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18 Cards in this Set
- Front
- Back
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60 y/o man from Arizona is in ICU with pulm edema, respiratory distress, and hypotension which progresses to shock. Hx of contact with deer mice. What is the virus/diagnosis?
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HANTAVIRUS PULMONARY SYNDROME
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how common is this virus & what are the man's chances of survival
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rare & 50%
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76 year old woman presents with respiratory distress and low O2 sats. She reports that a week ago she returned from china. On the plane she sat next to a man who was coughing heavily. 4 days later she developed a cough, high fever, and diarrhea. She assumed she had the flu until it progressed rapidly to extreme difficulty breathing. Seriologic testing shows what pathogen?
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SARS- CoV
a ss RNA corona virus |
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8 year old boy with a seizure disorder is in ICU for aspiration pneumonia. Suddenly he begins coughing up copious amounts of a foul-smelling sputum. What type of cx should you order?
Aerobic cx grows staph aurous & anerobic cx grows fusoform spp. X-ray is performed and shows cavity formation and permant lung damage. To what is this due? |
anaerobic & aeorobic on sputum
Lung abscess/necrotizing pneumonia |
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76 year old pneumonia patient is not improving. X-ray shows fluid in the plura. Aspiration of pleural fluid is cultured which shows a G+ cocci (Staphylococcus aureus) [most common] or gram-negative bacilli (Pseudomonas aeruginosa, Klebsiella pneumoniae, and Escherichia coli) [less common] Patient is treated with Antibiotics and puss drainage. What is the diagnosis?
or 76 year is having complications after his pneumocentis. X-ray shows fluid in the plura. Aspiration of pleural fluid is cultured which shows a G+ cocci (Staphylococcus aureus) [most common] or gram-negative bacilli (Pseudomonas aeruginosa, Klebsiella pneumoniae, and Escherichia coli) [less common] Patient is treated with Antibiotics and puss drainage. What is the diagnosis? |
EMPYEMA (purulent inflammatory exudate of the pleural cavity)
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45 year old migrant field worker presents with chronic cough. X-ray shows destructive lesions. Sputum culture easily grows a filamentous branching organism that stains gram positive and acid fast positive. What is it?
Is this organism a fungus? |
Nocardia asteroides
No |
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56 year old brittish man , Bernie McPlaquemouth, is admitted to the hospital for chronic pneumonitis that has been getting progressively worse. He is also showing symptoms of pericarditis. He reports respiratory symptoms began about 3 months ago after he got in a bar fight and aspirated one of his front teeth. On close examination his sputum is yellowish in color with granules when granules are crushed & cultured they grow fastideous anaerobic filamentous gram + rods. That do not stain acid fast. X-ray shows cavitary lung damage similar to tuberculosis. It also shows infiltration of the infection into the vertebrae. IV pennicillin is started. What is the organism?
Is this organism a fungus. |
Actinomyces israelii
No |
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24 year old female presents with white plaques on the back of her throat after being on a broad spectrum antibiotic. Fungus culture quickly grows out a G+ organism. What is the organism?
It is dimorphic, in its pathogenic state what form does it take? |
Candida spp.
psudohyphal |
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17 year old male with history of asthma becomes symptomatic. He has developed a productive cough with eosinophilia. Culture & microscopic examination shows a filamentous fungi with Y & V shaped branching hiphae. What is the organism?
Is this organism monomorphic or dimorphic? What is the danger in an immunocompromized patient? |
Aspergillosis
monomorphic fungus ball in the lung |
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55 year old male spelunker from the Mississipi river valley, presents with fever, chills, headache, cough, chest pain, weakness, & fatigue. X-ray shows tuburculosis like granulomas. Fungal culture grows what organism?
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Histoplasmosis
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Explain how chronic cavitary disease in histoplasmosis mimics tuberculosis.
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Inhalation of spores reach broncholes/alveoli and germinate into yeast. Yeast is phagocytosed by macrophages. Accumulation of infected macrophages & other cells result in an infiltrate at infected site. Infected macrophages migrate to spleen & liver. 9-15 days onset of aquired immunity causes vasculitis, tissue necrosis, & caseation at the site of infiltrate.
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Does a positive histoplasmosis skin test indicate current infection.
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No, just exposure.
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Philapeno woman who works in the dust fields of the San Juaquine Valley presents with flu like symptoms that progresses to pneumonia. Culture grows spherules.
What fungus do you suspect?- What test is an alternate to the culture which is dangerous because of it's high risk for spread of infection. |
Coccidioides immitis
Complement fixation, |
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What is the life cycle of Coccidiodes immites
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It exists in soil in the MYCELIAL PHASE and matures. Alternate cells along a hyphae become barrel shaped and are easily fragmented & become airborne. In the host the spores swell, become spherical and develop a thick wall. This structure is called a SPHERULE which is the diagnostic feature of a culture. The spherule contains as many as 800 ENDOSPORES which are released and turn into new sperules.
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30 year old male brazilian agricultural worker with a history of alcoholism presents with chronic progressive lung disease. Sputum fungal culture on a KOH mount grows out a dimorphic fungus in a characteristic “pilot wheel” pattern. What is the organism? What is its morphology in soil? In tissue?
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Paracoccidioides brasiliensis
mycelial in soil yeast form in tissue |
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45 year farmer in Mississippi river value presents with fever, chills, headache, cough, chest pain, weakness, & fatigue. Fungus culture grows dimorphic budding yeast with a broad base & thick wall that appears refractile under the microscope. What is the organism?
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Blastomyces dermatitidis
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50 year old male with AIDS presents with abrupt fever, cough and tachypnea.
Or 3 month old infant presents with slight fever insidious onset of dyspnea, & cyanosis. What is the most likely diagnosis? What is the treatment? |
Pneumocystosis carinii
tmp-smz |
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16 year old boy with contact to pigeon droppings has a mild respiratory infection and a week later develops meningitis. LP is performed and negative staining of CSF with India ink shows yeast cells with a wide capsule. IV treatment with amhotericin B & 5-Fluorocytosine is began. What was the organism?
In what patient population is this organism particularly dangerous |
Cryptococcus neoformans
patients with AIDS or immunocompromized. |
