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244 Cards in this Set

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What does fungi have in the membrane?
Ergosterol lipid
Fungi Like what type of environment?
Warmth and Moisture (btwn skin folds, groin, axilla, vagina), loves sugar (think diabetic pt)
How do fungi stain?
Methenamine silver stains
Best preventative measure for fungal infection?
Keep area cool, dry and control sugar
Polyene Antifungals mechanism of action
BIND ergosterol→ pores in fungal wall. Nystatin (Topical), Amphotericin B (Systemic)
Azole antifungals m.o.a.
INHIBIT ergosterol Synthesis
Topical Azoles
Miconazole, Clotrimazole, Econazole
Systemic Azoles
Ketoconazole, Itraconazole, Fluconazole
Mictrotubule inhibitor antifungal
Griseofulvin (fat soluble)
Anti-metabolite Antifungal
Terbinafine, Flucytosine
Terbinafine treats
Cutaneous fungi
Flucytosine MOA
Stops DNA replication (given w/ Amphotericin B)
Topical Antifungals Mechanism of Action
Do not get absorbed. BIND to Ergosterol→ punch holes in cell membrane→ K+leak out, N+ leak IN→ cell swells→Lysis of cell
Topical Antifungal Drugs
Nystatin, Clotrimazole, Econazole, Tinactin, Micatin, Miconazole
Topical Antifungals Side Effects
Erythema of Skin; Rash
What drug would you give for a systemic fungal infection?
amphotericin B (IM/IV) + Flucytosine then send home w/ oral antifungal for 2 weeks
Amphotericin B Mechanism of action
Also BINDS to Ergosterol, but also pokes holes in CHOLESTEROL (human cell membrane)
Amphotericin B MC SE
#1 MC- Hyperkalemia (systemic toxicity b/c pokes holes in cells in body→ K+ leaks out in plasma)
Amphotericin B SE
#1-Hyperkalemia (systemic toxicity) #2- HYPOkalemia (renal toxicity→ K+ leak out in urine) #3- Renal Failure (loosing K+ less likely to depol) #4-SIADH (occasionally)
Ketoconazole
Systemic Azole. Inhibits P450 and 5- α reductase⇒ Gynecomastia, excess menstruation
What antifungal gets the best CNS penetration?
Fluconazole (systemic azole)
1 dose PO tx against Candidiasis (Diflucan)
Fluconazole
Griseofulvin mechanism of action
Fat soluble drug that Inhibits Microtubule (inhibits Mitosis)
What drugs inhibit Ergosterol Synthesis and prevent fungal Ix in HIV pts?
Itraconazole, Ketoconazole, Fluconazole, Griseofulvin
Vincristine, Vinblastine, Colchicine, Paclitaxel all share in common?
Microtuble Inhibitors ( Paclitaxel- only one to inhibit microtubules after they are made)
What antifungal inhibits microtubules?
griseofulvin
4 MC Cutaneous Fungi Ix in general
Dermatophyton (skin), Trichophyton (hair), Epidermaphyton (epidermis), Microsporum
What cutaneous fungi is the only one that is woods lamp positive?
Microsporum
What does Tinea (cutaneous infections) look like under the microscope?
Mold Hyphae in KOH prep, not dimorphic
What is piedre hortae? Treatment
superficial, little black balls on the hair shaft- eats Keratin off of hair shaft. Mc involves Scalp (does NOT enter scalp). Tx: haircut/shave head
How do kids get Piedra?
Wearing eachothers hats
Keratin in hair has what amino acid?
Cysteine
Trichosporon beigelii
Superficial Fungi. Causes White Piedra- little white balls
White Piedra appearance
Nodules are loos aggregates of hyphae and arthroconidia. Easily detach from hair shaft. Color- white to light brown
White Piedra MC infects what areas?
Pubic hair, beard, mustache. May affect also scalp, body and genital area
Tinea capitus affects?
Scalp
Tinea capitis is what kind of fungi? Affects? MC affects who?
Cutaneous. Thick flaky crusty lesions on scalp, hair loss. Lives in Stratum Corneum. Children
Tinea Capitis (Trichophyton) Tx?
Terbinafine
Kerion is a complication of?
=complication of Tinea capitis. Ix of Hair follicles+ secondary Bacterial Infection (Staph aureus)
A complication caused by bacterial Ix (S.aureus) of flaky lesion, swollen lesion underneath is?
Kerion
Kerion Treat:
1. Fungus w/ Griseofulvin (fat soluble- only one can penetrate Stratum corneum). 2. Inflammation (steroids) 3. Bacteria (s. aureus) w/ antibiotic
How does a Kerion present?
Raised, Pus-filled and spony lesions. Classic Clue “SOFT BOGGY mass” underneath crusty lesions
Tinea versicolor clue and causes?
V on back. causes rxn on skin that destroys Melanin (degradation of lipids produce acids that damage melanocytes)
Tinea versicolor is caused by?
Malassezia furfur
Tinea Versicolor appearance?
Hypopigmented macules (varying shades of hypopigmentation/Hyperpigmentation). On Back “V Pattern”- upside down Christmas tree (ie pattern of how sweat runs down back)
“spaghetti and Meatball” appearance on KOH prep , worse in Hot, Humid weather?
Tinea Versicolor
Tinea Versicolor Tx?
Ketokonazole. Griseofulvin 1st line (drink w/ milk), then pt go jog sweat push fungus to surface attacked by drug. 2.5% selenium or “selsun blue”
Tinea Barbae
Looks like “razor bumps” on chin, but if are RED that means fungus in there
Tinea corporis?
on body anywhere (mc face)- ring worm (from cats)
Tinea Corporis Treatment?
Antifungal cream w/ fingertips and NOT scrape lesion in order to limit spread to others
Tinea manis?
“Red appealing” between fingers, digits, finger webs “Maceration”
Tinea nigra?
palms- lines get real dark (flaky lesion on palm of hand and “lifelines” turn black d/t irritation)
Tinea Intertrigo?
Btwn Skin Folds (where skin touches skin)- Armpits, under Breast, Neck (baby w/ big head) , Waste, Large breasted women. Red Macerated area
Tinea cruris?
Jock itch
Tinea pedis?
Between toes (athletes foot) Tx: Terbinafine or Tolnaftate cream
“smells like corn chips”
Tinea Pedis
Tinea unguum?
under nail beds (1 nail affected)= DISCOLORED nail in diabetic. Need to remove nail (turns black)
Cutaneous Fungi Treatment
Topical Clotrimazole (for most), Griseofulvin (best for capitus and versicolor), Selsun Blue (5% selenium), codl water and air to dry.
What are the 2 deep fungi?
Onychomycosis, Candidiasis
What is onychomycosis?
fungus of the ALL your nails. Diabetics. Tx: remove entire nail bed.
Candidiasis is normal flora where? Common sites of it?
Normal Skin Flora, BUT loves mucosal surfaces- GI, Respiratory, and GU tract
Candidiasis is the MCC of?
Vaginaitis (vulvovaginal) in females and Thrush in Neonates- white curdy discharge and itching. MCC of Opportunistic Mycosis (in IC pts)
When does Candidiasis go from being deep fungal to a Systemic fungal infection?
When you are Immunocompromised. (PN, Esophagitis, R.Endocarditis, Abscess, Candidemia (sepsis).
Candidiasis exists as? On LM?
Exist in yeast form (single cell). On LM- Budding Yeast w/ PSEUDOHYPHAE (+KOH)
Diagnostic Test for C. Albicans
Germ Tube Test. At 37 degrees form true Hyphae from yeast
What is the most common cause of vaginitis?
Candidiasis
Vaginitis described as a curdy white discharge is caused by what? Treatment?
Candida- treat with fluconazle (one dose tx)
Vaginitis described as a fishy odor with clue cells is caused by what? Treatment?
Gardnerella- treat with metronidazole
Vaginitis described as a frothy green discharge is caused by what? Treat?
Trichomonas- treat with metronidazole
What fungi can cause Systemic Mycoses?
Histoplasmosis, Blastomycosis, Coccidiomycosis, para-coccidiomycosis
All Systemic Mycoses can cause?
PNEUMONIA and can disseminate
All systemic mycosis are caused by what morphological type of fungi? Except
Dimporphic fungi: cold (20degrees)=MOLD; Heat (37degrees)=YEAST. (except Coccidiomycosis=Spherule (not yeast) in tissue.
How can you differentiate systemic mycosis from TB?
b/c it can mimc TB (granuloma formation) it may like same, but there is NO person-person transmission w/ systemic mycoses.
What fungi is associated with the Midwest, pigeon droppings and bat poop (missisipi river)?
Histoplasmosis (NO CAPSULE!)- only fungus that can live w/in Macrophages! Oral ulcers
Spelunker may get what?
Hes a Cave Explorer. May get Histoplasma Capsulatum
Histoplasma Capasulatum Exists as? On LM?
DIMOPRHIC Fungi. Exist in Yeast form at body temp. on LM→ OVAL YEAST CELLS w/in Macrophages. Does NOT form germ tubes.
What fungi is associated with the northeast and pigeon droppings?
Blastomycosis
Main way to get Blastomyces dermatidis?
Pigeon poop, rotting wood in beaver dam.
How does Blastomyces Dermatides present?
Black nodules on your skin. BIG BROAD BASED Budding Hypahe → Cavitary Lesions (can cause inflammatory lung dz and disseminate to skin and bone—form granulomatous nodules)
Only FUNGI associated with the Southwestrn US?
Coccidiomycosis (likes dry heat)- California
Coccidiomycosis general properties
Broad Based Cavity. Thin wall cavity (can keep off ALL free radicals). Dimporphic Fungi (forms molds at 25degrees, but exist as Spherules in human tissue)
Coccidiomycosis infection rate increased after earthquakes b/c?
Spores in dust are thrown up in air and become spherules in lungs
Soil (arizona), Desert pump Fever, Budding Yeast
Coccidiomycosis
Coccidiomycosis exist as what in human tissue?
Spherules- covered by a capsule + contain Endospores
Only VIRUS that likes southwest?
Hanta Virus (transmitted by rats)
Only BACTERIA that likes Southwest?
Yersinia enterocolitica (transmitted by rats)
What fungi is associated with South America and looks like a ships wheel or mariners wheel?
Paracoccidiomycosis (aka South American Blastomycosis)
What fungi is associated with rose bushes?
Sporothrix
Sporothrix Schenckii Tx
Potassium Iodide (KI) on skin and Ampho B if gets systemic.
What fungi is associated with meningitis in AIDS pts?
Cryptococcus
How is Cryptococcus neoformans acquired?
Inhalation w/ hematogenous dissemination
Cryptococcus Neoformans exist in what form?
Oval Buddying Yeast w/ THICK CAPSULE. Urease Positive
How do you test for Cyrptococcus neoformans?
Culture on Sabouraud’s agar. Stain w/ INDIA INK (clear zone around nucleus=unstained capsule). And LATEX AGGLUTINATION
What does Latex agglutination test detect?
Polysaccharide capsular antigen and is more specific test for Cryptococcus neoformans.
“Soap bubble” lesions in brain
Cryptococcus neoformans
Cyrptococcus neoformans Lung Tx, Meningitis Tx
Lung Tx- Fluconazole. Meningitis Tx: Ampho B/Flucytosine and life long fluconazole
What fungi is associated with moldy hay or basements?
Aspergillus
Aspergillus fmigatus exist in what form?
Only MOLD form (ie True Hypahe).
Aspergillus Fumigatus infection will present how in pt?
Severe Vasculitis (b.c invades BVs). Petechae, purpura, echymosis, Hemoptysis, Pulmonary hemorrhage, Intracerebral hemorrhage
Fungus ball
Aspergillus- lives in Old TB cavity
MCCOD in Aspergillus
Heart failure b/c of Vasculitis
Aspergillus affect on lung?
Can cause Severe Allergic Rxn in Lungs d/t Fibers (Mimics Ashtma**)- PIE Syndrome
Pulmonary Infiltrate w/ Eosinophilia (PIE) can be caused by?
ABPA in (most common)- Allergic BronchoPulmonary Aspergillosis, Loeffler (worms), Churg Strauss
ABPA affects who the most?
CF pts and Asthmatics (5-10% steroid resistant ones). → Proximal Bronchiectasis
What are the lab values in ABPA?
Very high IgE, Eosinophils, IgG, serum Ab to Aspergillus
Churg Strauss
Necrotizing vasculitis, idiopathic; mimcs asthma in kids. P-ANC+, sudden severe asthma in person
Aspergillus Fumigatus Tx
Steroids or Voriconazole if necrotizing
What fungus can cause hepatocellular carcinoma?
Aspergillus (via alfatoxins)
5 parasites that go thru your lung as part of their life cycle:
Aka 5 causes of Loeffler Syndrome. “NASSA”- Necator americanus, Ancylostoma duodenale, Schistomoniasis, Strongyloides, Ascaris lumbricoides
What fungi is found in the nose of diabetic pts?
Rhizor/mucor
Disease mostly in ketoacidotic diabetic and leukemic pts
Mucormycosis
Rhizopus/Mucor exist only in what form? Like to attack what? How do you Diagnos
Mold Form (true hyphae). Eats eyes, Nose Sinus. Dx- Orbital CT. Tx: cut out surgery + ampho B
T-cell defect involving only candidiasis
Mucocutaneous Candidiasis
Macrophage filled w/ histoplasma
Histoplasmosis (smaller than RC)
Broad-base budding
Blastomycosis (same size as RBC)
Spherule filled w/ endospores
Coccidiomycosis (much larger than RBC)
Budding yeast w/ “captain’s wheel” formation
Para-coccidiomycosis (much larger than RBC)
Dimorphic yeast. Pseudohyphae and budding yeasts at 20 degrees, germ tube at 37 degree
Candida albicans
Septate hypahe that branch at acute angles (<45) Conidiophore w/ rare fruiting bodies
Aspergillus
Yeast w/ wide capsular halos and unequal budding in light india ink stain
Cryptococcus neofrmans
Irregular, broad, nonseptate hyphae branching at wide angles
Mucor
Cigar shaped buddying yeast that lives on vegetation
Sporothrix schenckii
What does fungi have in the membrane?
Ergosterol lipid
Fungi Like what type of environment?
Warmth and Moisture (btwn skin folds, groin, axilla, vagina), loves sugar (think diabetic pt)
How do fungi stain?
Methenamine silver stains
Best preventative measure for fungal infection?
Keep area cool, dry and control sugar
Polyene Antifungals mechanism of action
BIND ergosterol→ pores in fungal wall. Nystatin (Topical), Amphotericin B (Systemic)
Azole antifungals m.o.a.
INHIBIT ergosterol Synthesis
Topical Azoles
Miconazole, Clotrimazole, Econazole
Systemic Azoles
Ketoconazole, Itraconazole, Fluconazole
Mictrotubule inhibitor antifungal
Griseofulvin (fat soluble)
Anti-metabolite Antifungal
Terbinafine, Flucytosine
Terbinafine treats
Cutaneous fungi
Flucytosine MOA
Stops DNA replication (given w/ Amphotericin B)
Topical Antifungals Mechanism of Action
Do not get absorbed. BIND to Ergosterol→ punch holes in cell membrane→ K+leak out, N+ leak IN→ cell swells→Lysis of cell
Topical Antifungal Drugs
Nystatin, Clotrimazole, Econazole, Tinactin, Micatin, Miconazole
Topical Antifungals Side Effects
Erythema of Skin; Rash
What drug would you give for a systemic fungal infection?
amphotericin B (IM/IV) + Flucytosine then send home w/ oral antifungal for 2 weeks
Amphotericin B Mechanism of action
Also BINDS to Ergosterol, but also pokes holes in CHOLESTEROL (human cell membrane)
Amphotericin B MC SE
#1 MC- Hyperkalemia (systemic toxicity b/c pokes holes in cells in body→ K+ leaks out in plasma)
Amphotericin B SE
#1-Hyperkalemia (systemic toxicity) #2- HYPOkalemia (renal toxicity→ K+ leak out in urine) #3- Renal Failure (loosing K+ less likely to depol) #4-SIADH (occasionally)
Ketoconazole
Systemic Azole. Inhibits P450 and 5- α reductase⇒ Gynecomastia, excess menstruation
What antifungal gets the best CNS penetration?
Fluconazole (systemic azole)
1 dose PO tx against Candidiasis (Diflucan)
Fluconazole
Griseofulvin mechanism of action
Fat soluble drug that Inhibits Microtubule (inhibits Mitosis)
What drugs inhibit Ergosterol Synthesis and prevent fungal Ix in HIV pts?
Itraconazole, Ketoconazole, Fluconazole, Griseofulvin
Vincristine, Vinblastine, Colchicine, Paclitaxel all share in common?
Microtuble Inhibitors ( Paclitaxel- only one to inhibit microtubules after they are made)
What antifungal inhibits microtubules?
griseofulvin
4 MC Cutaneous Fungi Ix in general
Dermatophyton (skin), Trichophyton (hair), Epidermaphyton (epidermis), Microsporum
What cutaneous fungi is the only one that is woods lamp positive?
Microsporum
What does Tinea (cutaneous infections) look like under the microscope?
Mold Hyphae in KOH prep, not dimorphic
What is piedre hortae? Treatment
superficial, little black balls on the hair shaft- eats Keratin off of hair shaft. Mc involves Scalp (does NOT enter scalp). Tx: haircut/shave head
How do kids get Piedra?
Wearing eachothers hats
Keratin in hair has what amino acid?
Cysteine
Trichosporon beigelii
Superficial Fungi. Causes White Piedra- little white balls
White Piedra appearance
Nodules are loos aggregates of hyphae and arthroconidia. Easily detach from hair shaft. Color- white to light brown
White Piedra MC infects what areas?
Pubic hair, beard, mustache. May affect also scalp, body and genital area
Tinea capitus affects?
Scalp
Tinea capitis is what kind of fungi? Affects? MC affects who?
Cutaneous. Thick flaky crusty lesions on scalp, hair loss. Lives in Stratum Corneum. Children
Tinea Capitis (Trichophyton) Tx?
Terbinafine
Kerion is a complication of?
=complication of Tinea capitis. Ix of Hair follicles+ secondary Bacterial Infection (Staph aureus)
A complication caused by bacterial Ix (S.aureus) of flaky lesion, swollen lesion underneath is?
Kerion
Kerion Treat:
1. Fungus w/ Griseofulvin (fat soluble- only one can penetrate Stratum corneum). 2. Inflammation (steroids) 3. Bacteria (s. aureus) w/ antibiotic
How does a Kerion present?
Raised, Pus-filled and spony lesions. Classic Clue “SOFT BOGGY mass” underneath crusty lesions
Tinea versicolor clue and causes?
V on back. causes rxn on skin that destroys Melanin (degradation of lipids produce acids that damage melanocytes)
Tinea versicolor is caused by?
Malassezia furfur
Tinea Versicolor appearance?
Hypopigmented macules (varying shades of hypopigmentation/Hyperpigmentation). On Back “V Pattern”- upside down Christmas tree (ie pattern of how sweat runs down back)
“spaghetti and Meatball” appearance on KOH prep , worse in Hot, Humid weather?
Tinea Versicolor
Tinea Versicolor Tx?
Ketokonazole. Griseofulvin 1st line (drink w/ milk), then pt go jog sweat push fungus to surface attacked by drug. 2.5% selenium or “selsun blue”
Tinea Barbae
Looks like “razor bumps” on chin, but if are RED that means fungus in there
Tinea corporis?
on body anywhere (mc face)- ring worm (from cats)
Tinea Corporis Treatment?
Antifungal cream w/ fingertips and NOT scrape lesion in order to limit spread to others
Tinea manis?
“Red appealing” between fingers, digits, finger webs “Maceration”
Tinea nigra?
palms- lines get real dark (flaky lesion on palm of hand and “lifelines” turn black d/t irritation)
Tinea Intertrigo?
Btwn Skin Folds (where skin touches skin)- Armpits, under Breast, Neck (baby w/ big head) , Waste, Large breasted women. Red Macerated area
Tinea cruris?
Jock itch
Tinea pedis?
Between toes (athletes foot) Tx: Terbinafine or Tolnaftate cream
“smells like corn chips”
Tinea Pedis
Tinea unguum?
under nail beds (1 nail affected)= DISCOLORED nail in diabetic. Need to remove nail (turns black)
Cutaneous Fungi Treatment
Topical Clotrimazole (for most), Griseofulvin (best for capitus and versicolor), Selsun Blue (5% selenium), codl water and air to dry.
What are the 2 deep fungi?
Onychomycosis, Candidiasis
What is onychomycosis?
fungus of the ALL your nails. Diabetics. Tx: remove entire nail bed.
Candidiasis is normal flora where? Common sites of it?
Normal Skin Flora, BUT loves mucosal surfaces- GI, Respiratory, and GU tract
Candidiasis is the MCC of?
Vaginaitis (vulvovaginal) in females and Thrush in Neonates- white curdy discharge and itching. MCC of Opportunistic Mycosis (in IC pts)
When does Candidiasis go from being deep fungal to a Systemic fungal infection?
When you are Immunocompromised. (PN, Esophagitis, R.Endocarditis, Abscess, Candidemia (sepsis).
Candidiasis exists as? On LM?
Exist in yeast form (single cell). On LM- Budding Yeast w/ PSEUDOHYPHAE (+KOH)
Diagnostic Test for C. Albicans
Germ Tube Test. At 37 degrees form true Hyphae from yeast
What is the most common cause of vaginitis?
Candidiasis
Vaginitis described as a curdy white discharge is caused by what? Treatment?
Candida- treat with fluconazle (one dose tx)
Vaginitis described as a fishy odor with clue cells is caused by what? Treatment?
Gardnerella- treat with metronidazole
Vaginitis described as a frothy green discharge is caused by what? Treat?
Trichomonas- treat with metronidazole
What fungi can cause Systemic Mycoses?
Histoplasmosis, Blastomycosis, Coccidiomycosis, para-coccidiomycosis
All Systemic Mycoses can cause?
PNEUMONIA and can disseminate
All systemic mycosis are caused by what morphological type of fungi? Except
Dimporphic fungi: cold (20degrees)=MOLD; Heat (37degrees)=YEAST. (except Coccidiomycosis=Spherule (not yeast) in tissue.
How can you differentiate systemic mycosis from TB?
b/c it can mimc TB (granuloma formation) it may like same, but there is NO person-person transmission w/ systemic mycoses.
What fungi is associated with the Midwest, pigeon droppings and bat poop (missisipi river)?
Histoplasmosis (NO CAPSULE!)- only fungus that can live w/in Macrophages! Oral ulcers
Spelunker may get what?
Hes a Cave Explorer. May get Histoplasma Capsulatum
Histoplasma Capasulatum Exists as? On LM?
DIMOPRHIC Fungi. Exist in Yeast form at body temp. on LM→ OVAL YEAST CELLS w/in Macrophages. Does NOT form germ tubes.
What fungi is associated with the northeast and pigeon droppings?
Blastomycosis
Main way to get Blastomyces dermatidis?
Pigeon poop, rotting wood in beaver dam.
How does Blastomyces Dermatides present?
Black nodules on your skin. BIG BROAD BASED Budding Hypahe → Cavitary Lesions (can cause inflammatory lung dz and disseminate to skin and bone—form granulomatous nodules)
Only FUNGI associated with the Southwestrn US?
Coccidiomycosis (likes dry heat)- California
Coccidiomycosis general properties
Broad Based Cavity. Thin wall cavity (can keep off ALL free radicals). Dimporphic Fungi (forms molds at 25degrees, but exist as Spherules in human tissue)
Coccidiomycosis infection rate increased after earthquakes b/c?
Spores in dust are thrown up in air and become spherules in lungs
Soil (arizona), Desert pump Fever, Budding Yeast
Coccidiomycosis
Coccidiomycosis exist as what in human tissue?
Spherules- covered by a capsule + contain Endospores
Only VIRUS that likes southwest?
Hanta Virus (transmitted by rats)
Only BACTERIA that likes Southwest?
Yersinia enterocolitica (transmitted by rats)
What fungi is associated with South America and looks like a ships wheel or mariners wheel?
Paracoccidiomycosis (aka South American Blastomycosis)
What fungi is associated with rose bushes?
Sporothrix
Sporothrix Schenckii Tx
Potassium Iodide (KI) on skin and Ampho B if gets systemic.
What fungi is associated with meningitis in AIDS pts?
Cryptococcus
How is Cryptococcus neoformans acquired?
Inhalation w/ hematogenous dissemination
Cryptococcus Neoformans exist in what form?
Oval Buddying Yeast w/ THICK CAPSULE. Urease Positive
How do you test for Cyrptococcus neoformans?
Culture on Sabouraud’s agar. Stain w/ INDIA INK (clear zone around nucleus=unstained capsule). And LATEX AGGLUTINATION
What does Latex agglutination test detect?
Polysaccharide capsular antigen and is more specific test for Cryptococcus neoformans.
“Soap bubble” lesions in brain
Cryptococcus neoformans
Cyrptococcus neoformans Lung Tx, Meningitis Tx
Lung Tx- Fluconazole. Meningitis Tx: Ampho B/Flucytosine and life long fluconazole
What fungi is associated with moldy hay or basements?
Aspergillus
Aspergillus fmigatus exist in what form?
Only MOLD form (ie True Hypahe).
Aspergillus Fumigatus infection will present how in pt?
Severe Vasculitis (b.c invades BVs). Petechae, purpura, echymosis, Hemoptysis, Pulmonary hemorrhage, Intracerebral hemorrhage
Fungus ball
Aspergillus- lives in Old TB cavity
MCCOD in Aspergillus
Heart failure b/c of Vasculitis
Aspergillus affect on lung?
Can cause Severe Allergic Rxn in Lungs d/t Fibers (Mimics Ashtma**)- PIE Syndrome
Pulmonary Infiltrate w/ Eosinophilia (PIE) can be caused by?
ABPA in (most common)- Allergic BronchoPulmonary Aspergillosis, Loeffler (worms), Churg Strauss
ABPA affects who the most?
CF pts and Asthmatics (5-10% steroid resistant ones). → Proximal Bronchiectasis
What are the lab values in ABPA?
Very high IgE, Eosinophils, IgG, serum Ab to Aspergillus
Churg Strauss
Necrotizing vasculitis, idiopathic; mimcs asthma in kids. P-ANC+, sudden severe asthma in person
Aspergillus Fumigatus Tx
Steroids or Voriconazole if necrotizing
What fungus can cause hepatocellular carcinoma?
Aspergillus (via alfatoxins)
5 parasites that go thru your lung as part of their life cycle:
Aka 5 causes of Loeffler Syndrome. “NASSA”- Necator americanus, Ancylostoma duodenale, Schistomoniasis, Strongyloides, Ascaris lumbricoides
What fungi is found in the nose of diabetic pts?
Rhizor/mucor
Disease mostly in ketoacidotic diabetic and leukemic pts
Mucormycosis
Rhizopus/Mucor exist only in what form? Like to attack what? How do you Diagnos
Mold Form (true hyphae). Eats eyes, Nose Sinus. Dx- Orbital CT. Tx: cut out surgery + ampho B
T-cell defect involving only candidiasis
Mucocutaneous Candidiasis
Macrophage filled w/ histoplasma
Histoplasmosis (smaller than RC)
Broad-base budding
Blastomycosis (same size as RBC)
Spherule filled w/ endospores
Coccidiomycosis (much larger than RBC)
Budding yeast w/ “captain’s wheel” formation
Para-coccidiomycosis (much larger than RBC)
Dimorphic yeast. Pseudohyphae and budding yeasts at 20 degrees, germ tube at 37 degree
Candida albicans
Septate hypahe that branch at acute angles (<45) Conidiophore w/ rare fruiting bodies
Aspergillus
Yeast w/ wide capsular halos and unequal budding in light india ink stain
Cryptococcus neofrmans
Irregular, broad, nonseptate hyphae branching at wide angles
Mucor
Cigar shaped buddying yeast that lives on vegetation
Sporothrix schenckii