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Fugal LRT Dickenson
Fungal LRT infections and hypersensitivity penumonitis- 1/17/2013
| Question | Answer |
|---|---|
| Opportunistic fungi occur predominantly in | Immunocompromised patients |
| Non-dimorphic | Exist as mycelium in nature and in the body (ex. Aspergillos) |
| Mycelium | A mass of branching thread-like hyphae |
| Aspergillosis is spread by | Inhaling spores |
| 95% of human illnesses caused by Aspergillus are by which species? | Aspergillus fumigatus |
| Aspergillus hyphae are septate and exhibit what type of branching? | Acute angle (<90) branching |
| 3 clinical forms of Aspergillosis | Hypersensitivity, Colonizing, Invasive |
| Two major risk factors for Allergic bronchopulmonary aspergillosis | Asthma and Cystic fibrosis |
| Allergic bronchopulmonary aspergillosis is often misdiagnosed as | Asthma |
| Allergic bronchopulmonary aspergillosis (ABPA) presents with | Prominent wheezing, cough, dyspnea, exercise intolerance, fever and expectoration of rubbery brown mucus plugs |
| ABPA Type1 hypersensitivity is characterized by | An exaggerated IgE response to proteins associated with Aspergillus condidia and an immediate cutaneous reactivity to Aspergillus skin test antigen |
| Describe a Type 3 ABPA hypersensitivity reaction | IgG binds Aspergillus antigen forming small immune complexes that result in 1. Macrophage and mast cell activation 2. Complement activation and 3. Neutrophil recruitment. The net result is inflammation and tissue damage |
| Does colonizing aspergillosis invade tissues? | No |
| Pulmonary mycetoma/colonizing aspergilloma forms in a | Preexisting lung cavity |
| Aspergilloma | A mass of fungal mycelia that grows in preexisting lung cavities |
| Diseases that can cause formation of a lung cavity | Tb, Emphysema, Cystic fibrosis, Sarcoidosis |
| Clinical manifestation of Aspergilloma | Hemoptysis, productive cough, fever, dyspnea, bloody sputum with hyphae |
| Chest radiograph characteristic of Aspergilloma | A crescent sign or Monod's sign, aka a solid mass surrounded by a radiolucent crescent |
| Greatest risk factor for invasive aspergillosis | Myelosuppression |
| Sypmtoms of invasive aspergillosis | Cough, high fever and pleuritic chest pain |
| Risk factors for invasive aspergillosis | Stem cell transplantation, AIDS, Immunodeficiency, Corticosteroid use, Chemotherapy, prolonged neutropenia |
| Aspergillosis hyphea invade blood vessels and can cause | Thrombosis, infarction and necrosis |
| Most common Mucormycosis etiologic agent | Rhizopus |
| Morphology of Rhizopus | Non-septate hyphae with broad, short stubby side branches at 90degree angles |
| Biggest predisposition for Mucormycosis | Diabetic Ketoacidosis |
| 2 Clinical manifestations of Mucormycosis | Rhnocerebral and Pulmonary |
| Major clinical form of mucormycosis | Rhinocerebral |
| Why do mucormycosis like diabetics? | High blood glucose and low tissue pH favors fungal growth and inhibits neutrophil function |
| Rhinocerebral mucormycosis progression | Begins in the nose and rapidly invades the palate, sinuses and orbits with eventual erosion into the cranium |
| Pulmonary mucormycosis progression | Begins as an acute pneumonia with fever and cough and is followed by signs and symptoms of pulmonary infarction with pleuritic chest pain and hemoptysis |
| Sick House/Building syndrome is caused by which etiologic agents | Stachybotrys, Aspergillus, Cladosporium, Penicillium, and Alternaria |
| Sick house/building syndrome manifestation | Allergy, asthma, Gi and neurological symptoms, Pulmonary hemmorrhage and hemosiderosis |
| 3 Presentations of Hypersensivity Pneumonitis | Acute, Subacute, or chronic |
| Acute Pneumonitis | Symptoms present after a brief, single, large exposure |
| Subacute Pneumonitis | Insidious beginning over weeks with cough, dyspnea and weight loss |
| Chronic Pneumonitis | From low-dose continuous exposure. Fatigue, cough, and weight-loss with gradual dyspnea. Development of fibrosis with an increased mortality |
| A lavage of the lungs of a patient with Hypersensitiviy Pneumonitis will contain mostly | Mononuclear cells (Tcells and macrophages) |
| Treatment for hypersensitivity Pneumonitis | Avoidance of allergen, oral corticosteroids, early diagnosis and treatment |
| Actinomyces causes which disease when inhaled | Farmer's lung |
| Pathogenesis of hypersensitivity Pneumonitis | Allergen activates Th1 cells which activate Macrophages and invade lungs. Large IgG antigen specific response is precipitated |
Created by:
mcasto
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