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42 Cards in this Set
- Front
- Back
Circular
Round Reproduces by budding |
Yeast
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Filamentous and hyphal forms
Reproduces by spores |
Mold
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Meningitis in HIV patients
Brain or spinal abscesses Pulmonary nodules and lobar pneumonia Crohn's like ulcers Skin manifestations |
Cryptococcus neoformans
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Cryptococcus neoformans - ecology
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Bird guano and soil
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Cryptococcus neoformans - pathogenesis
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Inhalational route
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Cryptococcus neoformans - risk factors
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HIV
SLE Lymphoproliferative disorders Cirrhosis Sarcoidosis Organ transplantation |
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Subacute headache, fever, malaise, neuropsychiatric symptoms
Elevated protein, lymphocytosis, and elevated opening pressure in CSF |
Cryptococcal meningitis
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Cryptococcal meningitis - poor prognostic indicators
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Altered mental status
High CSF pressure High cryptococcal antigen titer Disseminated infection Underlying disease |
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Cryptococcal meningitis - long term sequelae
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Communicating hydrocephalus
Blindness Deafness CN palsy |
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Cryptococcal meningitis - treatment
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Amphotericin B followed by fluconazole until CSF cultures are negative
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Cryptococcus in AIDS
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Seen mostly in CD4 counts < 50
Most develop encephalitis and meningitis More insidious onset |
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Treatment of AIDS cryptococcus
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Lifelong suppression with fluconazole until CD4 goes above 200
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Cryptococcus neoformans - diagnosis
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Tissue biopsy for fungal culture
Encapsulated narrow-based budding yeast |
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Cryptococcus neoformans - treatment
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LP to rule out meningitis
Fluconazole for pulmonary infection Amphotericin B and fluconazole for others |
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Infection in immunocompromised host with impaired cellular immunity
Centrally located pneumonia with interstitial infiltrate |
Pneumocystis jiroveci
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Pneumocystis jiroveci - ecology
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Unicellular fungus
Inhalational infection |
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Pneumocystis jiroveci - risk factors
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HIV with low CD4 count
Corticosteroids Immunosuppressives Malnutrition |
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Pneumocystics jiroveci - treatment
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TMP-SMX for 21 days
Prednisone for severe disease |
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Pneumocystics jiroveci - poor prognostic indicators
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Non-HIV patient
Respiratory failure |
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Pneumocystics jiroveci - complications
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Pneumothorax from bullae and cysts that rupture into pleura
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Thick-walled cavitary pneumonia
Vasculitis through invasion of arterial wall Downstream necrosis and infarction Opportunistic pathogen |
Aspergillus
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Aspergillus - risk factors
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Immunocompromise
Neutropenia Solid organ and bone marrow transplants Chronic granulomatous diseases Corticosteroids AIDS |
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Fever
Hemoptysis Pleuritic chest pain Cough |
Pulmonary aspergillosis
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Pulmonary aspergillosis - diagnosis
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CXR or CT with halo sign
Culture from bronchial specimens or biopsy Serum galactomannan assay Histology - acute angle branching and septate hyphae |
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Sinusitis - fever, cough, sinus headache, epistaxis, headache
CNS mass lesions with surrounding edema Disseminated necrotic ulcerative lesions |
Non-pulmonary aspergillosis
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Aspergillus - poor prognostic indicators
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Severe immunosuppression
Disseminated or extensive disease CNS manifestations |
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Aspergillus - treatment
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Reduce immunosuppression
Voraconazole - TOC Amphotericin B Caspofungin Itraconazole |
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Facial pain
Headache Fever Orbital cellulitis Black nasal discharge Proptosis CN deficits Dusky eyelid |
Rhinocerebral mucormycosis
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Fever
Dyspnea Cough Infiltrate or cavity |
Pulmonary mucormycosis
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Cutaneous mucormysosi - pathogenesis
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Direct trauma or burns
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Abdominal pain
Distention Fever Abscess |
GI mucormycosis
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Mucormycosis - ecology
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Mold
Widely distributed in environment |
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Mucormycosis - clinical sites of infection
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Rhinocerebral
Pulmonary Cutaneous GI CNS Renal |
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Mucormycosis - risk factors
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DKA
Neutropenia Hematologic malignancies Iron chelating therapy Burns and trauma - direct inoculation |
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Mucormycosis - pathogenesis
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Inhalation or cutaneous inoculation
Spread through direct or vascular invasion |
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Mucormycosis - diagnosis
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Tissue diagnosis
Broad-based non-septate hyphae at right angles |
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Mucormycosis - treatment
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Correct underlying risk factors
Surgical debridement IV amphotericin B |
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Mucormycosis - poor prognostic indicators
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Pulmonary disease
Extensive involvement |
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Cutaneous lesion with ulceration and scaly plaques after trauma
Chronic septic arthritis Chronic cavitary pneumonia |
Sporothrix schenkii
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Sporothrix schenkii - ecology
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Dimorphic fungus
Associated with straw, sphagnum moss, wood, rose plants |
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Sporothrix schenkii - diagnosis
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Biopsy and culture
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Sporothrix schenkii - treatment
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Itraconazole for 3-6 months
Supersaturated KI solution Amphotericin B |