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126 Cards in this Set
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systemic mycoses include
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histoplasmosis
blastomycosis coccidioidomycosis paracoccidioidomycosis |
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systemic mycoses all have certain characteristics in common:
exception? |
they can:
--pneumonia --disseminate dimorphic except coccidioidomycosis spherule (not yeast) in tissue |
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treatment for systemic mycoses
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local infection:
--fluconazole --ketoconazole systemic: --amphotericin B |
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systemic mycoses:
like TB, they _ unlike TB, they _ |
granulomas
no person-person transmission |
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histoplasmosis -->
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pneumonia
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size of systemic fungi in microns
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3-5 histoplasmosis
5-15 blastomycosis 20-60 coccidioidomycosis 40-50 paracoccidioidomycosis |
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histoplasmosis histopathology
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macrophage filled with Histoplasma
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blastomycosis histopathology
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broad-base budding
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coccidioidomycosis histopathology
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spherule filled with endospores
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paracoccidioidomycosis histopathology
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budding yeast with "captain's wheel" formation
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locations of systemic fungi
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histoplasmosis
--mississippi, ohio river valleys blastomycosis --east of mississippi --central america coccidioidomycosis --southwestern united states --california --san joaquin valley paracoccidioidomycosis --latin america |
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blastomycosis -->
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inflammatory lung disease
disseminate to skin & bone granulomatous nodules |
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coccidioidomycosis -->
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pneumonia
meningitis disseminate to bone & skin |
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case rate of this fungal infection ^ after earthquakes
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coccidioidomycosis
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cutaneous mycoses include
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tinea versicolor
tinea pedis tinea cruris tinea corporis tinea capitis |
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tinea versicolor is caused by
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malassezia furfur
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tinea versicolor pathophysiology
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degradation of lipids -->
acids --> damage melanocytes--> hypopigmented and/or hyperpigmented patches occurs in hot humid weather |
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treatment for tinea versicolor
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topical miconazole
selenium sulfide |
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spaghetti & meatball appearance on KOH prep =
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tinea versicolor
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athletes' foot and other tinea is caused by _ fungi
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dermatophytes
--microsporum --trichophyton --epidermophyton |
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KOH prep:
tinea versicolor vs. other tinea |
spaghetti & meatball
mold hyphae |
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appearance of dermatophytic infection on skin
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pruritic lesions
central clearing |
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opportunistic fungal infections
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candida
aspergillus cryptococcus mucor, rhizopus pneumocystis jiroveci sporothrix |
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candida-->
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--oral & esophageal thrush in immunocompromised
(neonates, steroids, diabetes, AIDS) --vulvovaginitis (diabetes, use of antibiotics) --diaper rash --endocarditis in IV drug users --disseminated candidiasis (to any organ) --chronic mucocutaneous candidiasis |
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treatment for candida albicans
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nystatin (superficial infection)
amphotericin B (serious systemic infection) |
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types of aspergillosis -->
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allergic bronchopulmonary
lung cavity (fungus ball) invasive, esp. in immunocompromised & CGD |
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dimorphics, molds, yeasts?
candida aspergillus cryptococcus mucor, rhizopus pneumocystis sporothrix |
dimorphic:
--candida --sporothrix mold --aspergillus --mucor, rhizopus yeast --cryptococcus --pneumocystis |
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45^ angle branching
90^ angle branching |
aspergillus
mucor, rhizopus |
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aspergillus vs.
mucor, rhizopus appearance of hyphae |
septate, 45^
nonseptate, 90^ |
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cryptococcus neoformans -->
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cryptococcal meningitis
cryptococcosis |
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cryptococcus is found in _
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soil
pigeon droppings |
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cryptococcus lab details
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Sabouraud's agar
india ink stain, but... latex agglutination detects the capsule and is more specific |
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mucor, rhizopus mainly attacks _ patients
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ketoacidotic diabetic
lukemia |
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mucor, rhizopus -->
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--rhinocerebral frontal lobe abscesses
--headache --facial pain --black necrotic eschar on face --cranial nerve involvement |
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pneumocystis jiroveci -->
mainly in what patients? |
diffuse interstitial pneumonia
(most infections are asymptomatic; immunosuppression predisposes to disease) |
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pneumocystis jiroveci is diagnosed by _
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lung biopsy or lavage
methenamine silver stain |
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pneumocystis jiroveci Rx
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trimethoprim-sulfamethoxazole
pentamidine dapsone |
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pneumocystis jiroveci: begin prophylaxis when CD4 drops below... in HIV patients
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< 200 cells/mL
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treatment for sporothrix schenckii
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itraconazole
potassium iodide |
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protozoa that cause GI infections
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giardia lamblia
entamoeba histolytica cryptosporidium |
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protozoa that cause CNS infections
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toxoplasma gondii
naegleria fowleri trypanosoma brucei --gambiense --rhodesiense |
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protozoa that cause visceral infections
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trypanosoma cruzi
leishmania donovani |
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giardia -->
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bloating
flatulence foul-smelling, fatty diarrhea |
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giardia epi
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campers, hikers
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giardia
entamoeba cryptosporidium transmission |
cysts in water
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giardia
entamoeba cryptosporidium diagnosis |
trophozoites or cysts in stool
serology trophozoites or cysts in stool RBCs in entamoeba cysts on acid-fast stain |
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what protozoans are treated with metronidazole?
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giardia
entamoeba trichomonas |
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giardia rx
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metronidazole
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entamoeba rx
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metronidazole and iodoquinol
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entamoeba -->
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bloody diarrhea (dysentery)
liver abscess (reddish brown) RUQ pain |
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a histological finding re: entamoeba
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flask-shaped ulcer if submucosal abscess of colon ruptures
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toxoplasma gondii -->
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brain abscess in HIV
--ring-enhancing lesions congenital --chorioretinitis --hydrocephalus --intracranial calcifications |
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congenital toxoplasmosis classic triad
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chorioretinitis
hydrocephalus intracranial calcifications |
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toxoplasma gondii transmission
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cysts in meat or cat feces
crosses placenta (pregnant women should avoid cats) |
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diagnosis of toxoplasma gondii
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serology
biopsy |
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toxplasma gondii treatment
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sulfadiazine + pyrimethamine
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swimming in freshwater lakes
entry by cribriform plate... what organism? |
naegleria fowleri
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diagnosis of naegleria fowleri
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amoebas in spinal fluid
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naegleria fowleri -->
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rapidly fatal meningoencephalitis
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trypanosoma brucei sxs
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enlarged lymph nodes
recurring fever* somnolence coma *antigen variation |
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diagnosis:
trypanosoma brucei vs. cruzi |
blood smear
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trypanosoma cruzi rx
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nifurtimox
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leishmania donovani rx
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sodium stibogluconate
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leishmania donovani
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spiking fevers
hepatosplenomegaly pancytopenia |
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leishmania donovani tx
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sandfly
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leishmania donovani diagnosis
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macrophages containing "amastigotes"
(a form that lacks flagella) |
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leishmania donovani rx
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sodium stibogluconate
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plasmodium rx
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CaMP:
begin with chloroqine if resistant, use mefloquine vivax/ovale: add primaquine |
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babesia rx
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quinine
clindamycin |
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malaria sxs
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cyclic fever
headache anemia splenomegaly |
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malaria diagnosis
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blood smear
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babesia diagnosis
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blood smear
--no RBC pigment --appears as "Maltese cross" |
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babesia sxs
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fever
hemolytic anemia |
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plasmodium vivax/ovale vs.
plasmodium falciparum fevers occur when? |
every other day
daily |
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plasmodium falciparum additional severe symptoms
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parasitized RBCs occlude capillaries in:
--brain --kidneys --lungs |
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trichomonas vaginalis sxs
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foul-smelling,
greenish discharge itching burning |
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bendazoles treat...
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a worm will EAT what it EATS
enterobius ascaris trichinella echinococcus ancyclostoma/necator taenia solium strongyloides |
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pyrantel pamoate:
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as the Cyclist Entered, the
Americans got Scared ancyclostoma enterobius necator Americanus ascaris |
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diethylcarbamazine:
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i Woke up feeling Low and Toxic
wuchereria bancrofti loa loa toxocara canis |
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praziquantel:
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Praziquantel Destroys These Slimy Cestodes
*Paragonimus westermani Diphyllobothrium latum Taenia solium *Schistosoma *Clonorchis sinensis * actually trematodes |
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intestinal nematodes
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enterobius vermicularis
ascaris lumbricoides trichinella spiralis strongyloides stercoralis ancyclostoma/necator |
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tissue nematodes
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dracunculus medinensis
onchocerca volvulus loa loa wuchereria bancrofti toxocara canis |
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cestodes
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taenia solium
diphyllobothrium latum echinococcus granulosus |
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trematodes
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schistosoma
clonorchis sinensis paragonimus westermani |
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enterobius vermicularis (4)
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food contaminated with eggs
intestinal infection anal pruritis Scotch tape test |
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enterobius vermicularis Rx
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-bendazoles
pyrantel pamoate |
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ascaris (2)
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intestinal infection
eggs are visible in feces |
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ascaris Rx
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-bendazoles
pyrantel pamoate |
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what organisms are treated by both -bendazoles and pyrantel pamoate?
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Enter, even if you're
Scared. the Strong Americans are actually Tiny enterobius ascaris strongyloides ancyclostoma, necator taenia solium: usually praziquantel; -bendazoles for neurocysticercosis |
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trichinella spiralis (3)
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undercooked meat,
(usually pork) inflammation of muscle (larvae encyst in it) periorbital edema |
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strongyloides stercoralis (5)
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larvae in soil penetrate skin
--> intestinal infection vomiting diarrhea anemia |
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trichinella spiralis rx
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-bendazoles
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use ivermectin for _
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strongyloides stercoralis
onchocerca volvulus |
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strongyloides stercoralis rx
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bendazoles
ivermectin |
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ancyclostoma/necator rx
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bendazoles
pyrantel pamoate |
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pinworms =
hookworms = |
enterobius vermicularis
ancyclostoma/necator |
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ancyclostoma/necator (2)
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larvae penetrate skin of feet
anemia 2^ sucking blood from intestinal walls |
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dracunculus medinensis (3)
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in drinking water
skin inflammation ulceration |
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dracunculus medinensis rx
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niridizole
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onchocerca volvulus (4)
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"blackflies, black skin, black sight"
female blackflies hyperpigmented skin river blindness allergic rxn to microfilaria |
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loa loa (3)
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deer fly, horse fly, mango fly
swelling in skin see worm crawling in conjunctiva |
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wuchereria bancrofti (3)
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female mosquito
blockage of lymphatics --> elephantiasis sxs about 1 year later |
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toxocara canis (3)
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food contaminated with eggs
granulomas (if in retina --> blindness) visceral larva migrans |
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taenia solium (6)
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larvae encysted in undercooked pork
--> intestinal tapeworms ingestion of eggs in food or water contaminated with human feces --> --cysticercosis --neurocysticercosis --mass lesions in brain ("swiss cheese" appearance) |
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diphyllobothrium latum (3)
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larvae in raw freshwater fish
vitamin B12 deficiency --> anemia |
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echinococcus granulosus (3)
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eggs in dog feces
cysts in human liver anaphylaxis if antigens are released from cysts (surgeons inject ethanol before removal to kill daughter cysts) |
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onchocerca volvulus rx
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ivermectin
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loa loa rx
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diethylcarbamazine
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wuchereria bancrofti rx
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diethylcarbamazine
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toxocara canis rx
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diethylcarbamazine
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taenia solium rx
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praziquantel
-bendazoles for neurocysticercosis |
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diphyllobothrium latum rx
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praziquantel
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echinococcus granulosus rx
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-bendazoles
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schistosoma (6)
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snails
cercariae penetrate skin spleen & liver: --granulomas --fibrosis --inflammation chronic s. haematobium: --> squamous cell carcinoma of the bladder |
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___ --> squamous cell carcinoma of the bladder
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chronic schistosoma haematobium
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trematodes
rx? |
schistosoma
clonorchis sinensis paragonimus westermani praziquantel |
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clonorchis sinensis (3)
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undercooked fish
biliary tract inflammation --> pigmented gallstones cholangiocarcinoma |
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paragonimus westermani
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undercooked crab meat
--lung inflammation -->bacterial infection -->hemoptysis |
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nematode routes of infection
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ingested
--enterobius --ascaris --trichinella cutaneous --strongyloides --ancyclostoma, necator you'll get sick if you EAT these these get into your feet from the SANd |
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parasites:
brain cysts, seizures |
taenia solium (cysticercosis)
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parasites:
liver cysts |
echinococcus granulosus
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parasites:
portal hypertension |
schistosoma mansoni
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parasites:
hematuria, bladder cancer |
schistosoma haematobium
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parasites:
microcytic anemia |
ancyclostoma, necator
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scrub typhus is caused by
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rickettsia tsutsugamushi
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_ --> yaws
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treponema pertenue
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