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23 Cards in this Set
- Front
- Back
Opportunistic Mycoses
______ is the most common cause of mycoses. |
Candida
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Opportunistic Mycoses
_______ is the 2nd most common cause of mycoses. |
Aspirgillosis
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Opportunistic Mycoses
True Pathogens |
-Dimorphic
-endemic to specific regions (require specific pH and temperature conditions for growth) -affect both normal healthy people AND immunocompromised people |
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Opportunistic Mycoses
Opportunistic Pathogens |
-not dimorphic
-found all over the world -only affect immunocompromised people |
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Opportunistic Mycoses
Examples of Opportunistic Mycoses and the Pathogenic Fungi that Cause Them |
-Aspergillosis (caused by: Aspergillus sp)
-Candidiosis (" " Candida sp.) -Cryptococcosis (" " Cryptococcus neoformans) -Murcomycosis= HIGHLY FATAL in large % of cases= (" " Mucor Rhizopus) -Phycomycosis & Zygomycosis--- caused by fungi w/o septae -Fusarymycosis= typically affects plants, b/ can affect humans too (" " Fusarium) -Penecilliosis (" " Penicillium) -Saccharomyetis= baker's yeast (can infect compromised host) |
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Opportunistic Mycoses
Factors that predispose individuals to opportunistic mycoses (4) |
-1) Medical procedures (surgery, catheterization, implants, etc)
-2) Medical Therapies (immunosuppressive therapies, cancer therapies, radiotherapies, etc) -3) Pre-existing conditions (AIDS, leukemia, lymphoma, diabetes, etc) -4) Lifestyle Factors (poor diet, poor hygeine, IV drug use) |
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Opportunistic Mycoses
Malassezia (a group of opportunistic mycoses) |
-superficial opportunistic mycoses
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Opportunistic Mycoses
Zygomycetes (a group of opportunistic mycoses) |
-opportunistic mycoses that have neither septae or a cell wall
-EX) Rhizopus & Mucor |
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Opportunistic Mycoses
Hyaline Moulds |
-dematacious: brown, black
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Opportunistic Mycoses
"Other" Hyaline Moulds |
-not of the normal colour
-transparent |
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Opportunistic Mycoses
Aspergillus |
-2nd most common cause of mycoses (after Candida)
-spores are found in the soil |
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Opportunistic Mycoses
Why should hospital patients breath air that is purified with a HEPA-filter? |
-because opportunistic mycoses can be transmitted through the air
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Opportunistic Mycoses
Diseases caused by Aspergillus (4) |
1) Allergic Aspergillosis= many people are allergic to aspergillus and to candida
2) Aspergilloma= fungus ball in the lung (looks like a cancer; appears in lungs that have cavities, which may be b/c of previous diseases or immunocompromised hosts) 3) Aspergillosis of the lung (inflammation of the lung)--- Actue Invasive Aspergillosis & Chronic Necrotixing Aspergillosis (worse) 4) Invasive Aspergillosis (mainly affects/colonizes SINUES & LUNGS)= -infection of paranasal sinuses -CNS aspergillosis -ocular aspergillosis -endocarditis & myocarditis -osteomyelitis -cutaneous |
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Opportunistic Mycoses
Epidemiology of Aspergillosis: 1) Method of transmission 2) Incidence of Infection 3) Mortality in Infected Patients |
1) Airborne transmission
2) 4%-38% (incidence of infection) 3) 85% (mortality in infected patients)--- mortality is less in people who are infected at fewer sites |
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Opportunistic Mycoses
________ is a good treatment for Aspergillosis |
-Amphotericin B (can be combined w/ antifungal agents such as 5-fluorocytosine; liposomal treatment is also used)
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Opportunistic Mycoses
Penicilliosis (esp. Peneceilliosis Marneffei) |
-found in bamboo rats
-clinical manifestations: 1) papules on skin 2) esophageal lesions 3) lesions on eyes |
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Opportunistic Mycoses
Mucromycosis |
-causal fungi: RHIZOPUS & MUCOR (other fungi include: Absidia & Cumminghamella)
-zygomycetes (= don't have septum) -high % of death (b/c these fungi multiply v. fast <2-3 days> and quickly affect several places in the body: head, neck, arteries, veins, and cause INFARCTION and CVA in the brain b/c they grow v. quickly and can obstruct arteries) -diagnosis is mostly post-mortem (b/c of rapid progression of disease) -DIABETES patients are esp. susceptible |
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Opportunistic Mycoses
Why are Diabetes patients especially susceptible to mucromycoses? |
-b/c these patients have acidosis, which is one of the triggers for these fungi to grow
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Opportunistic Mycoses
Forms of Mucromycoses (4) |
-RHINOCEREBRAL= most common, most difficult to treat= facial/eye pain, involvement of nerves, muscles, vessels
-Complications= cavernous sinus & internal carotid artery thrombosis -Mostly Affects: Diabetics w/ ketoacidosis 2) Pulmonary Mucromycoses= nonspecific symptoms (fever, cough, dyspnea) -Who is Affected: Neutropenic patients 3) Gastrointestinal Mucromycoses= affects stomach, ileum, colon (appears similar to intra-abdominal abscesses) -Who is Affected: Pt's w/ severe malnutrition -4) Cutaneous Mucromycoses= necrotic lesions progress from epidermis to dermis to muscle |
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Opportunistic Mycoses
Pre-disposing factors for opportunistic fungal infections |
-1) Underyling Conditions (leukemia, lymphoma, bone marrow transplant, organ transplant, AIDS, primary immune disorders, GI disease, diabetes, severe burns, premature birth, IV drug abuse)
-2) Immune Defect (Granulocytopenia, T-cell-mediated immunity= T-Cell immunity is v. important in fungal infections) -3) Iatrogenic Factors (chemotherapy, immunosuppressive drugs, broad-spectrum antibiotics, breaks in skin or mucosa, catheters, dialysis, prolonged hopitalization, antifungal prophylaxis) -in transplant pt's, only CORNEA transplant pt's don't take immunosuppressive drugs |
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Opportunistic Mycoses
________ (type of medical procedure) can cause both Mycromycosis and Aspergillosis |
-bone marrow transplants
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Opportunistic Mycoses
Pneumocystis carinii (PCP/PJP) |
-always affects LUNGS
-used to be the #1 cause of death in AIDS patients -affects IMMUNOSUPPRESSED populations -Clinical Manifestations= cough, dyspnea, fever, hypoxemia, & bilateral interstitial infiltrates -Diagnostic Methods= sputum induction, bronchoalveolar lavage -Treatment/Prophoylaxis= TRIMETHOPRIM-SULFAMETHOXAZOLE= 1st choice of treatment (Adjunctive corticosteroid therapy improves survival in moderate to severe cases) -Complications= pneumothorax, respiratory failure -declining mortality rates (in developed world) due to use of prophylactics (hard disease to treat) |
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Opportunistic Mycoses
Types of PCP/PJP (3) |
-1) Superficial PCP/PJP (Type of infection= Direct Contact; Microorganism type= Parazitic)
-2) Subcutaneous PCP/PJP (Type of infection= Direct Contact <almost>; Microorganism type= Saprophyte) -3) Systemic Deep-Mycosis PCP/PJP (Type of infection= inhalation, skin <trauma>; Microorganism type= Saprophyte <almost always from soil>) -Saphorytic Diseases= most dangerous diseases -Parazitic Diseases= less dangerous |