export_cns fungi

Question 1

Which fungi can cause CNS infections?

Answer 1

Systemic fungi - Histoplasma, Blastomyces, Paracoccidioides, Coccidioides, Cryptococcus

Question 2

What is the leading cause of fungal meningitis?

Answer 2

Cryptococcal

Question 3

Coccidioides immitis important feature

Answer 3

Dimorphic; molds in environment, yeast in tissues

Question 4

Cryptococcus neoformans important feature

Answer 4

Encapsulated yeast in both environment and man

Question 5

Coccidioides immitis life cycle

Answer 5

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

Question 6

Coccidial meningitis

Answer 6

Develops slowly

Headache, fever, stiff neck, other neurological signs

Question 7

Treatment for C. immitis

Answer 7

Amphotericin B

Question 8

Cryptococcus is commonly found where?

Answer 8

In soil contaminated with bird droppings

Question 9

Cryptococcal meningitis symptoms

Answer 9

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

May present over weeks or months

Question 10

Cryptococcus diagnosis

Answer 10

India Ink stain

Question 11

Treatment for Cryptococcal meningitis

Answer 11

Long term treatment of Amphotericin B and fluconazole

Relapse in AIDS patients is common, may require suppressive therapy

Question 12

Rhinocerebral zygomycosis most commonly affects?

Answer 12

Primarily diabetic patients

Question 13

Symptoms of rhinocerebral zygomycosis

Answer 13

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

Question 14

Diagnose zygomycoses

Answer 14

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

Question 15

Treatment for zygomycoses

Answer 15

Amphotericin B

Question 16

Main parasitic infections

Answer 16

Entamoeba histolytica
Trypanosoma brucei

Plasmodium falciparum

Protozoa

Helminth

Question 17

What does entamoeba histolytica cause in the CNS?

Answer 17

Brain abscesses

Question 18

What does Trypanosoma brucei cause in the CNS?

Answer 18

African sleeping sickness

Question 19

What does Plasmodium falciparum cause in the CNS?

Answer 19

Cerebral malaria

Question 20

What do protozoa’s cause in the CNS

Answer 20

Toxoplasmosis

Question 21

What do helminths cause in the CNS?

Answer 21

Cysticercosis

Question 22

Free-living amoeba that can affect the CNS

Answer 22

Acanthamoeba
Naegleria

Balamuthia

Question 23

What does Naegleria cause?

Answer 23

Primary amebic meningoencephalitis (PAM)

Question 24

Symptoms of PAM

Answer 24

Fever, headache, vomiting, confusion

Rapidly progress to coma and death

Question 25

Diagnose Naegleria fowleri

Answer 25

Observation of trophozoites in biopsy material or CSF

Question 26

Treatment of Naegleria fowleri

Answer 26

Infection is usually fatal | Can treat with Amphotericin B, some success is found

Question 27

What do Acanthamoeba and Balamuthia cause?

Answer 27

Granulomatous amoebic encephalitis (GAE)

Question 28

Symptoms of GAE

Answer 28

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

Question 29

Acanthamoeba keratitis

Answer 29

Chronic infection of the cornea, associated with contact lens usage

Question 30

Toxoplasma gondii symptoms

Answer 30

Majority of people are asymptomatic Ocular infections Encephalitis in immunocompromised

Question 31

Congenital Toxoplasma gondii

Answer 31

Can result in miscarriage or stillbirth | Blindness, mental retardation, neurological disorders if baby makes it to term

Question 32

Toxoplasmosis symptoms

Answer 32

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

Question 33

Toxoplasma gondii life cycle

Answer 33

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

Question 34

Diagnose Toxoplasma gondii

Answer 34

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

Question 35

Taenia solium disease

Answer 35

Pork tapeworm

Question 36

Taenia solium dissemination

Answer 36

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

Question 37

Neurocysticercosis symptoms

Answer 37

Seizure and neurological defects

Question 38

Diagnose Taenia solium

Answer 38

CT scan, MRI, serology

Question 39

What disease does Ascaris lumbricoides cause in the CNS?

Answer 39

Visceral larval migrans (VLM)

Question 40

What kind of disease is VLM?

Answer 40

Zoonotic; infection by worms that normally infect dogs and cats

Question 41

VLM transmission

Answer 41

Ingestion of eggs

Question 42

VLM life cycle

Answer 42

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

Question 43

Symptoms of VLM

Answer 43

Fever and eosinophilia

Question 44

Treatment of VLM

Answer 44

Primarily symptomatic | Steroids