Fungal and parasites of the CNS Flashcards Preview

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Flashcards in Fungal and parasites of the CNS Deck (83):
1

What are the systemic fungal infections that can cause CNS infections? (5)

Histoplasma
Blastomyces
Paracoccidioides
Coccidioides
Cryptococcus

2

What is the most common fungal cause of meningitis? Second most common?

1. Cryptococcal
2. Coccidiodies

3

Are the fungi that cause systemic diseases opportunistic?

no

4

How are fungi infections started?

Through inhalation

5

What is the form that coccidioides immitis infects?

Yeast

6

What is the only encapsulated yeast?

Cryptococcus neoformans

7

Where is coccidioides immitis found in the world? Why?

Desert southwest d/t drought-rain-drought pattern

8

What is the morphology of coccidioides immitis?

Spherules

9

What are the symptoms of coccidioidomycosis?

Usually asymptomatic

Mild to moderate pulmonary disease

10

How does coccidial meningitis present, relative to bacterial meningitis?

Same symptoms, but much slower onset

11

How do you diagnose coccidioidomycosis meningitis?

Antigen detection
Serology

12

What is the treatment for coccidioidomycosis meningitis?

Amp B

13

Can you cultivate coccidioidomycosis

rarely

14

Which fungus is NOT dimorphic? Why?

Cryptococcus neoformans b/c it is encapsulated

15

India ink stain?

Cryptococcus neoformans

16

Where is Cryptococcus neoformans found?

Bird droppings, soil

17

What are the symptoms of infx with Cryptococcus neoformans usually? What about for meningeal infections?

Mild pulmonary disease (or none)

Slow meningitis symptoms

18

What population are we concerned about with Cryptococcus neoformans infections (cryptococcosis)?

AIDS/ immunosuppressed

19

How do you diagnose Cryptococcus neoformans? How sensitive is this?

India ink stain
Serology


Only 50%

20

What is the treatment for Cryptococcus neoformans infections of the CNS?

Long term Amp B and 5-fluorocytosine

21

What causes rhinocerebral mucormycosis? Who is usually infected with this?

Zygomycetes

DM pts usually get these

22

What are the symptoms of rhinocerebral mucormycosis?

Rhinitis
CNS symptoms

23

What are the three molds that cause zygomycosis?

Rhizopus
Absidia
Mucor

24

Are zygomycetes septate? Broad or narrow?

Broad, aseptate

25

How do you diagnose zygomycosis?

Culture confirmation

26

What is the treatment for zygomycosis?

Amp B

27

What is the parasite that causes GI symptoms, and can also cause CNS infections?

Entamoeba histolytica

28

What do entamoeba histolytica cause in the brain?

Abscesses

29

What does trypanosoma brucei cause?

Sleeping sickness

30

What does plasmodium falciparum cause?

Cerebral malaria

31

What causes cerebral malaria?

Plasmodium falciparum

32

What causes sleeping sickness?

Trypanosoma brucei

33

What causes neurocysticercosis?

Pork tapeworm
(Tenia solium)

34

What are the three genera of amoeba that cause infections in man?

Acanthamoeba
Naegleria
Balamuthia

35

Where are the opportunistic amoebas found in the environment?

Fresh water

36

What is primary cause of primary amebic meningoencephalitis (PAM)?

Naegleria

37

How is Naegleria acquired?

Snorting water while swimming

38

What are the symptoms of Naegleria infections?

Fever, HA, CNS, death

39

What are the amoebas associated with Neti Pot use?

Naegleria fowleri

40

How do you diagnose naegleria fowleri?

Trophozoites in CSF

41

True or false: Infection with naegleria fowleri is usually fatal

True

42

How do you treat naegleria fowleri infections?

Amp B... maybe

43

What causes granulomatous amoebic encephalitis (GAE)?

Acanthamoeba and balamunthia

44

What is the pathology of acanthamoeba and balamunthia?

Amoebas invade the brain, resulting in slow CNS involvement and ulcerative lesions

45

What is acanthamoeba keratitis? What are infections associated with?

Chronic infection of the cornea, associated with contact lenses

46

What are the symptoms of acanthamoeba keratitis?

Corneal ulceration and ocular pain

47

How does acanhamoeba appear under a microscope?

Stop-sign appearance

48

How does toxoplasma gondii move about?

Sporozoan (tank tread)

49

Where are toxoplasma cysts found?

Cat litter
Garden vegetables

50

What does the TORCH test used on pregnant women screen for?

Toxopalsma
Other
Rubella
CMV
Herpes

51

True or false: infections with toxoplasma gondii are usually fatal?

False- usually asymptomatic

52

What can toxoplasma lead to if a pt becomes immunosuppressed?

Encephalitis

53

What are the congenital symptoms of toxoplasmosis gondii?

Blindness
MR
Neuro disorders

54

What are the ocular signs of toxoplasmosis?

Small, asymptomatic scarring

55

What do the toxoplasma lesions look like on a CT?

Ring enhanced lesion

56

How does transmission of toxoplasma gondii occur? (2)

Ingestion of cysts through meats

Cat litter

57

What are the definitive hosts for toxoplasma gondii?

cats

58

How are cats infected with toxoplasma?

Infected rodents

59

When are congential transmission of toxoplasma concerning?

When **primary** infection occurs during pregnancy--later the better

60

What are the symptoms of toxoplasmosis, if it is symptomatic at all?

Flu-like

61

When, besides pregnancy, it toxoplasmosis concerning? What can it cause?

Immunosuppression

Encephalitis

62

How do you diagnose toxoplasmosis? (3)

1. PCR testing
2. IgM or rising IgG in mother
3. IgM in newborn

63

How do you prevent toxoplasmosis?

Cook meat
Avoid cat feces

64

What is the treatment for toxoplasmosis? When?

Treat mothers

65

What causes neurocysticercosis?

Tenia solium

66

What are the GI symptoms of tenia solium?

Diarrhea

67

What is the main pathology with cystercercosis?

Lesions in vital organs

68

What are the symptoms of neurocysticercosis?

Szs, neuro stuff

69

What population gets neurocysticercosis?

immigrants

70

How do you diagnose neurocysticercosis?

Serology
MRI

71

What is the main disease that is associated with ascaris lumbricoides?

Intestinal disease

72

What causes visceral larval migrans?

Ascarid worms (similar to Lumbricoides) from dogs/cats

Toxocara canis/cati

73

What is the mech of transmission of visceral larval migrans?

Ingestion of eggs via dog/cat poop contamination

74

What happens in infections with visceral larval migrans?

Granulomatous lesions in vital organs d/t larval death

75

What are the symptoms of visceral larval migrans?

Depend on location of granuloma development

76

How do you diagnose visceral larval migrans?

Eosinophilia
Serology

77

Can you diagnose viceral larval migrans via fecal cysts?

No, because there are no cysts

78

What is the treatment for visceral larval migrans?

Symptomatic (steroids)

79

Sphereules = ?

Coccidioides immitis

80

Broad, aseptate hyphae, branching at 90 degree angles = ?

Zygomycoses

81

Septate hyphae, branching at 45 degree angles = ?

Aspergillus

82

What two places in the body does acanthamoeba infect?

Eye (acanthamoeba keratitis) and brain (GAE)

83

Stop-sign appearing amoeba = ?

acanthamoeba