Treatments for fungal infections Flashcards Preview

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Flashcards in Treatments for fungal infections Deck (11):
1

TB

?

2

disseminated Histoplasmosis

amphotericin B with itraconazole for 1yr

if meningitis, fluconazole

3

Blastomycosis - Symptomatic but not severe:

itraconazole

4

minor Coccidiomycosis

nothing if minor infection (flue like symptoms, mild pneumonia erythemia nodosa/multiforme) if disseminated or severe pneumonia or black/fillipino/immunosupressed/diabetes/cadiopulminary disease use oral itraconazole or Amphotericin B (for pregnancy!)

if memingitis - us fluconazole

5

Severe Blastomycosis (including any CNS):

amphotericin B, may switch to itraconazole after improvement

Fluconazole also appropriate for meningitis

Surgical excision of loci

6

Histoplasmosis Spreading in lung

oral itraconazole 6-12 weeks

7

persisting lung lesions or disseminated Coccidiomycosis

Amphotericin B and long-term itraconazole, May require years of therapy to clear

Minimum of 6 months of drug therapy, followups for at least a year

8

disseminated Coccidiomycosis meningitis

fluconazole, continue as a long-term suppressive, may add intrathecal amphotericin B if severe, may need to add corticosteroids to reduce immunogenic symptoms from amphotericin therapy

Minimum of 6 months of drug therapy, followups for at least a year

9

Allergic bronchopulminary Aspergillosis

▪ Oral corticosteroids and itraconazole
▪ Consider sinus surgery and/or omalizumab (Xolair)

10

Asperigilloma

Remove surgically if hemoptysis
▪ Oral itraconazole

11

Invasive Aspergillosis or CNPA

▪ Voriconazole and/or amphotericin B, alt capsofungin, but may not work – high mortality.
▪ Decrease immunosuppression if possible.
▪ Surgical resection of diseased area may be considered.