Flashcards in Final Exam Review- Fungi and Parasites Deck (43):
Candida albicans type and key concepts
Opportunistic infection. Found in indwelling catheters and parenteral nutrition. Mucocutaneous, esophageal (AIDS), vaginal, cutaneous.
Treatment for C. albicans
Fluconazole, amphotericin, echinocandins.
Opportunistic infection. Leading cause of fungal meningitis. Found in bird droppings. Causes halo shape when stained with India ink. Virulence factors include melanin and phenotypic switching (changes in capsule/cell wall).
Treatment for C. neoformans
Amphotericin, followed by fluconazole
Systemic dimorphic endemic fungus that hides in macrophages. Can be inhaled when spelunking or around bats. Causes necrotizing granulomas, diagnosed with a urine antigen test. Found in Ohio River Valley. Treat with amphotericin or itraconazole.
Treatment for histoplasma capsulatum?
Amphotericin or itraconazole
Systemic dimorphic endemic fungus. Broad based budding. Also found in Ohio River Valley. Causes lung disease. Treat with amphotericin, itraconazole, fluconazole.
Systemic dimorphic endemic fungus. Crowds in southwestern US, spheroid is diagnostic, causes flu-like illness.
Mariner's wheel appearance. Male predominance, causes a cough and necrotizing granulomas. Treat with itraconazole.
Opportunistic and dimorphic. In asia causes umbilicated skin lesions. Treat with amphotericin and 5FC.
Opportunistic infection, common in diabetes, treatment with iron chelators, causes black necrotic lesions. Has wide hyphae with right angle branching. Treat with posaconazole
Treatment for mucormycosis?
Posaconazole - stops angioinvasion and tissue death
and tissue debridement.
Opportunistic fungus with narrow hyphae that branch at acute angles. Has fruiting body. Causes Allergic BP aspergellosis (ABPA) and aspergillomas. Treat by reinstating the immune system, but if severe, try voriconazole.
How to treat aspergillosis?
Voriconazole or immune system reinstatement.
Caused by pneumocystic jiroveci, treat with TMP-SMZ. Common when CD4 <200.
Dermatophyte that causes hypopigmentation (Pityriasis versicolor) and has a spaghetti and meatballs look with KOH stain.
Swollen foot with fungal granules
Rose gardener's disease, lymphangitic spread. Treat with itraconazole.
Apicompexa protozoan. Causes malaria. Fever, shivering, arthralgias, vomiting, end-organ failure, brain damage (infarct). Worst type. This form does not have a hypnozoite form, so primaquine is not useful. Multiply infected RBC's and heavy parasitemia. Transmitted by anopheles mosquitos.
Has hypnozoite form. Can treat with primaquine, will relapse because schizonts will enter bloodstream. Enlarged erythrocytes. Every 48 hours
Trophozoite ring form is oval shaped. Causes malaria, also has hypnozoite form. Treat with primaquine. Every 48 hours
Affects aging RBCs, no hypnozoite form. Band like on peripheral blood smear. Every 72 hours.
Apicomplexa protozoan that is transmitted by ixodes. Commonly affects people from cape cod and hamptons. Impossible to distinguish on PBC from plasmodia Causes wide range of clinical manifestations, mostly flu like, but really affects immunosuppressed and asplenics. Treat with atovaquone and azithromycin.
Fecal-oral transmission (analingus, contaminated water), causes amoebic dysentary (bloody diarrhea). Most asymptomatic though. Has two life forms: multiplying trophozoite and infective cyst. Treat with metronidazole and ionoquinol to kill cysts.
Naeglaria fowleri/ balamuthia mandrillaris/ acanthamoeba
Infect in fresh water, no host-host transmission, usually kill host. Cause meningoencephalitis (innoculate nasopharynx and move to CNS).
Fecal-oral transmission, causes putrid smelling diarrhea that lasts weeks, sulfur burps. Treat with metronidazole. Loss of brush border and inhibition of sucrase and maltase.
Treat with metronidazole, causes green weeping cervical discharge, sexually transmitted.
Spore forming protozoa
Cause watery diarrhea, treat by restoring immune system.
Kinetoplastid protozoan. South America. Multiply in macrophages Transmitted via the sandfly, reservoir is dogs. Can be cutaneous (painless ulcer, think of the vet on vacation), mucocutaneous (spreads to mucous membranes of oropharynx), and visceral (hepatosplenomegaly, AKA DUM DUM FEVER). Treat with pentavalent antimony
Kinetoplastid protozoan. Causes Chagas disease and transmitted by the Reduviid bug. Causes Romana sign (edema of the eye where inoculated), chronic phase marked by megacolon, megaesophagus, cardiomegaly. Treated with Benznidazole and nifurtimox.
Kinetoplastid protozoan (bar-like) transmitted by tse tse fly that causes sleeping sickness. Can be gambiense or rhodiense, but east african is worse. Initially causes winterbottom's sign (inflammation at inoculation site). Then causes personality changes, daytime somnolence, cns penetration. Antigenic variation and replication in bloodstream. Treat with suramin/melarsoprol for rhod. Pentamidine/melarsoprol for gamb.
Kinetoplastid protozoan. Transmitted by cats, can cause congenital infection marked by retardation, choreoretinitis. Ring enhancing lesions in AIDS patients. Treatment with TMP-SMZ
Egg consumption leads to migration through wall up to lungs, causes Loeffler's Syndrome (allergic response to worms in alveoli), then swallowed to gut where they cause obstructions (esp in children) and malnutrition. Treat w/ albendazole and mebendazole
Necatur americanus/ancylostoma duodenale
Hookworms, have 2 pairs of cutting plates, penetrate intact skin, migrate through venous system up to lungs. Swallowed to gut. Important cause of childhood anemia (microcytic), also dog tapeworm (ancylostoma braziliense) causes creeping eruption. Albendazole/mebendazole
Penetrates intact skin, causes superinfection with klebsiella and other gut flora by migrating around walls. Ivermectin, albendazole, mebendazole.
Pinworm, causes perianal itching, use scotch tape to diagnose. Autoinnoculation, eggs hatch and move back in.
Whipworm, causes tenesmus and rectal prolapse. Has polar plugs, also polyparasitism.
Transmitted by mosquitos causes filariasis. Destruction of lymphoid organs and causes elephantiasis by backup. Even after treatment, elephantiasis persists.
Causes river blindness when the worms migrate up to eye. Transmitted by blackfly treat with ivermectin.
Pig tapeworm (cestode), has fewer proglottids but hooked scolex, more uterine branches than beef counterpart. Infects people who eat undercooked pork. Also, neurocysticercosis is cause of adult onset seizures in people who eat food contaminated with feces of people infected. Treat with praziquantel.
Fish cestode, causes macrocytic anemia, treat with praziquantel.
Dog tapeworm transmitted in sheepherders causes hydatid cysts that burst and cause vomica. Treat with albendazole.