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45 Cards in this Set

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  • Back
Histoplasmosis
Bird/bat feces; demolition, construction, caves
Snowstorm CXR, coin-lesions, yeast in tissue
Acute or chronic pulmonary (emphesema), disseminated w/ HIV/AIDS
Ohio/Miss River Valley, opportunistic infxn
Itraconazole, Amph B in tx failures
Blastomycosis
Inhale microconidia, dogs & men w/ prostate infxn
Broad-based budding, serology
T-cell response granulomas, acute pulmonary: weight loss, cavitations; pulmonary disseminated: bones, joints, prostate, CNS; chronic cutaneous
A-antigen
Large and inhibit phagocytosis
Itraconazole, Amph B in tx failures
Coccidiomycosis
Inhaled arthroconidia
Serology, Accuprobe, hazardous to culture
Pulmonary infxn + erythema nodosum, tender nodules on anterior legs, joint pain
Southwest US, Mexico
Fluconazole, Amph B in tx failures
Candidiasis
Inhalation, dirty hands
Culture invalid w/ catheter
Superficial, oral, vaginal, invasive
Normal flora
Broad spectrum Abx, transplant, immunosuppressed
Amph B, Fluconzaole (recent shift in pathogen distribution), Caspofungin/Micafungin
Cryptococcus
Pigeon poop
India ink of CSF, latex agglutination, culture
Pulmonary infxn, disseminated infxn includes meningitis, skin, osteomyelitis
Encapsulated
No mold form (monomorphic)
Amph B + flucytosine; then Fluconazole; maintenance tx in HIV/AIDS pts
Pneumocystosis
Diffuse perihilar infiltrates in CXR
Bronchioalveolar lavage
No serology
Alveolitis, pneumonia (PCP) – adheres to Type I pneumocytes
No ergosterol  can’t use normal antifungals
Bactrim
Histoplasmosis
Bird/bat feces; demolition, construction, caves
Snowstorm CXR, coin-lesions, yeast in tissue
Acute or chronic pulmonary (emphesema), disseminated w/ HIV/AIDS
Ohio/Miss River Valley, opportunistic infxn
Itraconazole, Amph B in tx failures
Histoplasmosis
Bird/bat feces; demolition, construction, caves
Snowstorm CXR, coin-lesions, yeast in tissue
Acute or chronic pulmonary (emphesema), disseminated w/ HIV/AIDS
Ohio/Miss River Valley, opportunistic infxn
Itraconazole, Amph B in tx failures
Penicilliosis
Mold w/ red pigment & brush shaped conidiophore
Fission yeast (no budding)
SE Asia (Thailand)
Bamboo rat
Molluscum Contagiousum-like lesions on forehead/face and upper trunk
Microscopy or Culture (dangerous) or serology
Amph B; maintenance w/ fluconazole or itraconazole
Aspergillosis
Mold infects lungs
Death rates in untreated high-risk = 80-90%
Avoid contact w/ foods, flowers, plants + use HEPA filter
Ubiquitous in evironment
Neutropenia, GVHD, steroid use = major risk factor
Becomes disseminated in immunocompromised  brain, heart, kidney, liver
CT: halo (early), air crescent (advanced)
Acute angle branching
Culture: commonly contaminated
Antigen detection: galactomannan (cell wall) – false + w/ certain therapies
Amph B, Voriconazole (new best tx)
Blastomycosis
Inhale microconidia, dogs & men w/ prostate infxn
Broad-based budding, serology
T-cell response granulomas, acute pulmonary: weight loss, cavitations; pulmonary disseminated: bones, joints, prostate, CNS; chronic cutaneous
A-antigen
Large and inhibit phagocytosis
Itraconazole, Amph B in tx failures
Zygomycosis
Sporadic
 incidence w/ use of Voriconazole
Ubiquitous in environment – common contaminant
Inhalation, ingestion or traumatic implantation
Rhinocerebral infxn (30-50% cases) – black discharge from nose (death w/in hours)
Pulmonary infxn – GVHD, neutropenic cancer pts
Cutaneous infxn – necrotizing fasciitis (must use aggressive surgical debridement + meds)
IV drug abusers – cerebral infxn
Broad, non-septate hyphae w/ wide angled branching
High dose Amph B
Coccidiomycosis
Inhaled arthroconidia
Serology, Accuprobe, hazardous to culture
Pulmonary infxn + erythema nodosum, tender nodules on anterior legs, joint pain
Southwest US, Mexico
Fluconazole, Amph B in tx failures
Sporotrichosis
Dimorphic: mycelia in environment (daisy clusters with dark center), yeast at 37˚ (cigar-shaped)
N America, African gold mines (splinters)
Traumatic implantation – rose bushes, sphagnum mosses
75% lymphocutaneous w/ cording effect
Fixed cutaneous mimics squamous cell carcinoma w/ pseudoepitheliomatous hyperplasia
Extracutaneous: bones, joints, meningitis in rose gardners
Tx: potassium iodide, Amph B, Itraconazole capsules
Candidiasis
Inhalation, dirty hands
Culture invalid w/ catheter
Superficial, oral, vaginal, invasive
Normal flora
Broad spectrum Abx, transplant, immunosuppressed
Amph B, Fluconzaole (recent shift in pathogen distribution), Caspofungin/Micafungin
Chromoblatomycosis
Chronic, indolent granulomas of feet/legs
Dimorphic black molds
Sclerotic bodies (non-budding) = copper pennies
Decaying wood, plants
Traumatic implantation (men get it more due to their occupational exposures)
Culture: gray mouse fur mold
Surgical resection for early lesions; Itraconazole for advanced
Cryptococcus
Pigeon poop
India ink of CSF, latex agglutination, culture
Pulmonary infxn, disseminated infxn includes meningitis, skin, osteomyelitis
Encapsulated
No mold form (monomorphic)
Amph B + flucytosine; then Fluconazole; maintenance tx in HIV/AIDS pts
Mycetoma
Pseudallescheria boydii = soil saprophyte
Triad: tumefaction, granules, draining sinus tracts
Does not spread to other organs
Ascospores (sexual reproduction)
Surgical resection for early lesions; Itraconazole for advanced
Resistant to Amph B
Pneumocystosis
Diffuse perihilar infiltrates in CXR
Bronchioalveolar lavage
No serology
Alveolitis, pneumonia (PCP) – adheres to Type I pneumocytes
No ergosterol  can’t use normal antifungals
Bactrim
Dermatophytosis
Trichophyton tonsurans: black-dot ringworm, endothrix growth, hair breaks off at scalp
Microsporum canis: multiseptate macroconidia (canoe shaped), Woods lamp positive, ectothrix
4-6 y/o day care/school issue
Communicable
Keratinases determine pathogenicity
4 clinical signs: inflammation, active borders, pruritis, scaling, (alopecia in tinea capitis)
Oral griseofulvin, itraconazole for tinea capitis
Penicilliosis
Mold w/ red pigment & brush shaped conidiophore
Fission yeast (no budding)
SE Asia (Thailand)
Bamboo rat
Molluscum Contagiousum-like lesions on forehead/face and upper trunk
Microscopy or Culture (dangerous) or serology
Amph B; maintenance w/ fluconazole or itraconazole
Tinea versicolor
Malassezia spp
Meatball and Spaghetti
Budding yeast
Tan people have pale spots (hypopigmentation), pale people have dark spots (hyperpigmentation)
Tend to occur on upper trunk/back
Swimmers with lotions
Tx w/ selenium sulfide lotion
Aspergillosis
Mold infects lungs
Death rates in untreated high-risk = 80-90%
Avoid contact w/ foods, flowers, plants + use HEPA filter
Ubiquitous in evironment
Neutropenia, GVHD, steroid use = major risk factor
Becomes disseminated in immunocompromised  brain, heart, kidney, liver
CT: halo (early), air crescent (advanced)
Acute angle branching
Culture: commonly contaminated
Antigen detection: galactomannan (cell wall) – false + w/ certain therapies
Amph B, Voriconazole (new best tx)
Anthrax
Bacillus anthracis: aerobic, gram positive bacillus
Skin innoculation or spore inhalation
Virulence: protective antigen, lethal toxin, edema toxin, capsule
NO person to person spread = no respiratory isolation needed
Cutaneous: 20% untx pts die
Pruritic papule + necrotic black eschar + ulceration
Pulmonary: 80-90% untx pts die (1-42 days incubation)
Nonproductive cough
Hemorrhagic mediastinitis, pulmonary edema, septicemia, respiratory distress, shock, death
Tx: cipro, doxycycline + 1 of 2 other antimicrobials for 60 days (75 for prophylaxis)
Zygomycosis
Sporadic
 incidence w/ use of Voriconazole
Ubiquitous in environment – common contaminant
Inhalation, ingestion or traumatic implantation
Rhinocerebral infxn (30-50% cases) – black discharge from nose (death w/in hours)
Pulmonary infxn – GVHD, neutropenic cancer pts
Cutaneous infxn – necrotizing fasciitis (must use aggressive surgical debridement + meds)
IV drug abusers – cerebral infxn
Broad, non-septate hyphae w/ wide angled branching
High dose Amph B
Sporotrichosis
Dimorphic: mycelia in environment (daisy clusters with dark center), yeast at 37˚ (cigar-shaped)
N America, African gold mines (splinters)
Traumatic implantation – rose bushes, sphagnum mosses
75% lymphocutaneous w/ cording effect
Fixed cutaneous mimics squamous cell carcinoma w/ pseudoepitheliomatous hyperplasia
Extracutaneous: bones, joints, meningitis in rose gardners
Tx: potassium iodide, Amph B, Itraconazole capsules
Chromoblatomycosis
Chronic, indolent granulomas of feet/legs
Dimorphic black molds
Sclerotic bodies (non-budding) = copper pennies
Decaying wood, plants
Traumatic implantation (men get it more due to their occupational exposures)
Culture: gray mouse fur mold
Surgical resection for early lesions; Itraconazole for advanced
Mycetoma
Pseudallescheria boydii = soil saprophyte
Triad: tumefaction, granules, draining sinus tracts
Does not spread to other organs
Ascospores (sexual reproduction)
Surgical resection for early lesions; Itraconazole for advanced
Resistant to Amph B
Dermatophytosis
Trichophyton tonsurans: black-dot ringworm, endothrix growth, hair breaks off at scalp
Microsporum canis: multiseptate macroconidia (canoe shaped), Woods lamp positive, ectothrix
4-6 y/o day care/school issue
Communicable
Keratinases determine pathogenicity
4 clinical signs: inflammation, active borders, pruritis, scaling, (alopecia in tinea capitis)
Oral griseofulvin, itraconazole for tinea capitis
Tinea versicolor
Malassezia spp
Meatball and Spaghetti
Budding yeast
Tan people have pale spots (hypopigmentation), pale people have dark spots (hyperpigmentation)
Tend to occur on upper trunk/back
Swimmers with lotions
Tx w/ selenium sulfide lotion
Anthrax
Bacillus anthracis: aerobic, gram positive bacillus
Skin innoculation or spore inhalation
Virulence: protective antigen, lethal toxin, edema toxin, capsule
NO person to person spread = no respiratory isolation needed
Cutaneous: 20% untx pts die
Pruritic papule + necrotic black eschar + ulceration
Pulmonary: 80-90% untx pts die (1-42 days incubation)
Nonproductive cough
Hemorrhagic mediastinitis, pulmonary edema, septicemia, respiratory distress, shock, death
Tx: cipro, doxycycline + 1 of 2 other antimicrobials for 60 days (75 for prophylaxis)
Blastomycosis
Inhale microconidia, dogs & men w/ prostate infxn
Broad-based budding, serology
T-cell response granulomas, acute pulmonary: weight loss, cavitations; pulmonary disseminated: bones, joints, prostate, CNS; chronic cutaneous
A-antigen
Large and inhibit phagocytosis
Itraconazole, Amph B in tx failures
Coccidiomycosis
Inhaled arthroconidia
Serology, Accuprobe, hazardous to culture
Pulmonary infxn + erythema nodosum, tender nodules on anterior legs, joint pain
Southwest US, Mexico
Fluconazole, Amph B in tx failures
Candidiasis
Inhalation, dirty hands
Culture invalid w/ catheter
Superficial, oral, vaginal, invasive
Normal flora
Broad spectrum Abx, transplant, immunosuppressed
Amph B, Fluconzaole (recent shift in pathogen distribution), Caspofungin/Micafungin
Cryptococcus
Pigeon poop
India ink of CSF, latex agglutination, culture
Pulmonary infxn, disseminated infxn includes meningitis, skin, osteomyelitis
Encapsulated
No mold form (monomorphic)
Amph B + flucytosine; then Fluconazole; maintenance tx in HIV/AIDS pts
Pneumocystosis
Diffuse perihilar infiltrates in CXR
Bronchioalveolar lavage
No serology
Alveolitis, pneumonia (PCP) – adheres to Type I pneumocytes
No ergosterol  can’t use normal antifungals
Bactrim
Penicilliosis
Mold w/ red pigment & brush shaped conidiophore
Fission yeast (no budding)
SE Asia (Thailand)
Bamboo rat
Molluscum Contagiousum-like lesions on forehead/face and upper trunk
Microscopy or Culture (dangerous) or serology
Amph B; maintenance w/ fluconazole or itraconazole
Aspergillosis
Mold infects lungs
Death rates in untreated high-risk = 80-90%
Avoid contact w/ foods, flowers, plants + use HEPA filter
Ubiquitous in evironment
Neutropenia, GVHD, steroid use = major risk factor
Becomes disseminated in immunocompromised  brain, heart, kidney, liver
CT: halo (early), air crescent (advanced)
Acute angle branching
Culture: commonly contaminated
Antigen detection: galactomannan (cell wall) – false + w/ certain therapies
Amph B, Voriconazole (new best tx)
Zygomycosis
Sporadic
 incidence w/ use of Voriconazole
Ubiquitous in environment – common contaminant
Inhalation, ingestion or traumatic implantation
Rhinocerebral infxn (30-50% cases) – black discharge from nose (death w/in hours)
Pulmonary infxn – GVHD, neutropenic cancer pts
Cutaneous infxn – necrotizing fasciitis (must use aggressive surgical debridement + meds)
IV drug abusers – cerebral infxn
Broad, non-septate hyphae w/ wide angled branching
High dose Amph B
Sporotrichosis
Dimorphic: mycelia in environment (daisy clusters with dark center), yeast at 37˚ (cigar-shaped)
N America, African gold mines (splinters)
Traumatic implantation – rose bushes, sphagnum mosses
75% lymphocutaneous w/ cording effect
Fixed cutaneous mimics squamous cell carcinoma w/ pseudoepitheliomatous hyperplasia
Extracutaneous: bones, joints, meningitis in rose gardners
Tx: potassium iodide, Amph B, Itraconazole capsules
Chromoblatomycosis
Chronic, indolent granulomas of feet/legs
Dimorphic black molds
Sclerotic bodies (non-budding) = copper pennies
Decaying wood, plants
Traumatic implantation (men get it more due to their occupational exposures)
Culture: gray mouse fur mold
Surgical resection for early lesions; Itraconazole for advanced
Mycetoma
Pseudallescheria boydii = soil saprophyte
Triad: tumefaction, granules, draining sinus tracts
Does not spread to other organs
Ascospores (sexual reproduction)
Surgical resection for early lesions; Itraconazole for advanced
Resistant to Amph B
Dermatophytosis
Trichophyton tonsurans: black-dot ringworm, endothrix growth, hair breaks off at scalp
Microsporum canis: multiseptate macroconidia (canoe shaped), Woods lamp positive, ectothrix
4-6 y/o day care/school issue
Communicable
Keratinases determine pathogenicity
4 clinical signs: inflammation, active borders, pruritis, scaling, (alopecia in tinea capitis)
Oral griseofulvin, itraconazole for tinea capitis
Tinea versicolor
Malassezia spp
Meatball and Spaghetti
Budding yeast
Tan people have pale spots (hypopigmentation), pale people have dark spots (hyperpigmentation)
Tend to occur on upper trunk/back
Swimmers with lotions
Tx w/ selenium sulfide lotion
Anthrax
Bacillus anthracis: aerobic, gram positive bacillus
Skin innoculation or spore inhalation
Virulence: protective antigen, lethal toxin, edema toxin, capsule
NO person to person spread = no respiratory isolation needed
Cutaneous: 20% untx pts die
Pruritic papule + necrotic black eschar + ulceration
Pulmonary: 80-90% untx pts die (1-42 days incubation)
Nonproductive cough
Hemorrhagic mediastinitis, pulmonary edema, septicemia, respiratory distress, shock, death
Tx: cipro, doxycycline + 1 of 2 other antimicrobials for 60 days (75 for prophylaxis)