1331a68c Oppurtunistic Mycosis Ch75
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Transcript of 1331a68c Oppurtunistic Mycosis Ch75
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Oppurtunistic mycosis.
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Agents of Oppurtunistic mycosis: Candid a sp e cie s:
C.alb ica ns. C.tropic al is. C.du blie nsis.
C.glab r a ta . C.krus e i.
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Cryptococcus n e oform a ns: Malass ez ia .furfur. Trichosporon. Rhodotoru la . Geotrichum.c a pita tum. Asp e r gillus sp e cie s:
A.fumi ga tus. A.f lav us. A.nige r.
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Zygomyc e te s: Rhizopus. Mucor. Absidi a .Oth e r hy al ine mo lds:
Fus a rium.
Acr e monium. Scopu lariopsis. Pne umocystis jiro ve ci.
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Candid a .alb ica ns: Candid a sp e cie s a r e known co loni ze rs of hum a ns a nd
oth e r wa rm blood e d a nim als.
The pr e domin a nt sourc e of inf e ction c a us e d by Ca ndid a spp-from sup e rficial mucos al a nd cut a ne ous dis ea s e tohe ma toge nous diss e min a tion-Endo ge nous inf e ction.Exo ge nous inf e ction-cont a min a te d irriga tion so lutions
,pa r e nte r al nutrition f luids,c a rdia c valve s,corn ea s. Hospit al inf e ction-nosocomi al ca ndid e mia .
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Type s of Ca ndid a inf e ction:Oroph a ryn geal inf e ction.Esoph ag itis.
Vulvovag inal inf e ction.
Inf e ction of skin a nd n a ils. Chronic mucocut a ne ous c a ndidi a sis. Urina ry tr a ct inf e ction. Pne umoni a .
Endoc a rditis. Perica rditis.
Ocu lar inf e ction. Bon e a nd joint inf e ction. Abdomin al inf e ction. Hema toge nous inf e ction.
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Lab diag nosis: Microscopy-KO H. Gr a m st a in-gr a m+ y ea st like . Ps e udohyph ae . CHROM aga r: C.alb ica ns- gr ee n co loni e s- ge rm tu be +
C.tropic al is- blue gr e y. C.krus e i-pale pink. Tr ea tm e nt: a ntifun gal age nts.
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Cryptococcus.n e oform a ns: Fun gus is u biquitous s a prophyt e of soi l e sp e cially th a t
e nrich e d withy pi ge on droppin gs.
Morpho logy: sph e rical to o val e nc a psu late d-y ea st. Cryptococcosis is a quir e d by inh al ing ae roso lize d c ells of
Cryptococcus.n e oform a ns. Pulmon a ry cryptococcosis- fu lmin a nt bila te r al
pn e umoni a . C.n e oform a ns is hi ghly n e urotropic a nd c a us e
ce r eb rom e nin geal dis ea s e .
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Lab diag nosis: Cultur e of blood, CSF . Microscopy: 1% indi a ink-c a psu late d or ga nisms. Dete ction of Cryptococc al a ntige n- la te xaggl utin a tion.
Tr ea tm e nt: Amphot e ricinB+itr a con az ole or
f lucon az ole .
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Asp e r gillosis;Exposur e to Asp e r gillus in th e e nvironm e nt c a nca us e alle r gic r ea ction in hyp e rs e nsiti ze d host.
Spe ctrum of dis ea s e s c a us e d by Asp e r gillussp e cie s: Aller gic dis ea s e s: Nas al cav ity.
Par a na s al sinus e s. Lowe r r e spir a tory tr a ct.
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Coloni za tion: Bronchi. Pr e form e d pu lmon a ry c av itie s. Sup e rficial cut a ne ous inf e ctions. Limite d in va sive inf e ction: Bronchi.
Pulmon a ry p a r e nchym a . Fr a nk ly inva sive P ulmon a ry inf e ction-s eve r elyimmunod e ficie nt p a tie nts.
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Clinical syndrom e s: Aller gic bronchopu lmon a ry a sp e r gillosis. Fun gus ball . Inva sive pu lmon a ry a sp e r gillosis. Lab diag nosis; LPCB mount.
Asp e r gillus gala ctom a nn a a ntige n in s e rum c a nbe de te cte d. Tr ea t m e nt: Amphot e ricin B.
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Zygomycosis: Mucor ale s. Gene r a : Rhizopus, Mucor, Absidi a .
Rhizopus a rrhizus-hum a n dis ea s e . Inva sive Zygomycosis:immunocompromis e d p a tie nts
,tr a nsp lant p a tie nts,di abe te s m ellitus,h e ma to logicmaligna ncy,my elosuppr e ssion.
Pulmon a ry Zygomycosis. Cuta ne ous Zygomycosis. Tr ea tme nt: Amphot e ricin B.
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Oth e r mo lds:Fus a rium:Fus a rium.moni liform ae .Fus a rium.oxysporum.Fus a rium.so lani.Diss e min a te d inf e ction in immunocompromis e d
pa tie nts.
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The Re spir a tory tr a ct is th e ma in port al of e ntry. Pne umoni a is th e ma in pr e s e nta tion.Ons e t is with si gn a nd symptom of dyspn ea ,cy a nosis,nonproducti ve cou gh a ndf eve r.
Radio logically it is s ee n a s diffus e inte rsti al infiltr a te with a ground gla ss a pp ea r a nc e from
hilar r eg ion. Histo logically a foa my e xud a te is s ee n withinalve olar sp a ce s compos e d of p lasm a cells.
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Diag nosis: The diag nosis for P .jirove ci inf e ctionis ba s e d e ntir ely ba s e d on microscopice xa min a tion of BAL,bronchi al brushin g,op e n
lun g biopsy sp e cim e n. Tr ea tm e nt: Trime thoprim- S ulf a me thox az ole .