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Name 4 Opportunistic Mycoses (occur in immunocompromised patients)
- Candidiasis
- Cryptococcus
- Aspergillosis
- Zygomycosis
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2 Main predisposing factors for opportunistic fungal infections
- 1) Granulocytopenia
- 2) Impaired T-cell mediated immunity
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What are the 4 organisms most frequently infecting patients with T-cell dysfunction?
- Coccidioides (systemic)
- Cryptococcus
- Histoplasma (systemic)
- Candida (mucocutaneous infections only)
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5 disease forms of Candidiasis
- Thrush
- Vaginitis
- Chronic mucocutaneous candidiasis
- UTI
- Systemic infection
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Which organism is a common cause of disease in the blood?
Candidiasis (Candidemia)
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Candidaisis has a ____ mortality rate.
high (38%)
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Oval yeast with a single bud
Candida albicans
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Candida albicans is seen as an _____
oval yeast with a single bud
As opposed to Cryptococcus neoformans, which is seen as an encapsulated oval, budding yeast (pigeon droppings)
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Candida albicns form
pseydohyphase (germ tube)
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Dormant spores of C. albicans
Chlamydiospores
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Which organism has pseudohyphae and chlamydiospores?
C. albicans
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One of the most common manifestations of HIV infection.
Is this associated with disseminated candidiasis?
- Mucocutaneous candidiasis
- HIV candidiasis involves oropharynx, esophagus, or vagina.
- No
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3 things that have increased the incidence of Candidiasis.
- Antimicrobial agents
- Corticosteroids
- Central venous access devices
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Use of antimicrobial agents, corticosteroids, and central venous access devices have increased the incidence of ____
Candidiasis
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Candidal endocarditis occurs most commonly in (3 ppl)
- IV drug users
- Pts w/ prosthetic heart valves
- Prolonged use of central venous catheters
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IV drug users, patients with prosthetic heart valves, and IV drug users are at an increased risk of developing
Candidal endocarditis
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How do you diagnose disseminated candidiasis?
CT scan, confirm with biopsy
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Candidiasis Tx: What form?
OTC
Fluconazole, itraconazole
Amphotericin B
Fluconazole prophylaxis; risk of resistance
- OTC: Vaginitis
- Azoles
- AmpB- Systemic Candidiasis infections
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Causative agent of Cryptococcis
Found?
- Cryptococcus neoformans
- Found in pigeon droppings
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Cryptococcus neoformans is seen microscoppically as
Encapsulated oval, budding yeast
High salt and polysaccharides limits capsule formation!!!
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What two things inhibit capsule formation of C. neoformans?
High salt, polysaccharides
Once in the lungs, they regenerate their capsules
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Name two fungi that are NOT dimorphic.
- Cryptococcus neoformans
- Aspergillus fumigatus
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C. neoforms causes:
- Lung infection (often asymptomatic, but may produce pneumonia)
- Predilection for CSF
- Meningitis
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Which organism has a predilection for CSF and can cause meningitis?
Cryptoccocus neoformans
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Name 3 diseases associated with HIV.
- Candida albicans- thrush
- Cryptococcus neoformans- meningitis (90%)
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How do you treat Cryptococcus neoformans?
- AmpB and flucytosine (2 wks)
- Azoles (8 wks)
- HIV (therapy for up to a year)
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Which organism historically has infections in temperate areas? (ie. Australia) Infects
- Cryptococcus gatti
- Animals and healthy individuals
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Cryptococcus gatti historically causes infections in healthy individuals_____ areas.
temperate
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Cryptococcus gattii (the Aussies) causes:
- Pneumonia
- Neurologic involvement
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Causative agent of Aspergillosis
Aspergillus fumigatus
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Which organism has septate hyphae and V-branching?
Aspergilllus fumigatus
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Aspergillus fumigatus grows only as a ____. Is it dimorphic?
mold, not dimorphic
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2 differentiating factors of A. fumigatus
- Septate hyphae
- V-branching
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Infectious particle of A. fumigatus
Radiating conidia
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Associated with infections of corneal transplants and fungus balls.
A. fumigatus
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Histoplasmoces can spread from ____ to _____
Aspergillosis can infect ____ and spread to ________
- H. capsulatum: lungs to skin
- A. fumigatus: skin to body (lungs)
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3 species of Zygomycosis
Rhizopus, Mucor, Absidia
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Saprophytic molds
Zygomycosis
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4 Disease forms of Zygomycosis
- Rhinocerebral (nasal passage--> brain)...Like animorphs!!!!
- Pulmonary
- Cutaneous
- GI
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Which fungus has an overall mortality rate of > 50% with disseminated disease rates approaching 100%?
Zygomycosis
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3 Risk factors for Zygomycosis.
- Diabetic ketoacidosis
- Burn victims
- Leukemia
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Nonseptate hyphae, broad irregular walls, right angle branching
Zygomycosis
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Aspergillos has a conidiaphore with conidiospores.
Zygomycosis has a _____ with spores
sporangium
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Facial pain w/ eye protrusion
Zygomycosis (very rapidly growing)
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