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Flashcards in fungal infection 3 Deck (24)
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1

what is a primary pathogen that acts more like an opportunistic pathogen

cryptococcus

2

what are the 2 pathogenic species of cryptococcosis

Cryptococcus neoformans (most common)
Cryptococcus gaittii

3

how does cryptococcosis infect people, who is at high risk for this type of infection

inhalation of organism
AIDS patients

4

where is cryptoccoccosis typically found outside of the human body

soil and pigeon droppings

5

what is the pathogenesis involved in cryptococcis infection

1. inhalation
2.yeast particles rehydrate in alveoli
3. capsules form resisting phagocytosis
4. macrophages carry pathogen via bloodstream to lymph nodes and meninges

6

where is a culture typically taken to diagnose cryptoccocal infections

CSF; always starts in lungs but meningitis is very common

7

what are the symptoms of non-AIDs dissimenant cryptococcosis

headache
fever
n/v
mental status changes
neck stiffness

8

what are the symptoms of AIDs pt. dissimenant cryptococcosis

fever and headache

9

what are the symptoms of non-AIDs dissimenant cryptococcosis that are uncommon in AIDs patients

meningismus and photophobia

10

primary cryptococcosis in humans almost always occurs where? how is this typically treated if asymptomatic?

in the lungs
usually resolves itself spontaneously

11

how is cryptococcosis diagnosed

india ink staining (stain the background, not the organism)

12

what levels of cryptococcal antigens indicates a diagnosis

>1:4 = infection
>1:8 = active disease

13

a pt. with isolated pulmonary disease and mild to moderate symptoms of cryptococcal infection should be treated how?
for what duration?

fluconazole 200-400 mg daily
3-6 months

14

a pt. with isolated pulmonary disease and severe symptoms of cryptococcal infection should be treated how?
for what duration?

amphotericin B
until a cumulative dose of 1-2 grams is given
(may also be used if pt. is mild but can't take azoles)

15

what are the 3 different strategies for treating a cryptococcal infection in the CNS?

1. induction phase - rapid fungicidal activity
2. consolidation phase - to achieve remission
3. maintenance phase - to prevent relapse

16

what is the induction phase treatment for HIV infected patients who have aCNS cryptococcal infection?
duration?

amphotericin B plus flucytosine
2 weeks

17

what is a risk for flucytosine

cardiac problems

18

if renal dysfunction is a concern, what is the induction phase treatment for HIV infected patients who have a CNS cryptococcal infection?

lipid formulation of ampho B

19

If flucytosine intolerant, what is the induction phase treatment for HIV infected patients who have a CNS cryptococcal infection?

treat with amphotericin monotherapy

20

what is the consolidation phase treatment for HIV infected patients who have a CNS cryptococcal infection?

high dose fluconazole

21

what is the maintenance phase treatment for HIV infected patients who have a CNS cryptococcal infection?

low dose fluconazole

22

what is the induction phase treatment for transplant patients who have a CNS cryptococcal infection?

amphotericin B plus flucytosine

23

what is the consolidation phase treatment for transplant patients who have a CNS cryptococcal infection?

high dose fluconazole

24

what is the maintenance phase treatment for transplant patients who have a CNS cryptococcal infection?

low dose fluconazole