Infection Flashcards
(199 cards)
1
Q
What is gastro enteritis?
A
3+ loose stools/day
With accompanying features
2
Q
What causes gastroenteritis?
A
Contamination of foodstuffs (eg chicken)
Poor storage (allowing proliferation of bacteria)
Travel related infections
Person-person spread - norovirus
3
Q
What bacteria is the most common foodborne pathogen?
A
Campylobacter
4
Q
Which bacteria causes the most hospital admissions for food poisoning?
A
Salmonella
5
Q
Types od diarrheal illness
A
Non-inflammatory/secretory (cholera)
Inflammatory - shingella
Mixed (c.diff)
6
Q
Describe secretory/non-inflammatory diarrhoea
A
Secretory toxin-mediated
I.E - cholera raises cAMP levels + cl secretion
Frequent watery stools - little abdominal pain
Rehydration for therapy
7
Q
Describe inflammatory diarrhoea
A
Toxin damage causes inflammation + mucosal destruction
Causes pain + fever
Bacterial infection
Often rehydration sufficient. Sometimes antimicrobials
8
Q
How long does gastroenteritis last?
A
Normally less than 2 weeks
9
Q
Investigations into gastroenteritis
A
Stool culture Blood culture Renal function (dehydration) Blood count Abdominal xray if distended abdomen
10
Q
What are the differentials of gastroenteritis?
A
inflammatory bowel disease
Spurious diahrroea
Carcinoma
11
Q
Define campylobacter gastroenteritis
A
Up to 7 days incubation
Stools negative within 6 weeks
Severe abdominal pain
Very unlikely to be invasive (into blood <1%)
12
Q
What can campylobacter gastroenteritis lead to?
A
Guillian barre syndrome
Reactive arthritis
13
Q
Define salmonella gastroenteritis
A
Symptoms usually within 48 hours
Diahrroea lasts for less than 10 days
<5% invasive
20% still have positive stools 20 weeks later
14
Q
Bacterial cultures - differences
A
Salmonella are lactose non-fermenters
Campylobacter needs specialised conditions
15
Q
What are the most common salmonella strains in UK
A
Salmonella enteritidis
Salmonella typhimurium
Most are imported
16
Q
What salmonella cause enteric fever?
A
Salmonella typhi
Salmonella paratyphi
17
Q
Why strain of e.coli causes gastroenteritis?
A
E.coli O157
18
Q
What is characterisitc of E.Coli O157 gastroenteritis?
A
Frequent bloody stools
Produces toxins which causes harmolytic-uraemic syndrome
E.Coli stays in blood, but toxin enters blood
Often from contminated meat or person to person spread
19
Q
What is HUS? (haemolytic-ureamic syndrome)
A
Renal failure
Haemolytic anaemia
Thrombocytopenia
Through binding of globotriaosylceramide
20
Q
What bacteria cause gastroenteritis outbreaks?
A
Staph A
Bacillus cereus (from refriend rice)
Clostridium perfringens
21
Q
When are antibiotics indicated for gastroenteritis?
A
In immunocomprimised Severe sepsis/invasive infection Valvular heart disease Diabetes Chronic illness
22
Q
How do you treat c.diff infection?
A
Metronidazole - First line, no severity markers
Oral vancomycin - 2+ severity markers
Fidaxomaicin
Stool transplants
23
Q
How do you prevent C.diff
A
Avoid the 4 c antibiotics Isolate symotomatic patients Wash ahnds (not alcohol gel) between patients
24
Q
What are the 4 antibiotics to avoid to prevent c.diff
A
Cephalosporins
Co-amoxiclav
Clindamycin
Clarithromycin
25
How do you request a parasite screen?
Parasites, cysts + ova
26
What are the common UK parasites?
Giardia lamblia
| Cryptosporidium parvum
27
Describe Giardia lamblia
Found in contaminated water
Causes diarrhoea, malabsorption + failure to thrive
Cysts seen on stool micropsopy
Treat with metronidazole
28
Describe Cryptosporidium parvum
Found in contaminated water (animal faeces)
Cysts on micropscopy
No specific treatment required
29
What is entamoeba histolytica
```
Parasite causing amoebic dysentery
Vegitive form in symptomatic patients - hot stools
Cysts in asymptomatic patients
May cause liver abscesses long term
Treat with metronidazole
```
30
What is viral diarrhoea
Common in winter
Often rotaviruses
Sometimes adenoviruses
Common cause of outbreaks (hospital, community, cruise ships)
31
What are noraviruses
```
Small round structured viruses
Diagnosed through PCR
Very infectious
Infect through airbourne particles
Need strict infection control measures
Ward closures common
```
32
What is SIRS?
```
Temperature change
->38 or <36
HR > 90
RR>20 or paCO2 <32
WBCs
- >12000 or <4000
```
33
What is sepsis?
An infection of blood along with SIRS
34
What is the mortality with septic shock?
40%
35
What is qSOFA?
Hypotension - Systolic <100mmHg
Altered mental state
Tachypnea (Resp rate >22)
Score of 2 or more indicates high risk of poor outcome
36
What is Sepsis 6?
Blood cultures
|-> From two-three different sites, before antibiotics start
Blood lactate
Measure urine output
Oxygen
IV antibiotics
IV fluids
37
Why is lactate important in sepsis?
A marker of generalised hypoperfusion/severe sepsis/poor prognosis
Type A indicated Hypoperfusion
Type B - mitochondrial toxins, alcohol, malignancy, metabolism errors
38
When should you refer a septic patient to ITU?
Septic shock
Multi-organ failure
Needing sedation, intubation or ventilation
39
When should you refer a septic patient to HDU?
```
Low BP
Lactate >2 despite resus
Elevated creatinine
Oliguria
Liver dysfunction
Bilateral infiltrates
```
40
What is a pyrexia of unkown origin?
No diagnosis after 3 outpatient visits
3 days in hospital
Or one week of outpatient investigation
41
What is a fabricated fever?
A real fever that is induced by patient ie inject self with foreign material (eg faeces)
Microbiology strongest clue
42
What is the difference between colonisation and infection?
Colonisation is presence on surfaces open to environment
| Infection is presence inside the body that causes damage to body/tissues
43
Which bactera are spread through direct contact?
Staph A
| Coliforms
44
Which bactera are spread through respiratory/droplets?
Neisseria meningitidis
| Mycobacteria tuberculosis
45
Which bactera are spread through faecal oral?
Clostridium difficile
| Salmonella
46
Which bactera are spread through Penetrating injury?
Group A streptococcus
| Blood bourne viruses
47
What are the modes of HIV infection?
Sexual - mostly MSM in this country
Injecting drug users
Blood products
Organ transplant
48
What is the virology of HIV?
A type of retrovirus (lentivirus) that attaches to cells with CD4 on surface (lymphocytes) and other chemokine receptors
Uses reverse transcriptase to replicate
Uses integrase to integrate into host cell DNA
49
What is the main strain of HIV?
HIV-1 group M
50
What does an HIV infection do to the CD4 count?
Decreases it
51
What is the CD4 level for AIDS diagnostics?
Below 200
52
What are the most common (new) opportunistic infections in HIV?
Pneumocytis jiroveci pneumoia
Candidiasis
Mycobacterium avium complex
Cryptosporidious
53
What are the most common reactivation opportunistic infections in HIV?
Cerebral toxoplasmosis
TB
CMV disease
54
What is the natural history of HIV?
```
Acute infection (seroconversion)
Asymptomatic
HIV related illness
AIDS-defining illness
Death
```
55
What is a seroconversion illness?
When HIV antibodies first develop
Has abrupt onset 2-4 weeks post exposure
Self limiting - lasts 1-2 weeks
56
What are the symptoms for seroconversion illness
```
Flu-like illness
Fever
Malaise/lethargy
Pharyngitis
Lympjadenopathy
Toxic exanthema
```
Looks like glandular fever but EBV not in keeping
57
How do you determine length of HIV infection?
If seroconversion illness, date of that
Else stored blood
Else most at risk
58
What are the respiratory AIDS-defining conditions?
TB
| Pneumocystisis
59
What are neurology AIDS-defining conditions?
Cerebral toxoplasmosis
Primary cerebral lymphoma
Crytptococcal meningitis
Progressive multifocal leucoencephalopathy
60
What are the dermatology AIDS-defining conditions?
Kaposi's sarcoma
61
What are the gastroenterology AIDS-defining conditions?
Persistant cryptosporidosis
62
What are the Oncology AIDS-defining conditions?
Non-hodgkin's lymphoma
63
What are the Gynaecology AIDS-defining conditions?
Cervical cancer
64
What are the optholomology AIDS-defining conditions?
Cytomegavirus retinitis
65
How is HIV monitored?
CD4 lymphocyte count
HIV viral load
Clinical features
66
What is the current treatment for HIV therapy?
Combincation antiretroviral therapy - with 3 drugs from at least 2 groups
67
What do the different HIV drugs act on?
Different stages of HIV lifecycle
68
What is the adherance to medication needed to supress HIV? Can this lead to a normal life?
Adherance must be over 90%
cART can lead to a normal life but side effects can be significant
i.e metabolic, lipodystrophy
69
What are the three main types of medication MOAs for HIV?
Reverse transcriptase inhibtor
Integrase inhibitor
Protease inhibitor (prevents release of new virus)
70
When should you start HIV treatment?
If CD4 drops below 350cells/mm OR rapidly falling
71
What is the life expectancy based off CD4 of less than 100 before starting therapy?
52
72
What is the life expectancy based off CD4 of 100-200 before starting therapy?
62
73
What is the life expectancy based off CD4 of more than 200 before starting therapy?
70+
74
Why do HIV treatments fail?
Poor adherance
Not strong enough etc
All leads to viral mutation + resistance
75
What are the side effects of nucleoside reverse transcriptase inhibitors (HIV drug)?
Marrow toxicity
Neuropathy
Lipodystrophy
76
What are the side effects of non-nucleoside reverse transcriptase inhibitors drugs (HIV)?
Skin rashes
Hypersensitivity
Drug interactions
77
What are the side effects of protease inhbitors? (HIV drug)
Drug interactions
Diarrhoea
Lipodystrophy
HYperlipidaemia
78
What are the side effects of itegrase inhbiitors? (HIV drug)
Rashes
79
How can you reverse the effects of lipodystrophy (side effect from HIV medication?)
```
Change drugs
Cosmetic procedures
Facelift
Liposuction
Fillers
```
80
What is the relationship between HIV and cardiovascular diseae?
Increased MI incidence
Hyperlipidaemia
Insulin resistance
81
What are the main challenges of HIV care in this day and age?
```
Osteoporosis
Cognitive impairment
Malignancy
Cerebrovascular disease
Renal disease
diabetes mellitus
Ischaemic heart disease
```
82
How can you prevent HIV?
Change behaviour (condoms)
Treatment as prevention
Pre-exposure prophylaxis
Post-exposure prophylaxis
83
What are the risks of transmission for percutaneous exposure?
HBV positive - 30%
HCV RNA positive blood - 3%
HIV positive blood - 0.3%
84
What is the mucotaneous exposure of HIV positive blood? (Fluid entering eyes, nose, mouth or broken skin)
0.1%
85
What fluids have to be handled with the same precautions as blood?
```
CSF
Pleural, peritoneal or pericardial fluid
Breast milk
Amniotic fluid
Vagical secretions or semen
Synovial fluid
Unfixed tissues/organs
Saliva
Exudate/tissue fluid from burns or skin lesions
```
86
What actions should be taken after bodily fluid exposure?
Wash off splashes on skin with soap/running water
Encorage bleeding
Report to sensior manager or doctor + OHS
87
How is the risk assesed for bodily fluid exposure?
Source of contamination
Extendt of injury and type of sharp causing it
Liklihood of virus in source
Vaccination history
88
What is an HAI (healthcare acquired infection?)
Infections that weren't present at time of admission
| Or an infection that arises after 48 hours of admission or within 48 hours of discharge
89
What is the prevelance of HAIs?
4.9% of all patients in scotland
90
What are the most common HAIs?
UTI (mainly due to cathertisation) 22.6%
Surgical site infection18.6%
Respiratory tract infection 17.5% (intubation)
Bloodstream infections (catheter related)
GI
Skin + soft tissue
91
What microbial factors make infection more likely?
```
Increased resistance
Increased virulence
Increased transmissability
Increased survivability
Ability to evade hosts immune
```
92
What host factors make HAIs more common?
```
Devices (catheters etc)
Antibiotics taken incorrectly
Break in skin
Foreign body
Immunosuppresion
Age extremes
Overcrowding
```
93
What are the stages in the chain of infectio?
Source of microbe
Tranismission
Host
94
What are the means of transmission for infections?
Direct contact
Respiratory/droplet
Faecal oral
Penetrating injury
95
How can you break the chain of infection?
```
Risk awareness
Hand hygiene
Appropriate PPE
Vaccination
Post exposure prophylaxis
Standard infection prevention and control precautions
```
96
What is the definition of cleaning?
Physical removal of organic material + decreasing microbial load
97
What is the definition of disinfection?
Large reduction in micrbe numbers, spores may remain
98
What is the definition of sterilisation?
Removal/destruction of all microbes and spores
99
When is cleaning appropriate?
Low risk procedures (intact skin contact)
I.e stethoscopes
Cots
Mattresses
100
When is disinfection appropriate?
Medium risk procedures - mucous membrane contact
Endoscopes
Vaginal specula etc
101
When is sterilisation appropriate?
```
High risk (and sometimes medium risk)
Eg surgical instruments
```
102
What is the cleaning process?
Detergent + water
DRY
Cleaning essential before disinfection + sterilisation if required
103
What are the methods of disinfection?
Heat (pastureisation/boiling)
| Chemical (alcohol etc)
104
What are the methods of sterilsation?
Steam under pressure
Hot air oven
Gas
Ionising radiation
105
What is the definition of an outbreak?
2 or more infections linked in time and palce
106
What are the control measure in an outbreak?
```
Single room isolation
Cohorting of cases
Clinical area or ward closure
Staff exclusion
Staff decolonisation
```
107
What are the three main groups of influenza?
A (mammals and birds)
| B + C (only humans)
108
What family does influenza belong to?
Orthomyoxviridae family
| 8 segment RNA virus
109
What is antigenic drift?
Mechanism of viral genetic variation
| Occurs continually over time by small point mutations
110
What do the changes in antigenic drift lead to?
Changes the antigenic properties - eventually immune system will not cope as well
Causes worse than normal epidemics + vaccine mismatch
111
What is antigenic shift?
An abrupt major change in virus - leads to new H/N combinations
This is what allows for strains to jump from one species to another
112
What can antigenic shift lead to?
Combination of multiple strians to form a new subtype
Reassortment of genome
This can lead to pandemics
113
What are the differences between seasonal flue and pandemic flu?
Seasonal - every winter
Pandemic sporadically
Seasonal - 10-15% of population
Pandemic - 25%+ of population
Seasonal - unpleasant, not life-threatening
Pandemic - life threatening
114
What are the two surface proteins on influenza?
Haemaglutinin (H)
| Neuramindiase (N)
115
How many different haemaglutinin antigens are there?
18 (H1-3 affect humans)
116
How many different N antigens are there?
11
117
What is the function of haemaglutinin surface protein?
Facilitats viral attachment and entry to host cell
118
What is the function of neuramindiase surface protein of influenza?
Enables new viron to be released from host cell
119
What two strains of avian bird flue affect ?humans
H5N1
| H7N9
120
What are the fatality rates of avian flu?
H5N1 - 60%
| H7N9 - 35%
121
What is the incubation period for avian flu?
2-4 days
122
What are the transmission modes for avian flu?
Direct contact with infected birds (dead or alive)
Occasional transmission with human contact
No know contact by eating properly cooked poultry
123
What are the clinical features of influenza?
Fever lasting ~ 3 days
+ 2 or more of:
Cough, sore throat, rhinorrhoea, myalgia, headache, malaise
Mostly systemic symptoms
124
What are the symptoms of swine flu?
Sudden fever + cough
Tiredness, chills
Heaache, sore throat, runny nose, sneezing
Diarrhoea, stomach upset loss of appeitte
Aching muscles, limb or joint pain
125
What is the tranmission mode for flu?
Aiborne (person to person by large droplets)
| Contact - direct vs indirect
126
How long does the virus survive outside the host?
24-48 hours on no porous surfaces
| 8-12 hours on porous surface (eg tissue)
127
What are the high risk groups for catching influenza?
```
Chronic disease
Diabtetes mellits
Severe immunosuprresion
65+
Pregant women
Children under 6
Morbid obesity
```
128
What are common complications of influenza?
Acute bronchitis
| Seoncary bacterial penumonia (4-5 days after surgery)
129
What are some uncommon complcaitions associated with influenza?
Primary viral pneumonia
Myocarditis/pericarditis
Transverse myelitis / guillian barre
Myositis & myoglobinuria
130
How do you diagnose influenza?
```
Clinical diagnosis
Viral nose/throat swabs
Chest x-ray
Blood culture
Resp rate/pule oximetry
U&Es, FBC, CRP
```
131
what is the assesment for penumonia?
```
CURB65
Confusion
Urea ?7mmol/l
Resp rate >30
Blood pressure (diastolic <60, systolic <90)
65+
```
132
What are the two types of antivirals for flu?
Osetamivir (tamiflu) - taken orally
| Zanamivir (relenza) - inhaled dry poweder
133
What areh the side effects of selatamir (tamiflu)?
Common - Nausea, vomitting, abdo pain, diarrhoea
Less common - Headache, hallucinations, insomina + rash
Cautions - renal dosing needed
134
What are the side effects for zanamivir (relenza)?
Rare - occasional bronchospasm
135
What is the first + second line in a complicated influenza (not immunocomprimised + immunocomromised)?
Osteamivir PO - 1st line
| Zanamivir - 2nd line
136
What is the treatment for uncomplicated influnza?
No treatment preferred
| Osteltamivir PO within 48 hours if at risk of developing complications
137
What treatment for immunocomprised patients with uncomplicated influenzae?
Oseltamivir PO + commence therapy within 48 hours
138
What is the treatment in pregancy for influenza?
Antivirals with oseltamivir being first line
| Also safe in breastfeeding.
139
When does a patient become non-infections
24 hrs after last symptom (or after treatment if that is longer)
In immunocomprimised - cases differ
140
What PPE is needed for healthcare staff in influnzae?
Surgical face mask
Plastic aprom
Gloves
Handwashing after examination
141
What do seasnonal influnzae vaccines contain?
2 type A and 1 type B subtype viruses
| Contraindicated in those with egg allergy
142
Why should healthcare workers get a vaccination?
Protect themselves + family
Reduce risk to at risk patients
Reduce absence from work
143
What is a zoonoses?
An infection that can pass between living animcals and humans, with the source being the animal
Note, malaria etc are not zoonoses as depend on human host for part of lifecycle
144
What is anthroponosis?
Infections from humans to animals
145
What are some common bacterial zoonoses>
```
Salmonella
Campylobacter
Shigella
Anthraz
Brucella
Plague
```
146
What are some common viral zoonoses?
```
Rabies
Avian influnza
Ebola virus
Lassa fever
Rift valley fever
Yellow fever/west nile fever
```
147
What are some parasitc zoonoses?
```
Toxoplasmosis (Common in the UK)
Cysticercosis
Echinococcosis
Trichinellosis
Visceral Larva Migrans (Toxocara)
```
148
What are some fungal zoonsoses?
Dermatophytoses
| Sporotrichosis
149
How is rabies transmitted?
From the bite of an infected animal
150
What is the life cycle of rabies?
```
Incubation period of 2 weeks in humans
Travels to brain via periperal nerves
Causes acute encephalitis
Progresses to mania, lethargy and coma
Overproduction of saliva + tears
Unable to swallow and hydrophobia
Death by respiratory failure
```
151
How do you treat rabies?
Immediate post-exposure prophylaxis
Human rabies immunoglobulin
+ 4 doses of rabies vaccines over 14 days
Fatal if untreated
152
what is brucellosis?
Was an occupational hazard of animal workers
| Due to an organism excreted in milk, placenta and aboreted foetus
153
How are humans infected with brucellosis?
Milking infected animals
During parturition
Handling carcasses of infected animals
Consumption of unpasteurised dairy products
154
How does brucellosis present?
Incubation of 5-30 days (up to 6 mongths)
| Split into acute, subacute, chronic and subclinical presentations
155
What is the acute presentation of brucellosis?
```
1-3 weeks of:
High fever
Weakness + headaches
Drenching sweats
Splenomegaly
```
156
What is the subacute presentation of brucellosis?
A month or more of fever and joint pains
157
What are the chronic presentations of brucellosis?
```
Lasting months to years
Flu like symptoms.
Depression
Maliase
Chronic arthritis
Endocarditis
Rarely - meningism
Splenomegaly
```
158
What is subclinical brucellosis?
50% have positive serology
159
How do you treat brucellosis?
Long acting doxycycline for 2-3 months + rifampicin or IM gentamicin for first week
If chronic difficult to treat
If CNS add cotrimoxazole for 2 weeks
160
What is the most common form of leptospirosis?
L. hardjo (from cattle)
161
How does leptopriosis present?
Fever, menigism
| No Jaundice
162
What is leptospirosis?
Highly mobile spirochaetesSurvives environment for weeks-months
163
How do you treat leptospirosis?
Penicillin as early as possible
Prompt dialsysis
Mechanical ventilation
164
What organisms cause lyme disease?
Borrelia burgdorferi
| Spirochaete found in wild deer
165
How is lyme disease spread to humans?
Via ticks
166
What is ereythema migrans?
A rash occuring in 80-90% of lyme disease cases
Appears 7-30 days after bite
Can have single or multiple lesions
167
What is acrodermatitis chronica atroficans ACA? (caused by lyme disease)
Extensor surfaces of distal extremities turn bluish/reddish
Progresses to atrophic disease
Peripheral neuropathy common
Common in elderly
168
What is lymphocytoma? (caused by lyme disease)
Bluish, solitary + painless nodules
Often in earlobe or areola
More common in children
169
What is neuroborreliosis? (caused by lyme)
Triad of facial nerve palsy,
radicular pain (migratory and worse at night)
lymphocytoic meningitis
170
How do you diagnose lyme disease?
Clinical diagnosis
-Single or multiple lesions with red area that then spread
ACA + lymphocytoma, clinical and high serology titres
Arthritis
171
How do you treat lyme disease?
Oral doxycyline or ammoxicillin, or IV ceftriaxone
Treat for 21 days
Unless arthritis or ACA, then 28 days
172
What is the main source of toxoplasmosis?
Toxoplasma gondii (found commonly in cats)
173
How is toxoplasmosis transmitted to humans?
From oocysts in cat faeces
| From trophozoites in under-cooked meats
174
How does tocoplasmosis infection present?
```
Can be asymptomatic
Acute: Pneumonia, fever, cough, rash
Chronic: Lymphadenopathy
Lymphocytosis
Atypical mononuclear cells on blood film
```
```
Can present with chorio-retiniits + uveitis
Ocasionally congenital (calcification in brain on x-ray. Often fatal)
```
175
How is toxoplasmosis treated?
Most don't require treatment
Sulponamide + pyrimethamine
Ocasionally tetracycline
176
How is toxoplasmosis treated?
Most don't require treatment
Sulponamide + pyrimethamine
Ocasionally tetracycline
177
What are the main three fungal pathogens?
Aspergillus species (fumigatus)
Candida sp. (albicans)
Crytptococcus sp. (neoformans)
178
Who do fungal infections affect?
As they are oportunistic:
Impaired immune systems (AIDS, malignancies/transplants, primary immunodeficiencies etc)
Chronic lung diseases like asthma/CF
ICU setting
179
What is the most common type of candida sp. infection
Mucocutaneous candidiasis
| i.e nappy rash, thrush
180
Where do candida infections occur?
Commensal, so on skin
Attracted to moist areas
Often when patient is on antibiotics, steroids (or immuno depressed)
Neonates often affected
181
What is the pathology of invasive candidiasis?
A comensal gut flora, mostly endogenous origin of infection (going to sterile area)
4th most common blood stream infection, with same clinical presentation as bacterial BSIs
up to 40% mortality
182
What are the risk factors for invasive candidiasis?
Broad-spectrum antibiotics
IV catheters
Total parenteral nutrition
183
How is Aspergillosis transmitted between people?
Sproulation - inhaled spores
| An intact immune system will have no problem
184
What are the classifications of pulmonary Aspergiullus disease?
Acute invasive
Chronic (> 3months)
Allergic
185
What are the predispositions for Acute invasive Aspergillus pulmonary disease?
Neutropnenic patients
| Phagocyte defects
186
What are the predispositions for chronic Aspergillus pulmonary disease?
Patients with underlying chronic lung conditions
187
What are the predispositions for Allergic Aspergillus pulmonary disease?
Common in CF/asthma
Extrinsic allergic alveolitis
More common in fungal sensitisation
188
What are the symptoms of Acute invasive pulmonary aspergilliosis?
Rapid + extesive hyphal growth
Thrombosis + haemorrhage
Non-spefici signs
Persistent febrile neutropenia (despite antibiotics)
189
What is pulmonary aspergillioma?
Fungal mass growing in lung cavities
| More common in: TB, Sarcoidosis, cronchiectasis + after pulmonary infections
190
Where are cryptococcal species found?
Bark of trees
Bird faeces
Organic matter
191
Which cryyptococcal disease is associated with HIB/AIDS?
Cryptococcal meningoencephalitis
192
How do you diagnose Cryptococcal meningoencephalitis?
Indian-ink CSF
193
What are the classes of antifungal drugs?
Polenes
Azoles
Echinocandins
194
What are the most common Polyene antifungal drugs?
Amphotericin B
Grisofulvin
Nystatin
195
What are the most common Azole antifungal drugs?
Fluconazole
Voriconaxole
Posaconazole
196
What are the most common Echinocandin antifungal drugs?
Anidulafungin
Caspofungin
Micafungin
197
How is invasive aspergilliosis
IV or oral Azole
| IV amphotericine B(if serious)
198
How is invasive candidiasis treated?
Echocandins IV
| Fluconazole IV/oral
199
How is crytptococcal meningitis treated?
IV amphotericine B + flyctosine
| Followed by fluconazole
