Term
| What fungal infections can be found in a normal host (not immunocompromised)? |
|
Definition
| the dimorphic fungi and aspergillus |
|
|
Term
| What do you need to have a definitive diagnosis of candida? |
|
Definition
| need a tissue biopsy showing yeast |
|
|
Term
| How can candida cause pneumonia in an immunocompromised host? (2) |
|
Definition
| aspiration of oral secretions or hematogenously |
|
|
Term
| Why can't a sputum culture diagnois candida infection? |
|
Definition
| b/c candida is natural flora |
|
|
Term
| Where is aspergillus found in the environment? |
|
Definition
| mulch, plants, construction sites |
|
|
Term
| What is the most common method of entry of aspergillus? What are two other methods? |
|
Definition
most common is inhalation
also can be acquired cutaneously or by GI |
|
|
Term
| What are the host defenses to aspergillus? (3) |
|
Definition
mucosa (antimicrobials and mechanical)
macrophages and neutrophils |
|
|
Term
| What stage in the lifecycle of aspergillus do the macrophages attack? |
|
Definition
|
|
Term
| What type of fungus is aspergillis? |
|
Definition
|
|
Term
| What two filamentous fungi were studied in this lecture? |
|
Definition
| aspergillus and zygomytes |
|
|
Term
| What two yeasts were studied in this lecture? |
|
Definition
| candida and cryptococcus neoformans |
|
|
Term
| What life stage of aspergillis do the neutrophils target? |
|
Definition
|
|
Term
| What receptors are on the surface of the epithelial cells that sense aspergillus? |
|
Definition
|
|
Term
| What disease is due to a deficiency of NADPH oxidase? |
|
Definition
| chronic granulomatous disease |
|
|
Term
| What is allergic bronchopulmonary aspergillosis? |
|
Definition
| a non-invasive over inflammatory response to aspergillis |
|
|
Term
| What level of immunity does allergic bronchopulmonary aspergillosis occur in? |
|
Definition
|
|
Term
| What is the treatment for allergic bronchopulmonary aspergillosis? (2) |
|
Definition
|
|
Term
| What is the central T cell response to allergic bronchopulmonary aspergillosis? |
|
Definition
|
|
Term
| What happens to the risk of invasive aspergillus with length of neutropenia? |
|
Definition
|
|
Term
| Why is there an incresased risk of invasive aspergillus with acute leukemia as opposed to solid tumors? |
|
Definition
| b/c the length of neutropenia is longer in leukemias compared to solid tumors |
|
|
Term
Why are there two peaks in occurance of invasive aspergillis in stem cell transplant patients?
what is the reason for the two increases in occurance |
|
Definition
b/c there are two times in which they are neutropenic
once at beginning when they get their transplant
and then during graft vs. host when they are treated with steriods |
|
|
Term
| In stem cell transplant patients, what causes the neutropenia in graft vs. host? |
|
Definition
|
|
Term
| How can you prevent invasive aspergillus? (2) |
|
Definition
HEPA filters
antifungal prophylaxis |
|
|
Term
| What is the best way to diagnois aspergillosis? |
|
Definition
|
|
Term
| What does zygomycosis cause? (2) |
|
Definition
rhinocerbral invasion
pulmonary
|
|
|
Term
| What patients are zycomycoses infections unique to? (2) |
|
Definition
Diabetics
iron overloaded patients |
|
|
Term
| What is the treatment of zycomycoses? (2) |
|
Definition
Amphotericin B
emergency debridement |
|
|
Term
| What are the two dimorphic fungi discussed in this lecture? |
|
Definition
coccidiodes immitis
histoplasma capsulatum |
|
|
Term
| When is a dimorphic fungi yeast and when is it a mold? |
|
Definition
yeast at high temps
mold at low temps |
|
|
Term
| How do you acquir a dimorphic fungi? (route of transmission) |
|
Definition
|
|
Term
| Where is histoplasmosis found in the US? |
|
Definition
|
|
Term
| Where is blastomyces found in the US? |
|
Definition
|
|
Term
| Where is coccidiodes found in the US? |
|
Definition
|
|
Term
| Who has a higher likelihood of developing disseminated dimorphic fungi infections? |
|
Definition
|
|
Term
| What is the most usually clinical manifestation of dimorphic fungi? |
|
Definition
| no clinical presentation: usually asymptomatic |
|
|
Term
| What are the risk factors for coccidiodes immitis (4)? |
|
Definition
immunodeficient
elderly
pregnant
asian/AA |
|
|
Term
| What ethnic groups are at risk for coccidiodes immitis? (2) |
|
Definition
|
|
Term
| Where does coccidiodes immitis like to infect? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Explain the pathologic characteristic of the coccidioides organism? |
|
Definition
| spherules with yeast inside |
|
|
Term
| What is the treatment option for the assymptomatic dimorphic fungi? |
|
Definition
| there is no treatment option |
|
|
Term
| What is the treatment option for coccidioides? |
|
Definition
itraconazole
fluconazole
amphotericin B |
|
|
Term
| What dermatologic rash can accompany coccidioides inflammation reaction? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Where does histoplasmosis disseminate to? (3) |
|
Definition
|
|
Term
| Prior to dissemination, what does histoplasmosis cause? (3) |
|
Definition
pulmonary infiltrates
fever
acute sepsis syndrome |
|
|
Term
| What is the treatment of histoplasmosis? |
|
Definition
amphotericin B
itraconazole |
|
|
Term
| What stain is needed to detect histoplasmosis? |
|
Definition
|
|
Term
| What pattern is seen on chest xray of histopalasmosis? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| What fungal infection can produce asymptomatic infection all life long? |
|
Definition
|
|
Term
| Why is TB and histoplasmosis often in the same differential diagnosis? |
|
Definition
|
|
Term
| What is the most comon manifestation of cryptococcus neoformans? |
|
Definition
|
|
Term
| How is cryptococus neoformans acquried? |
|
Definition
|
|
Term
| What fungi causes pneumonia, ocular, hematogenous, and skin involvment? |
|
Definition
|
|
Term
| Why have cryptococcus and pneumocystis jiroveci decreased in incidence? |
|
Definition
|
|
Term
| In what patients is pneumocystis jiroveci seen in? |
|
Definition
|
|
Term
| What fungi produces acute sepsis syndrome? |
|
Definition
|
|
