Term
| What type of patient does Cryptococcus effect? |
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Definition
| immunocompromised with depressed T-cell immunity |
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Term
| How do these patients present? |
|
Definition
| Disseminated infection, frequently causing meningoencephalitis. |
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Term
| How does Cryptococcus effect generally healthy patients. |
|
Definition
| Pneumonia that is self-limited |
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Term
| How do you diagnose cryptococcosis? |
|
Definition
Fungal culture and antigen testing (CSF, blood, sputum)
Silver stain biopsies
India ink may show halo secondary to the capsule |
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Term
| How is cryptococcosis treated? |
|
Definition
Fluconazole 6-12 months for mild disease
Amphotericin (+/- flucytosine) in immunocompromised hosts and CNS infection. This is followed by long-term fluconazole |
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Term
| Who does histoplasmosis affect? |
|
Definition
| Both healthy and immunocompromised patients. |
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Term
| How does Histoplasmosis present? |
|
Definition
| Respiratory illness, but can be disseminated in the immunocompromised. |
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Term
| What does disseminated histoplasmosis look like? |
|
Definition
Mouth ulcers, fever, weight loss, splenomegaly, anemia, and elevated ESR
Hx of travel to Ohio/Mississippi or exposure to bat guano, bird excrement, or construction sites. |
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Term
| How do you diagnose Histoplasmosis? |
|
Definition
| Silver staining and culture of biopsied infected tissue, but histoplasma antigen tests of urine and serum are available. |
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Term
| How do you treat histoplasmosis? |
|
Definition
Mild cases in healthy pts don't require treatment.
Amphotericin is used in severe cases and itraconazole can be given if there is NO CNS involvement |
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Term
| Who does coccidioidomycosis effect? |
|
Definition
| immunocompromised, but not exclusively |
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Term
| How does coccidioidomycosis present? |
|
Definition
Primary disease is usually self-limited pneumonitis with dry cough and fever.
Disseminated disease affects the CNS, skin, bones, and joints
Hx of visit to SW US |
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Term
| How is coccidioidomycosis diagnosed? |
|
Definition
| Silver stain of culture or biopsy, serologic studies or antibody detection in CSF if meningitis is present. |
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Term
| How is coccidioidomycosis treated? |
|
Definition
| Fluconazole and amphotericin if disease is progressive or disseminated OR if the patient is immunocompromised |
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