(1)F: Fungal Infections (De Veyra)

Actinmycosis
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-Poor oral hygiene -Periodontal diseases -Radiation therapy -Trauma (jaw fracture) -Appendectomy -Immunosuppression -MalnutritionRisk Factors for Actinomycosis: _________________________________ _________________________________ _________________________________ _________________________________ _________________________________ _________________________________ _________________________________-It may affect surrounding bones and tissues -MeningitisComplications of Actinomycosis: ________________________________ ________________________________Good oral hygienePrevention of ActinomycosisAspergillus (common cold)Causative Agent of Aspergillosis-Chest x-ray -CT scan -Sample fluid for analysis -Tissue biopsyDiagnostics for Aspergillosis: _____________________________ _____________________________ _____________________________ _____________________________Aspergillus (common cold)⎯Breathed by people bust does not commonly cause a disease ⎯It would only cause a disease in immunocompromised patients-Allergic bronchopulmonary aspergillosis (ABPA) -Allergic Aspergillus Sinusitis -Azole-Resistant Aspergillus Fumigatus -Aspergilloma -Chronic Pulmonary Aspergillosis -Cutaneous or Skin Aspergillosis -Invasive AspergillosisTypes of Aspergillosis: __________________________________ __________________________________ __________________________________ __________________________________ __________________________________ __________________________________ __________________________________Allergic bronchopulmonary aspergillosis (ABPA)Types of Aspergillosis: Inflammation of the lungs-Coughing -Wheezing -SOB -FeverSymptoms of Allergic bronchopulmonary aspergillosis: ____________________________ ____________________________ ____________________________ ____________________________-Cystic fibrosis -AsthmaRisk factors for Allergic bronchopulmonary aspergillosis (ABPA): _____________________________ _____________________________Aspergillomaa fungus ball that colonizes in a healed lung scar or abscess from a previous disease.Allergic Aspergillus SinusitisTypes of Aspergillosis: causes inflammation in the sinuses-Drainage -Stuffiness -Rhinorrhea -Headache -Reduced ability to smellSymptoms of Allergic Aspergillus Sinusitis: _____________________________ _____________________________ _____________________________ _____________________________ _____________________________Azole-Resistant Aspergillus FumigatusTypes of Aspergillosis: One species of aspergillus fumigatus will become resistant to certain medicine used in the treatmentAspergillomaTypes of Aspergillosis: ball of aspergillus grown in lungs or sinuses-Cough -Hemoptysis -SOBSymptoms of Aspergilloma: _______________________ _______________________ _______________________RBRisk factor for AspergillomaChronic Pulmonary Aspergillosis⎯Causes cavities in the lungs ⎯Aside from the ball formation found in the lungs, there may be, or it may lead to cavities in the lungs-Weight loss -Cough -Hemoptysis -Fatigue -SOBSymptoms of Chronic Pulmonary Aspergillosis: _____________________________ _____________________________ _____________________________ _____________________________ _____________________________-TB -COPD -SarcoidosisRisk factors of Chronic Pulmonary Aspergillosis: ____________________________ ____________________________ ____________________________Cutaneous or Skin Aspergillosiswhich may enter in the break of skin integrityInvasive Aspergillosis⎯serious infection ⎯affects immunocompromised people ⎯Affects the lungs but also spread to other parts of the body-Fever -Chest pain -Cough -Hemoptysis -SOBSymptoms of Invasive Aspergillosis: ___________________________ ___________________________ ___________________________ ___________________________ ___________________________-Chemotherapy -Organ transplant -High doses of corticosteroidsRisk factors for Invasive Aspergillosis: _____________________________ _____________________________ _____________________________-Chest x-ray -CT scan -Sample fluid for analysis -Tissue biopsyDiagnostic Tests for Aspergillosis: _____________________________ _____________________________ _____________________________ _____________________________-Discontinue immunosuppressive drugs -Severe cases may need surgeryManagement for Aspergillosis: _____________________________ _____________________________-Avoid areas with a lot of dust -Avoid activities with close contact to soil or dust (wear mask or gloves) -Clean injury with soap and waterPrevention of Aspergillosis: ___________________________________ ___________________________________ ___________________________________BlastomycesCausative agent of Bastomycosis3 weeks - 3 monthsSource of Infection for BlastomycosisBreathing microscopic fungal spores from the air after participating in activities that disturb the soilMode of Transmission for Blastomycosis-History, symptoms, PE -Chest X-ray -CT scan of the lungs -Tissue biopsy -Culture of fluid from respiratory tractDiagnostics for Blastomycosis: _____________________________ _____________________________ _____________________________ _____________________________ _____________________________-Itraconazole -Antifungal -Amphotericin BTreatment for Blastomycosis: _____________________________ _____________________________ _____________________________Itraconazolefor mild to moderate cases (200 mg tid for 3 days, 200 mg OD or bid for 6-12 mos)Antifungalmay last 6 mos-1 yearAmphotericin Bfor severe casesBlastomycescommonly live in moist soil and commonly found in decomposing matters such as wood or leaves-Fever (common) -Cough -Night sweats -Myalgia -Arthralgia -Chest pain -FatigueClinical Manifestations of Blastomycosis: ____________________________ ____________________________ ____________________________ ____________________________ ____________________________ ____________________________ ____________________________Severe blastomycosisCan spread to the skin, bones, joints, CNS (brain and spinal cord)-Brain abscess -Epidural abscess -Meningitis -Bone lesions -Genital lesionsComplications of Blastomycosis: _____________________________ _____________________________ _____________________________ _____________________________ _____________________________Coccidiodomycosis (Valley Fever)⎯May spread via pulmonary or hematogenous route; inhalation of airborne arthroconidia ⎯Endemic to the US, Mexico, South America, Arizona, California's Southern San Joaquin Valley-Coccidiodes immitis -Coccidiodes posadassiiCausative Agents of Coccidiodomycosis: _____________________________ _____________________________1-3 weeksIncubation Period of CoccidiodomycosisBreathing microscopic fungal spores from the air after participating in activities that disturb the soilMode of Transmission for Coccidiodomycosis-Enzyme immunoassay -Immunodiffusion -Complement fixation (CF) -Lateral flow assay -Culture- tissue & respiratory specimens -Urinary antigen detection -PCRDiagnostics for Coccidiodomycosis: ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________-Immunocompromised -Pregnant -Diabetes Mellitus -Filipino or a person of colorRisk Factors for Coccidiodomycosis: _____________________________ _____________________________ _____________________________ _____________________________Enzyme immunoassaywherein we will be able to detect specific IgM and IgG antibodiesImmunodiffusionthrough this we are able to identify IgM antibodies, which are positive during the early course of infection. Helpful in detecting infection during its early stage. Not definitive.Complement fixation (CF)where you can find IgG-Fatigue -Cough -Dyspnea -Headache -Night sweats -Myalgia -RashClinical Manifestations of Coccidiodomycosis: _______________________ _______________________ _______________________ _______________________ _______________________ _______________________ _______________________Histoplasma capsulatumCausative Agent of Histoplasmosis3 - 17 daysIncubation Period of HistoplasmosisSoil, heavily contaminated with bird or bat droppingsReservoir of HistoplasmosisMode of Transmission for HistoplasmosisInhalation of airborne microconidia after disturbance of contaminated material-Antigen detection in urine and serum -Antibody test -Culture -Microscopy -CPRDiagnostics for Histoplasmosis: _____________________________ _____________________________ _____________________________ _____________________________ _____________________________-Primary pulmonary -DisseminatedTypes of Histoplasmosis: _____________________________ _____________________________Primary pulmonaryself-limitingDisseminatedbones, joints, soft tissue and meninges involvement-Progressive, chronic, or disseminated disease -Meningitis -Diffuse lung disease- HIV patientsComplications of Histoplasmosis: _____________________________ _____________________________ _____________________________-HIV -Organ transplant -Immunosuppression -Infants -More than 55 years oldRisk Factors for Histoplasmosis: _____________________________ _____________________________ _____________________________ _____________________________ _____________________________-Antigen detection in urine and serum -Antibody test -Culture -Microscopy -PCRDiagnostics for Histoplasmosis: ____________________________ ____________________________ ____________________________ ____________________________ ____________________________-Pericarditis -Broncholithiasis -Pulmonary nodules -Mediastinal granuloma -Mediastinal fibrosisComplications of Histoplasmosis: _____________________________ _____________________________ _____________________________ _____________________________ _____________________________-Amphotericin B -ItraconazoleTreatment for Histoplasmosis: _____________________________ _____________________________MucormycosisPreviously called ZygomycosisMucorales RhizopusCausative agent of Mucormycosis3 - 17 daysIncubation Period for MucormycosisSoilReservoir of Mucormycosis-Inhalation -Inoculation -Ingestion of Spores from the environmentMode of Transmission for Mucormycosis: ____________________________ ____________________________ ____________________________-Amphotericin B -Posaconazole, isavunconaxole -Surgical debridement or resection of infected tissuesTreatment for Mucormycosis: _____________________________ _____________________________ _____________________________-Uncontrolled DM -Malignancy -Organ or hematopoietic transplant -Prolong corticosteroid therapy -Skin trauma -IV drug useRisk Factors for Mucormycosis: ____________________________ ____________________________ ____________________________ ____________________________ ____________________________ ____________________________-Rhinocerebral mucormycosis -Pulmonary mucormycosis -Cutaneous mucormycosis -GI Mucormycosis -DisseminatedClinical Forms of Mucormycosis: __________________________________ __________________________________ __________________________________ __________________________________ __________________________________Rhinocerebral mucormycosisMost common form in pts. with DM, renal transplant, neutropenic cancer patients, hematopoietic stem cell transplant or solid organ transplant recipientPulmonary mucormycosisCommon in patients with hematologic malignancy or profound neutropeniaPrimary mucormycosis⎯Direct inoculation of fungus to disrupted skin ⎯Acute inflammatory response with pus, abscess formation, tissue swelling, necrosis, lesionSecondary mucormycosis⎯Pathogen spread hematogenously ⎯Lesions are erythematous, indurated, painful cellulitis, then progress to an ulcer covered with black escharGI Mucormycosis⎯Less common ⎯Non-specific abdominal pain, distention, nausea and vomiting, GI bleedingDisseminatedCommon in neutropenic patients with pulmonary infection-Brain -Spleen -Heart -SkinCommon site of spread: ______________________ ______________________ ______________________ ______________________-Avoid areas with a lot of dust (construction, excavation sites) -Avoid direct contact with water damaged building and flood water -Avoid activities that involve close contact to soil or dustPrevention of Mucormycosis: __________________________________ __________________________________ __________________________________NorcadosisRoutine culture must be held for at least 14 days tissue samples from lungs, mucus from lower airways, skin, brain tissues-Nocardia nova -N farcinica -N. cyrincigeorgica -N. brasiliensisCausative Agents of Norcadosis: _____________________________ _____________________________ _____________________________ _____________________________-Antimicrobial Susceptibility Testing (AST) -N. Farcinica - resistant to multiple antimicrobial agents including TrimethoprimSulfamethoxazole (TMP-SMX) -Abscess - Surgically drainedTreatment for Norcadosis: _____________________________________ _____________________________________ _____________________________________-Fever -Cough -Chest pain -Pneumonia -Lung abscesses -Cavitary lesionsClinical Manifestations of Invasive pulmonary infection: _____________________________ _____________________________ _____________________________ _____________________________ _____________________________ _____________________________-Headache -Lethargy -Confusion -Seizures -Sudden onset of neurologic deficitClinical Manifestations of CNS involvement - Brain abscess: _____________________________ _____________________________ _____________________________ _____________________________ _____________________________-Wear shoes -Protect open wounds and cutsPrevention for Norcadosis: _____________________________ _____________________________Cryptococcus neoformansCausative Agent of CryptococcosisSoil, decaying wood, tree hollows, bird droppingsReservoir of Cryptococcosis-Culture -Microscopy -Antigen detection (CSF or serum)Diagnostics for Cryptococcosis: _____________________________ _____________________________ _____________________________-Fluconazole -Amphotericin BTreatment for Cryptococcosis: _____________________________ _____________________________-Advanced HIV/AIDS (CD4 count of less than 200 cells/mm) -Organ transplant recipients -Immunosuppressive treatmentRisk Factors for Cryptococcosis: _____________________________ _____________________________ _____________________________-Meningoencephalitis -Permanent neurologic damageComplications of Cryptococcosis: _____________________________ _____________________________Fluconazolefor asymptomatic, mild-moderate pulmonary infectionsAmphotericin Bsevere pulmonary and CNS infectionsTinea Versicolorthe fungus will alter the pigmentation of the skin resulting in discolored patchesPityriasis VersicolorTinea Versicolor is also known as ____________________Malassezia (Alapao)Causative Agent of Tinea VersicolorInhalation of basidiospores or desiccated yeast cellsMode of Transmission for Tinea Versicolor-Selenium sulfide -Ketoconazole (gel/cream) -Itraconazole -FluconazoleTreatment for Tinea Versicolor: _____________________________ _____________________________ _____________________________ _____________________________-Hot humid weather -Oily skin -Hormonal changes -Weakened immune systemContributing factors to Tinea Versicolor: _____________________________ _____________________________ _____________________________ _____________________________-Patches of skin discoloration (back, chest, neck, and upper arms) -Mild itching -ScalingClinical Manifestations: _____________________________ _____________________________ _____________________________FomitesMode of Transmission for Ringworm-Hx and PE -Microscopy - KOH Potassium Hydroxide Stain -UV light (Wood's lamp) -CultureDiagnostics for Tinea (Ringworm): _____________________________ _____________________________ _____________________________ _____________________________-Antifungal terbinafine -Chronic - oral antifungal-terbinafine, itraconzole, fluconazole -Adjunctive therapy: foot powder, talcum powderTreatment for Tinea pedis (athlete's foot): _____________________________ _____________________________ _____________________________-topical antifungal -Griseofulvin (DOC) -Terbinafine (for patients more than 4 y.o) -Selenium sulfide shampoosTreatment for Tinea capitis: _____________________________ _____________________________ _____________________________ _____________________________-Lesion is erythematous, missed, scaly ring with central clearing -Multiple lesions present -Mild to exudative lesions.Clinical Manifestation of Tinea (Ringworm): _____________________________ _____________________________ _____________________________-Keep skin clean and dry -Wear shoes that allow air to circulate freely around your feet -Don't walk barefoot on areas like locker room, public showers -Cut fingernails and toenails short -Change socks, underwear at least once a dayPrevention for Tinea (Ringworm): _________________________________ _________________________________ _________________________________ _________________________________ _________________________________MoniliasisCandidiasis is also known as _____________________Candida albicansCausative agent of candidiasis12 hrs - 5 daysIncubation Period of CandidiasisSexual contactMode of Transmission for Candidiasis-Stool culture -Gram staining of skin, vaginal discharge, scrapingsTreatment for Candidiasis: _____________________________ _____________________________-Onchomycosis (nails) -Tinea corporis -Tinea pedis -Vaginitis -Aseptic meningitis -ParonychiaComplications of Candidiasis: _____________________________ _____________________________ _____________________________ _____________________________ _____________________________ _____________________________-Nystatin -Clitrimazole -FluconazolePharmacologic Treatment for Candidiasis: _____________________________ _____________________________ _____________________________-Practice universal precaution -Apply cream and lotion or oil on pruritic site -Advise client not to scrape the oral thrush -Check vaginal discharge & note the color, odor and amount -Check high risk patients dailyTreatment for Candidiasis: __________________________________ __________________________________ __________________________________ __________________________________ __________________________________