export_cns fungi

Question 1

What is the leading cause of fungal meningitis?

Answer 1

Cryptococcal

Question 2

Coccidioides immitis important feature

Answer 2

Dimorphic; molds in environment, yeast in tissues

Question 3

Cryptococcus neoformans important feature

Answer 3

Encapsulated yeast in both environment and man

Question 4

Coccidioides immitis life cycle

Answer 4

Mold spores inhaled, then converts into a spherule, which produces hundreds of single nucleated spores

Question 5

Coccidial meningitis

Answer 5

Develops slowly

Headache, fever, stiff neck, other neurological signs

Question 6

Treatment for C. immitis

Answer 6

Amphotericin B

Question 7

Cryptococcus is commonly found where?

Answer 7

In soil contaminated with bird droppings

Question 8

Cryptococcal meningitis symptoms

Answer 8

Develops slowly
Bouts of headaches, irritability, dizziness, other CNS

May present over weeks or months

Question 9

Cryptococcus diagnosis

Answer 9

India Ink stain

Question 10

Treatment for Cryptococcal meningitis

Answer 10

Long term treatment of Amphotericin B and fluconazole

Relapse in AIDS patients is common, may require suppressive therapy

Question 11

Rhinocerebral zygomycosis most commonly affects?

Answer 11

Primarily diabetic patients

Question 12

Symptoms of rhinocerebral zygomycosis

Answer 12

Nasal congestion, blood-tinged rhinorhhea, tender sinuses, headache, fever
Can progress to altered mental status, coma, and death

Question 13

Diagnose zygomycoses

Answer 13

Hyphal elements (broad, aseptate, branching at right angles) in clinical material
Culture

Question 14

Treatment for zygomycoses

Answer 14

Amphotericin B

Question 15

Free-living amoeba that can affect the CNS

Answer 15

Acanthamoeba
Naegleria

Balamuthia

Question 16

What does Naegleria cause?

Answer 16

Primary amebic meningoencephalitis (PAM)

Question 17

Symptoms of PAM

Answer 17

Fever, headache, vomiting, confusion

Rapidly progress to coma and death

Question 18

Diagnose Naegleria fowleri

Answer 18

Observation of trophozoites in biopsy material or CSF

Question 19

Treatment of Naegleria fowleri

Answer 19

Infection is usually fatal

Can treat with Amphotericin B, some success is found

Question 20

What do Acanthamoeba and Balamuthia cause?

Answer 20

Granulomatous amoebic encephalitis (GAE)

Question 21

Symptoms of GAE

Answer 21

Amoeba invade brain and cause a slow-developing ulcerative lesion
Slower course of disease than PAM

Question 22

Acanthamoeba keratitis

Answer 22

Chronic infection of the cornea, associated with contact lens usage

Question 23

Toxoplasma gondii symptoms

Answer 23

Majority of people are asymptomatic
Ocular infections

Encephalitis in immunocompromised

Question 24

Congenital Toxoplasma gondii

Answer 24

Can result in miscarriage or stillbirth

Blindness, mental retardation, neurological disorders if baby makes it to term

Question 25

Toxoplasmosis symptoms

Answer 25

Most are asymptomatic | "Flu like" - fever, headache, chills, lymphadenopathy

Question 26

Toxoplasma gondii life cycle

Answer 26

Parasite infects, then differentiates/disseminates to the muscle, brain, etc. Immune system "walls off" bradyzoite-filled cyst Immune weakness can result in reactivation

Question 27

Diagnose Toxoplasma gondii

Answer 27

PCR of amniotic fluid Maternal IgM or rising IgG (acute) IgM positive in newborn indicates congential, however not all affected are IgM positive

Question 28

Taenia solium disease

Answer 28

Pork tapeworm

Question 29

Taenia solium dissemination

Answer 29

Larvae hatch in intestines and enter circulation Travel to various body sites where they encyst Creates a space filling lesion, inducing local inflammation

Question 30

Neurocysticercosis symptoms

Answer 30

Seizure and neurological defects

Question 31

Diagnose Taenia solium

Answer 31

CT scan, MRI, serology

Question 32

What disease does Ascaris lumbricoides cause in the CNS?

Answer 32

Visceral larval migrans (VLM)

Question 33

What kind of disease is VLM?

Answer 33

Zoonotic; infection by worms that normally infect dogs and cats

Question 34

VLM transmission

Answer 34

Ingestion of eggs

Question 35

VLM life cycle

Answer 35

Humans ingest eggs, larvae hatch and enter bloodstream, can't develop in humans so granulomatous lesions develop (commonly in liver, lung, and eye)

Question 36

Symptoms of VLM

Answer 36

Fever and eosinophilia

Question 37

Treatment of VLM

Answer 37

Primarily symptomatic | Steroids