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13 Cards in this Set
- Front
- Back
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Cryptococcus neoformans |
- ● meningitis in AIDS Pt -exposure to pigeon droppings -● cryptococcus encephalitis ( soap bubble lesions in the brain) Heavily encapsulated org Inv- LP- csf - latex agglutination test - Serologic test 4 ag Px - amphotericin B + flucytosine Follow with a single dose of fluconazole |
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Aspergillus fumigatus |
-● Septate hyphae that branch at 45° acute angle - cause aspergillomas( fungal ball) in pre-existing lung cavities e.g after TB - ● some spp products aflatoxin ➡ hepatocellular ca - px - lipid form of amphotericin B - caspofungin - for invasive aspergillosis |
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Mucor, rhizopus |
-Broad non Septate hyphae branching at wide angles - ●cause dx in diabetic Pt with DKA and in neutropenic Pt - eg pt with leukaemia - proliferate along bld vessel wall ➡ penetrate cribriform plate and enter the brain ➡ ■CST ■Rhinocerebral Frontal lobe abscess CF -● black necrotic eschar on face, headache, facial pain, CN abnormality,blindness Inv - biopsy of tx Px- surgical debridement - amphotericin B |
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Candida albicans |
Cause ■- oral thrush ■esophagitis ■Vulvovaginitis ■ diaper rash ■ intertrigo ■ ●▪endocarditis - in IV drug users, - central lines ■ endopthalmitis ■ systemic dx- immunocompromized, oncology Pt, organ transplant pt
■ ● Vulvovaginitis- associated with acidic Ph Oral thrush - on tongue n mucosa, leaves raw red bleeding mucus when scrapped Different from - oral hairy leukoplakia - seen at sided of tongue, can't be scrapped off.
Inv - bld culture - yeast cells grow on bld culture Candida. Alb. Devps germ tubes within 90 mins wen put in serum |
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Pneumocystis Jiroveci |
● Start prophylaxis when CD4 count drops <200 cell/mm3 in HIV Pt -● diffuse interstitial pneumonia in immunosuppressive (AIDS Pt) Inv- ● CXRay / CT - ground glass opacities - bronchial lavage - silver stain - lung biopsy Methenamine silver stain of lung tx---- shows disc shaped yeast.
Px / prophylaxis - TMP-SMX,- if sulfa allergy give - Pentamidine -Atovaquone Dapsone (prophylaxis only) |
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Sporothrix schenckii |
Rose gardener's dx Traumatically introduced into skin by a thorn Px - potassium iodide or - itraconazole Plant a ROSE in the POT |
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Amphotericin B |
MOA- disrupts cell memb by forming pores by binding to ergosterol . (Amphotericin TEARS holes in fungal memb) Use- severe systemic mycoses. -● cryptococcal meningitis ROA- IV - Intrathecal for fungal meningitis (occasionally ) SE- Fever + chills - ● nephrotoxicity - arrhythmia - hypotension - thrombophlebitis - anemia |
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Nystatin |
MOA- same as amphotericin B ROA- topical only- too toxic 4 systemic use. USE - Oral candidiasis - swish n swallow. - diaper rash - vaginal candidiasis |
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Flucytosine |
MOA -inhibit nucleic acid syn. .'. Inhibit DNA n RNA syn by converting 5FU to cytosine deaminase USE - + Amphotericin B ---- Px cryptococcal meningitis SE- ● bone marrow depression |
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Azoles (Clotrimazole,fluconazole,itraconazole, ketoconazole,miconazole, voriconazole) |
Fluconazole - candida , cryptococcal meningitis in AIDS Pt. Itraconazole- blastomyces - coccidioides - histoplasma ● DOC - sporothrichosis Clotrimazole n miconazole - topical SE - ● inhibit hormone syn - cortisol and testosterone--->impotence, gynecomastia. (Esp -Ketoconazole) -liver dysfunction ---> hepatic toxicity----> increase liver enzyme.
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Terbinafine |
MOA: inhibit lanostetol syn ---> inhibition of ergosterol syn. USE : Onychomycosis- finger, toe nails. |
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Echinocandins (caspofungin, micafungin, anidulafungin) |
MOA - Inhibit cell wall synthesis ---> cell lysis ----> cell death USE - caspofungin - Px invasive Aspergillosis |
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Griseofulvin |
MOA - interferes with microtubule function ● deposit in keratin containing tissue. SE - ●Teratogenic - carcinogenic - increase cytochrome P-450 and warfarin Metabolism. |
