Term
| What is the most common fungal infection? What is the most common species? |
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Definition
| Candidiasis, Candida albicans |
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Term
| What are meds are risk factors for candidiasis? |
|
Definition
| Broad spectrum Abx, corticosteroids |
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Term
| What medical procedures are risk factors for candidiasis? |
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Definition
| indwelling catheters, mech. vent., recent surgery, HD |
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Term
| What medical conditions are risk factors for candidiasis? |
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Definition
| malignancies, RF, neutropenia, burns, trauma, HIV/AIDS |
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Term
| Descrobe cutaneous clinical presentation of candidiasis. |
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Definition
| Gen. pruritic erythematous rash with distinct border, worse in axillae, hands, feet, and folds |
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Term
| Describe candidiasis on the oropharynx. |
|
Definition
| Thrush - sore, painful mouth, burning tongue, dysphagia, whitish thick patches on oral mucosa |
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Term
| What is another name for chronic atrophic candidosis? |
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Definition
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Term
| Describe clinical signs of esophagitis from candidiasis. |
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Definition
| Dysphagia, odynophagia, retrosternal and/or epigastric pain, N/V |
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Term
| Describe vulvovaginitis d/t candidiasis. |
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Definition
| vulvar pruritus, thick curd-like discharge, dysuria, dyspareunia |
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Term
| What is chronic mucocutaneous candidiasis thought to be due to? What is it typ. associated with? |
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Definition
| Defect in T cell, endocrinopathies (DM, Addisons, hypothy, hypopara) |
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Term
| What are s/sx of candidemia? |
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Definition
| Fever, macronodular skin lesions, eye/retinal lesions |
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Term
| What are complications of disseminated systemic candidiasis? |
|
Definition
| Endocarditis, meningitis, hepatosplenic candidiasis, UTI, peritonitis |
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Term
| 6 diagnostic test for candidiasis? |
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Definition
| 1) KOH prep 2) Blood culture 3) Urinalysis 4) Serum beta-D-glucan detection assay 5) Endoscopy (poss. bx) 6) Ophthalmologic exam if severely ill |
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Term
|
Definition
| 1) Clotrimazole 2) Nystatin (swish and swallow) |
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Term
| What should AIDS pt w/ thrush be tx w/? |
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Definition
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Term
| Tx for vaginitis, esophagitis, candidemia, and focal invasive infxn (UTI) d/t candidiasis? |
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Definition
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Term
| Tx for candidemia if fluconazole has been used previously? |
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Definition
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Term
| Tx for endocarditis d/t candidiasis? |
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Definition
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Term
| Etiology of crytococcosis? What is the major pathogenic member of the genus? |
|
Definition
| encapsulated yeast, C. neoformans |
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Term
| What is the only form of cryptococcus to infect humans? |
|
Definition
| asexual - reproduces by budding |
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Term
| Where are variety grubii and variety neoformans (cryptococcus) found? |
|
Definition
| worldwide in soil contaminated by bird dropping (chicken and pigeons), roosting sites, and rotting vegetation |
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|
Term
| Where is variety gatti (cryptococcus) found? |
|
Definition
| flowering river red gum and forest red gum trees |
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Term
| Pts w/ what dz account for 50% of cryptococcal infxns? |
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Definition
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Term
| Name 4 other conditions that are likely to acquire crytococcal infxns? |
|
Definition
| 1) Prolonged steroids 2) organ transplant 3) malignancy 4) sarcoidosis |
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|
Term
| What variety of cryptococcus is commonly found in non-immunocompromised pts? |
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Definition
|
|
Term
| What is a common clinical manifestation of cryptococcal infxn w/ variety gattii? |
|
Definition
| cryptococcomas (large mass lesions in brain) |
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|
Term
| What geographical locations is variety gattii found? |
|
Definition
| N. Africa, mediterranean, India, SE Asia, Australia, Mexico, Brazil, Paraguay, S. California |
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Term
| Clinical manifestations of pulmonary cryptococcosis? |
|
Definition
| poss. asymptomatic in healthy, or invasive chronic pulm. dz that disseminates to CNS |
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Term
| Nsme 3 CNS dz d/t cryptococcus? who are sx generally worse in? |
|
Definition
| Meningitis (85%), menigoencephalitis, crytococcoma. Worse in non-immunocompromised |
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|
Term
| Clinical manifestation of cutaneous cryptococcus? |
|
Definition
| cellulitis, ulcerated or nodular lesions, poor prognosis in disseminated dz |
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|
Term
| Clinical manifestations of bone and joint dz in cryptococcal infxn? |
|
Definition
| lytic lesions in 10% of disseminated dz |
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|
Term
| Diagnostic tests for cryptococcus? |
|
Definition
| LP (CSF - gluc and prot abnormal, elev. WBC), India ink stain, crytococcal antigen assay |
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|
Term
|
Definition
| Amphotericin B X 2wks, +/- 2wks Flucytosine, Flucytosine X 10wks |
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Term
| What additional tx is needed in HIV/AIDS pts for crytococcus? |
|
Definition
| Flucytosine for life-long suppression |
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Term
| Tx for elevated ICP in cryptococcus? |
|
Definition
| Large volume (30-50ml) CSF removed prn, shunt or drain placement |
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Term
| Name 5 poor prognostic factors for cryptococcus infxn. |
|
Definition
| 1) CSF WBC <20 2) Initial CSF or serum antigen titer >1:32 3) Additional extraneural sites involvement 4) Elevated opening pressure 5) Persistently low CSF gluc |
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|
Term
| 2 preventive measures for cryptococcal infxn? |
|
Definition
| 1) Remove pigeon roosts near human dwellings 2) Educate HIV/AIDS pts to seek medical attention if severe HA or other neurologic sx |
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