Fungal Meningitis Flashcards
(22 cards)
fungal meningitis usually occurs in
ImmunoC pt.’s
rare overall
from bStream to CNS
requires dissemination
are fungal infections contagious
no
antigen detection test available for which agent
Cryptococcus
most common agent for fungal meningitis
cryptoccus neoformans
name the agents that can cause meningities
candida-nosocomial aspergillus coccidiodes histoplasma blasotmyces zygomyces
recently
Exserohilum rostratum-contaminated steroid preps-BLACK MOLD
Cryptococcosis most commonly in what patients base
HIV/AIDS-75% of cases
C neoformans most common-OPPORTUNISTIC
c gaddi-most in otherwise healthy individuals
Cryptococcus neformans found in
pidgeon droppings
transfer via inhalation
non opportunistic cryptococcus that infects healthy hosts
c. gaddi
is c neoformans dimorphic
no-it is always in the encapsulated yeast
most important virulence factor for c neoformans
capsule- antiphagocytic
these capsular antigens are used to diagnose
initial infection of c neoformans
pulmonary and usually asymptomatic
only in immuno c will it go critical and become meningitis
almost certainly fatal in untreated
diagnose c neoformans by
sampling csf and staining with india ink
india ink halos
diagnostic for c neoformans via the thick capsule preventing the india ink from invading the encapsulated yeast
most sensitive method of c neoformans dx
rapid antigen testing of csf
tx of c neoformans
ampho b and flucytosine
systemic tx of c neoformans
ampho b will be effective but ot cross BBB
cns infectiion of c neoformans requires what drug
flucytosine-this one can cross BBB, ampho B cannot
steroid associated meningitis caused by
Exserohilum rostratum
Exserohilum rostratum dx via
analysis of CSF
PCR (CDC only)
and culture
tx of Exserohilum rostratum meningitis
voriconazole IV for 3 months
severe- ampho B for 3 months
injected but asymptomatic should be observed only
meningitis cases of Exserohilum rostratum are from ….
epidural injections
if in a joint will only cause local infection
injection patient with contamination by Exserohilum rostratum what is the protocol
monitor very closely for ANY meningitis symptoms
be quick to take CSF sample
if there is 5 or more WBC’s in the sample–> they get ampho B as well
