Treatment of Fungal Infection of the Lung Flashcards
How does candida albicans infection present?
fever, tachycardia, patchy infiltrates on chest film
Is candida albicans a common cause of pneumonia?
No, seen more in immunocompromised patients
How does cryptococcus neoformans infection present?
Often asymptomatic; may have productive cough, fever and weight loss
What is cryptococcus neoformans commonly associated with?
pigeon droppings
How does aspergillus (mold) infection present?
Wheezing, dyspnea and cough with allergic broncho-pulmonary
aspergillosis:
fever, cough,
dyspnea, pleuritic chest pain, and hemoptysis seen in invasive forms, usually in immuno-compromised patients
What is aspergillomas?
fungal ‘balls’ that can form in pre-existing cavities and can spread via blood
How does blastomyces dermatitidis infection present?
-fever, chills, productive cough and possibly skin or bone lesions
How is candida albicans treated?
ampho B IV and fluconazole
How is CNS cryptococcus neoformans treated?
Ampho B IV + flucytosine PO (because they are fungicidal)
How is non-CNS cryptococcus neoformans treated?
Fluconazole PO
How is aspergillus treated?
-Voriconazole IV Ampho B
For Aspergillus there is a move to employ one of the newer azole drugs, which are
effective against these species, rather than amphotericin B.
How is blastomyces dermatitidis treated?
Fluconazole IV or Ampho B IV if severe
How is Histoplasma capsulate treated in severe cases or immunocompromised cases?
Ampho B IV followed by Itra PO
How is mild Histoplasma capsulate treated?
Itra PO
How is Ampho B given?
Most physicians now employ lipid formulations of amphotericin B to try and avoid the
nephrotoxicity associated with the deoxycholate form of the drug
HYDRATION helps
