ID Flashcards
(40 cards)
Histoplasmosis
Pulmonary/systemic dimorphic fungi
Mississippi/Ohio River valleys, bird/bat droppings
Path: Survives in M-Phages (smaller than RBC)
Tx: fluconazole/itraconazole
Histo lives in histiocytes
Blastomycosis
Pulmonary/systemic dimorphic fungi: inflammatory lung dz, broad dissemination. granulomatous nodules
East of mississippi, central Am
Path: broad-based budding (same size as RBC)
Tx: fluconazole/itraconazole
BBBB
Blast Broad based bud
Coccidioidomycosis
Pulmonary/systemic dimorphic fungi (NB is spherule, not yeast, in tissue): PNA and meningitis
SW, California, incr after earthquake
Path: spherule filled with endospores (larger than RBC)
Tx: fluconazole/itraconazole
I bruised my Coccyx after a Cali Earthquake and had to wear a Sphere cast
Paracoccidioidomycosis
Pulmonary/systemic dimorphic fungi
Latin America
Path: budding yeast with “captains wheel” formation. (much larger than RBC)
Tx: fluconazole/itraconazole
Captain Parasailed to Latin America
Tinea versicolor
Cutaneous mycoses caused by Malassezia furfur hot/humid weather damage to melanocytes Path: "spaghetti and meatball" on KOH Tx: topical miconazole, selenium sulfide
Candida albicans
Opportunistic infection (superficial or systemic)
thrush, vulvovaginitis, chronic mucocutaneous candidiasis
Path: dimorphic yeast. pseudohyphae and budding yeasts at 20C, germ tubes at 37C
Tx: topical azole for vag. fluc or caspo for oral/esophageal. Fluc, ampho, or caspo for systemic
Aspirgillus
Invasive, especially in immunocomporomised and chronic granulomatous dz
ABPA: asthma/CF, post-TB aspergilloma
Some produce aflatoxins –> HCC
Acute angles, septate hyphae. non-dymorphic. Can form conidophore with spores
Cryptococcus
Opportunistic. Meningitis, cryptococcosis
Soil, pigeon droppings.
Path: Sabouraud’s agar, India ink. Latex agglutination. “soap bubbles” in brain
Tx: ampho/flucytosine
Mucor/rhizopus
Opportunistic: DKA, leukemia
Rhinocerebral, frontal lobe abscesses
Headache, facial pain, black necrotic exchar, CN
Path: irregular, broad, nonseptate hyphae at wide angles
Pneumocystis jirovecii
Opportunistic: PCP in AIDS at CD4< 200
Path: disc-shaped yeast on methenamine silver stain
Tx: TMPSMX, pentamidine, dapsone.
PPx at CD4< 200
Sporothrix schenkii
Sporotrichosis. Rose gardener’s dz. Local pustule with nodules along lymphatics.
Path: cigar-shaped budding yeast
Tx: itraconazole or potassium iodide
Giardia
Bloating, flatulance, foul-smelling diarrhea in campers/hikers. Transmitted by cysts in water
Path: trophozoites or cysts in water
Tx: metronidazole
Entamoeba histolica
Amebiasis: bloody diarrhea (dysentery), liver abscess (anchovy paste exudate), RUQ pain. Flask-shaped ulcer if submucosal colonic abscess ruptures
Path: trophozoite (with intracellular RBCs) or multi-nucleated cysts in stool
Tx: metronidazole, iodoquinol for asymptomatic cyst passers
Don’t dys EntaAnchovy, he drinks from a flask, gobbles RBCs, but hates iodine and flagyl.
Cryptosporidium
Severe diarrhea in AIDS
Mild watery diarrhea in noncompromised
Path: cysts on acid fast stain
Tx: filtered water, nitazoxanide in AIDS
Toxoplasma
Protozoa -CNS
Brain abscesses in HIV (ring enhancing)
Triad: chorioretinitis, hydrocephalus, intracranial calcification
Transmitted by cysts in meat or cat feces
Dx: serology, bx
Tx: sulfadiazine, pyrimethamine
Naegleria fowleri
Protozoa - CNS Rapidly fatal meningoencephalitis Freshwater lakes (Nalgene): enters via cribiform plate Dx: amoebas in spinal fluid Tx: Ampho but not usually efective
Trypanosoma brucei, gambiense, rhodesiense
Protozoa -CNS
African sleeping sickness
LAD, recurring fever (antigenic variation), somnolence, coma
vector: tsetse fly (painful bite)
Dx: smear
Tx: Suramin for blood, melarsopol for CNS
“sure is nice to go to sleep. melatonin is helpful”
Plasmodium Vivax/Ovale
Malaria: fever, headache, anemia, splenomegaly
Path: smear. Trophozoite ring, RBC schizont with merozoites
48 hr cycle !!!
dominant form (hypnozoite) in liver
Tx: chloroquine (mefloquin if resistant) add primaquine (test for G6PD)
48 hypnotism? PROVe it to me
Plasmodium falciparum
Malaria: fever, headache, anemia, splenomegaly
Path: smear. Trophozoite ring, RBC schizont with merozoites
Severe, irregular fever patterns, parasitized RBCs occlude capillaries in brain (cerebral malaria), kidneys, lung
Tx: chloroquine (mefloquin if resistant) use IV quinidine in life-threatening (test for G6PD)
Plasmodium malariae
Malaria: fever, headache, anemia, splenomegaly
Path: smear. Trophozoite ring, RBC schizont with merozoites
72 hr cycle (quartan)
Tx: chloroquine (mefloquin if resistant) use IV quinidine in life-threatening (test for G6PD)
Babesia
Protozoa -- heme babesiosis: fever and hemolytic anemia NE USA Asplenia inc risk of severe dz vector: ixodes tick (same as borrelia burgdorferi) Smear: ring form, maltese cross PCR Tx: atovaqone + Azithro
Babes like Limes in Church where they Atone under the Cross.
Trypanosoma cruzi
Protozoa
Chagas dz: dilated cardiomyopathy, megacolon, megaesophagus.
South america
Vector: reduviid bug (kissing): painless bite
dx: smear
Tx: nifurtimox
I took a Tryp to mexico and Kissed a girl, now i’m blowing up and am Furtive
Leishmania donovani
Protozoa visceral leishmaniasis (kala-azar) spiking fever, HSM, pancytopenia vector: sandfly dx: mphages containing amastigotes Tx: sodium stibogluconate
the Goats on a Leash travel in Flies and live in macrophages, but hate Sties
Enterobius vermicularis
pinworm (nematode)
Eggs in food
anal pruritus (scotch tape test)
Tx: bendazoles or pyrantel pamoate
