticercosis Echinococcus Transmission: INGESTION of Eggs in Dog Feces Presentation: Hydatid Cyst Disease Cysts in Liver and Lungs If Echinococcal Antigens are RELEASED from Cyst ==> Anaphylactic Shock c. Treatment: Bendazole + Ethanol BEFORE Surgery (REMOVES Daughter Cysts) diPHylloBothrium latum = Phish + B12 deficiency a. Transmission: INGESTION of Larvae in Raw Fish b. Presentation: Vit B12 def ==> Megaloblastic Anemia |
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Flukes
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Schistosoma
***ALL S's*** Schistosoma = Swimmer’s Itch + Splenomegaly + Shittin Water and Peeing Blood + SqCC of Bladder C’s of Clonorchis – Chinese Fluke + Cholongiocarcinoma + GB Calculi a. Transmission: Undercooked Fish (Fluke) b. Presentation: Biliary Tract Inflammation Pigmented Gallstones/Cholangiocarcinoma Paragonimus westermani Undercooked Crab Meat Bacterial Infection of Lung ==> Hemoptysis |
