Opportunistic Fungal Infections

Question 1

opportunistic mycoses route of infection

Answer 1

inhalation
mucosal deposition
endogenous flora

Question 2

mucormycotina

Answer 2

non septate

90 degree branching pattern

Question 3

basidiomycota

Answer 3

septate

Question 4

ascomycota

Answer 4

septate

Question 5

aspergillus

Answer 5

common environmental fungi
angioinvasive
causes hemorrhage and nodular disease

Question 6

risk factors for aspergillis

Answer 6

neutropenia
transplants
immunosuppressed
rare in healthy

Question 7

pathogenesis of aspergilllus

Answer 7

conidia inhaled into upper and lower respiratory tract
germinate into hyphae
invade vascular walls
infarction, hemorrhage, necrosis

Question 8

what tries to clear aspergillus

Answer 8

macrophages and neutrophils

Question 9

presentation of aspergillus

Answer 9

sinus infection or pulmonary infection

Question 10

aspergillus histo

Answer 10

septate hyphae with 45 degree branching

conidia on end of branches

Question 11

aspergillus symptoms

Answer 11

fever
pleuritic chest pain
cough
hemoptysis
dyspnea
acute facial pain

Question 12

aspergillus CXR

Answer 12

nodules with hemorrhage around them

Question 13

aspergillus dissemination

Answer 13

invades blood vessels

Question 14

aspergillus is found in

Answer 14

general environment

Question 15

cryptococcus if found in

Answer 15

dirt with pigeon poop

Question 16

cryptococcus pathogenesis

Answer 16

inhaled as yeast into alveoli
produces a polysaccharide capsule which hides it from immune system
produces melanin- resists enzyme and free radical destruction

Question 17

risk factors for cryptococcus

Answer 17

transplant
immunosuppressive drugs
some immunocompetent

Question 18

cryptococcus

Answer 18

encapsulated yeast that causes chronic lymphocytic meningitis (infects CNS)

Question 19

aspergillus dissemination

Answer 19

vessels

Question 20

cryptococcus presentation

Answer 20

asymptomatic pulmonary infection

menigitis

Question 21

cryptococcus symptoms

Answer 21

headache
fever
cranial nerve palsy
mental status change
elevated ICP

Question 22

cryptococcus dissemination

Answer 22

meninges
pulmonary infiltrates
skin
viscera
buccal infection

Question 23

cryptococcus diagnosis

Answer 23

lumbar puncture to stain CSF with india ink- see the capsule and yeast
latex agglutination- check for capsule
culture

Question 24

murcormycosis

Answer 24

widely found in the environment
angioinvasive
causes pulmonary and rhino cerebral disease in neutropenic/diabetic patients

Question 25

mucormycosis found in

Answer 25

dirt

Question 26

mucormycosis looks like

Answer 26

nonseptate 90 degree branching

Question 27

major risk factor for mucormycosis

Answer 27

diabetes with ketoacidosis

Question 28

difference between aspergillum and mucor

Answer 28

both angioinvasive aspergillus- septate hyphae with 45degree branching mucor- non septate hyphae with 90degree branching

Question 29

murcormycosis dissemination

Answer 29

can invade caverns sinus and brain

Question 30

murcormycosis presentation

Answer 30

rhino-orbital-cerebral

Question 31

which are angioinvasive

Answer 31

aspergillis | mucormycosis

Question 32

candiadiasis histo

Answer 32

round/oval yeasts | develop pseudohyphae and true hyphae at body temp with germ tube test

Question 33

most common candida

Answer 33

albicans

Question 34

resistant candida

Answer 34

glabrata

Question 35

candida risk factors

Answer 35

immunosuppression trauma, major burns invasive access IV drugs

Question 36

usual candida pathogenesis

Answer 36

USUALLY disruption of normal flora

Question 37

weird candida pathogenesis

Answer 37

IV drug | exogenous spread- contamination, sexual activity

Question 38

presentation of candidiasis

Answer 38

mucosal- GI and genital | skin and nails- intertrigiouns (athletes foot)

Question 39

disseminated candidiasis

Answer 39

``` fever sepsis organ dysfunction visceral involvement- abscess formation meningitis chorientitis hepatosplenic abscesses vertebral osteomyelitis endocarditis ```