Infectious Disease

Front 1

Name the three groups of dermatophytes

Back 1

Microsporum, Trichophyton, Epidermophyton

Front 2

Name the three groups of dermatophytes

Back 2

Microsporum, Trichophyton, Epidermophyton

Front 3

Name 5 infections resulting from dermatophytes

Back 3

1. Tinea corporis - "ringworm." Red, inflammed ring surrounding healing, white center.
2. Tinea capitis - infection of hair shaft results in breaking of hair either at level of scalp (endothrix) or just above (ectothrix). Mostly in kids.
3. Tinea cruris - "jock itch." Usually well-demarcated. If green under fluorescent light, it is microsporum.
4. Tinea pedis - "athlete's foot" - dry, cracked skin +/- small clusters of blisters. Look between little toes.
5. Onychomycosis - may be superficial, distal, or proximal. If proximal, think IC'd.

Front 4

What 2 drugs can you use to treat onychomycosis from dermatophyte infection?

Back 4

1. Griseofulvin - must treat until nail completely grows out.
2. Terbenafine (Lamisil) - new and very expensive but works faster.

Front 5

Name the infections that can result from Aspergillus mold.

Back 5

1. Allergic alveolitis - hypersensitivity reaction resulting in flu-like symptoms 4-8 hrs after antigen exposure. Self-limited.
2. Allergic bronchopulmonary aspergillosis (ABPA) - chronic colonization of airways in ppl with preexisting asthma. Manifest as difficult to control asthma. Will find eosinophils and IgE in blood and bronchiectasis on CT. Tx with steroids.
3. Aspergilloms (mycetoma or fungus ball). Seen in ppl with preexisting lung cavities, such as from COPD, TB, Histo). The Aspergilloma grows on a stalk within the cavity. Usually asymptomatic. Rarely hemoptysis.
4. Acute Aspergillosis pneumonia - invasive; seen in IC'd, especially neutropenics, such as leukemia/BMT or ppl with CGD. Also in solid organ txps or AIDS. The mold invades blood vessels of lung, causing fever, hemoptysis, pleuritic chest pain.
5. Chronic necrotizing aspergillosis - also invasive; seen in pt's that are less IC's than above, such as those on steroids, or DM's. Causes TB like disease - slowly progressing, and apical cavitary lesions
6. Miscellaneous: ear, sinus, heart valve. Also cutaneous. Biopsy any skin lesion of a leukemic patient to look for this.

Front 6

Diagnosis and treatment of Aspergillosis

Back 6

Dx by bx of the lung and look for invasion of the mold into healthy tissue, not just in already necrotic areas. Also ELISA to diagnose invasive disease.

Tx with surgical excisions, Amphotericin B, itraconazole, or caspofungin.

Front 7

and what are 2 ways the infection can present?

Back 7

Patient population = leukemics/BMT, DM's (especially with DKA), and renal failure.
Can cause...
1. Rhinocerebral mucormysis - invades sinuses and nasal and oral cavities and can spread to orbit and brain. Results in black, necrotic tissue.
2. Pulmonary mucormycosis. Clinically identical to invasive pulmonary aspergillosis --> fever, pleuritic chest pain, and hemoptysis.