Warning:
JavaScript is turned OFF. None of the links on this page will work until it is reactivated.
If you need help turning JavaScript On, click here.
The Concept Map you are trying to access has information related to:
Opportunistic fungi, Opportunistic Fungi CANDIDA Dx- -KOH, gram stain of mucosal scraping -grows rapidly as yeast on most media -no fungal media necessary -C. albicans-germ tube test ->produces hyphal outgrowths (germ tubes) when in serum at 37C -after 2-3 hrs, Dz due to molds w/ hyaline, light- colored hyphal elements -w/out pigment in cells walls -Fusarium -Scedosporium -Penicillium -Paecilomyces SCEDOSPORIUM S. apiospermium -blood cultures (+) in 80% w/ disseminated dz -histo identical to Asp -resistant to AMB -susceptible to VORI-, POSACONAZOLE S. prolificans resistant to everything Tx-reverse immunosupp, surgical resection, Opportunistic Fungi ZYGOMYCOSIS/ MUCORMYCOSIS Tx -Correct underlying metabolic dz -high dose AMB-still mort=75% -POSACONAZOLE-NEW-79% response -Surgical debridement->mutilation, Opportunistic Fungi CANDIDA Candidiasis - Clinical Skin-intertrigonous areas -warm, moist skin-DM, obese ->Erythematous, macerated skin -Vesiculopustular satellite lesions Tx-Dry skin, azole creams-Lotrimin Vulvovaginitis-75% of women w/ ɬ episodes -predisposing: ABX, steroids, BCP, preg, DM Tx-vaginal troches, creams, ORAL AZOLES) -many women don't recognize Sx, wrong Tx Oral thrush-neonates, recent ABX, dentures, inhaled corticosteroids, HIV/AIDS* -creamy, curd-like patches -Angular cheilitis Dx-use KOH, gram stain, clinical recognition -if esoph Sx+thrush-prob esoph dz Chronic mucocutaneous candidiasis -severe chronic skin, nail, mucosal infx -mostly narrow, specific problem w/ CMI -almost never->systemic, disseminated Tx-life long Tx needed Candiduria-usually w/ bladder catheter -rarely -> candidemia, just remove catheter Candidemia-4th most common blood org -often w/ catheters->just remove cath! Disseminated Candidiasis-diff to Dx -(-) blood cultures, no serologic tests Hepatosplenic-w/ intensive CTX w/ neutropenia ->persistent fever AFTER resolved neutropenia ->hepatomegaly, inc. alk phosphatase, CT scan w/ nodules on liver or spleen -difficult to Tx, Opportunistic Fungi ZYGOMYCOSIS/ MUCORMYCOSIS Risk Factors-Metabolic acidosis* Hyperglycemia*, Corticosteroids, Leukopenia, Deferoxamine Tx*, Long-terim voraconazole prophylaxis*, Opportunistic Fungi ZYGOMYCOSIS/ MUCORMYCOSIS Class Zygomycetes, Order Mucorales -Rhizopus arrhizus, Absidia corymbifera, and Mucor most common -grow on all media except cycloheximide -FORM COENOCYTIC HYPHAE-asexual sporangia -common in environment->contamination -R. arrhizus-optimized in acid pH, high glucose, -39C, ketoreductase (wants to be in DM pt), Opportunistic Fungi Overview Prophylaxis- -Primary-at beginning of immunosupp -Preemptive-at first evidence of colony -Empirical-at first S/Sx/x-ray/lab, Opportunistic Fungi ZYGOMYCOSIS/ MUCORMYCOSIS Dx -NO SEROLOGIC OR SKIN TEST -histo exam of Bx -broad, irreg, non-septate hyphae, wide angle branching-RIBBON-LIKE -culture->dense, hairy mold, Opportunistic Fungi ZYGOMYCOSIS/ MUCORMYCOSIS Rhinocerebral ZM- most common in DM w/ ketoacidosis -paranasal sinuses->orbit->hard palate->brain -periorbital edema, proptosis, epistaxis, necrotic black eschars in nares/hard palate->CN palsies, death Angioinvasive->tissue infarction, necrosis, hemorrhage -can cause Asp-like pulm, disseminated syndromes, Opportunistic Fungi CRYPTOCOCCUS Dx-minimal tissue inflam, can just be mass of yeast w/out lots of immune cells, esp in immunosupp Serology for Ag -via latex agg or EIA RAPID w/ INDIA INK PREP -50% sensitive, can confuse w/ lymphos, etc. Mucicarmine stains capsule in TISSUE Grow on Sabouraud's or BIRD SEED MEDIUM (brown col)