Notes in 03. Fungal Lung infections

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Published	06/26/2023	{{c1::Objectives}} For each of the following → Aspergillosis, Coccidiomycosis, and Histoplasmosis, identify the following Pathophysiology&nb…
Published	06/26/2023	Aspergillosis definition → {{c1::noncontagious}} opportunistic infections caused by species of Aspergillus Inhaled as mold conidia…
Published	06/26/2023	Asperillgus → etiology and epidemiology ubiquitous in the {{c1::enviornemnt}} → soil, air, water, human habitats associated w/ {{c1::de…
Published	06/26/2023	Aspergillus → etiology and epidemiology major risk factors include: {{c1::neutropenia}}long-term high-dose {{c1::corticosteorid therapy…
Published	06/26/2023	Aspergillus → etiology and epidemiology MC human pathogens {{c1::A fumigatus}} (67%) a. flavus A. niger A. terrus
Published	06/26/2023	Aspergillus → etiology and epidmeiology tissue samples show {{c1::septate hyphae}}dichotomously branched hyphaecaracteristic {{c1::conidia}}…
Published	06/26/2023	Aspergillus → syndromes invasive disease → progression of infection across {{c1::tissue planes}}hallmark of invasive disease → vascular inva…
Published	06/26/2023	aspergillus → syndromes Disseminated disease → spread to multiple different organs abscesses → CNS, kindy, liver, myocardium microangio…
Published	06/26/2023	aspergillus → syndromes {{c1::endocarditis}} → cardiac surgery, IV drug use, negative blood cultures, overall survival 5% w/ valve replacement&nb…
Published	06/26/2023	Aspergillus → syndromes Allergic bronchipulmonary Aspergillosis (APBA) mucoid impaction of bronchi, eosinophilic pneumonia, bronchocentric g…
Published	06/26/2023	aspergillus → diagnosis definitive dx: → {{c1::biopsy}} → culture of Aspergillus supp in + evidence of tissue invasion Biopsy often not…
Published	06/26/2023	aspergillus → treatment invasive disease IV {{c1::Amphotericin B}} → 1-1.5 mg/kg/day in divided doses oral itraconazole effective …
Published	06/26/2023	treatment → aspergillus endocarditis → {{c1::chemotherapy}} plus valve replacement locally invasive dz → systemic or local chemo; surgical e…
Published	06/26/2023	aspergillus → prevention prophylaxis of susepctible pts intranasal, inahled, or systemic {{c1::antifungals}}reducing airborne spores → …
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Published	06/26/2023	Coccidioidomycosis → definition caused by fungus Coccidiodes immitis acute benign asymptomatic or self-limiting respiratory infection o…
Published	06/26/2023	Coccidioidomycosis → etiology, epidemiologydimorphic fungus → {{c1::ascomycete}}inhaled conidia convert at 98 F to large tissue-invasive spherule…
Published	06/26/2023	Coccidioidomycosis → incidence intense exposure → {{c1::archeology sites}} and military maneuvers
Published	06/26/2023	Coccidioidomycosis → pathogenisis and pathology acute, subacute, or chronic granulomatous reaction acute inflammation focal {{c1::…
Published	06/26/2023	Coccidioidomycosis → clinical manifestations usually {{c1::self-limited}} pulmonary syndrome minority develop chornic or progressive form&nb…
Published	06/26/2023	Coccidioidomycosis → clinical manifestations primary pulmonary infection → usually {{c1::asymptomatic}} → incubation time 5-21 days symptoms…
Published	06/26/2023	Coccidioidomycosis → clinical manifestations extrapulmonary {{c1::dissemination}}weeks, months, or a few years more common in {{c1…
Published	06/26/2023	Coccidioidomycosis → clinical manifestations of extrapulmonary dissemination low grade fever {{c1::anorexia}}weight loss weakness …
Published	06/26/2023	Coccidioidomycosis → diagnosis culture visualizing {{c1::spherules}}biopsy complement fixation → most useful test showing {{c…
Published	06/26/2023	Coccidioidomycosis → treatment primary pulmonary infection → uncessary in low risk pts residual cavities → {{c1::surgical resection}}mi…
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Published	06/26/2023	histoplasmosis → definition most common endemic systmic mycosis in US caused by histoplasma capsulatum asymptomatic self-limited&n…
Published	06/26/2023	histoplasmosis → etiology and epidemiology{{c1::dimorphic}} fungus mold in nature and room temperature converts to small yeast cell at 98.6 …
Published	06/26/2023	histoplasmosis → pathogenesis aerosolized microconidia inhaed into lungs converted to yeast form phagocytized by {{c1::macrophages}}&nb…
Published	06/26/2023	histoplasmosis → pathology immune-competent host development of yeast is rare well developed {{c1::granulomas}}limited disease&nbs…
Published	06/26/2023	histoplasmosis → clinical manifestations acute primary histoplasmosis → usually asymptomatic if symptoms → fever, chills, headache, {{c1::no…
Published	06/26/2023	histoplasmosis → acute primary complications acute {{c1::pericarditis}} {{c1::tracheal, bornchial, esophageal obstruction}} esophageal …
Published	06/26/2023	histoplasmosis → clinical manifestations chronic chronic cavitary histoplasmosis pulmonary {{c1::lesions}} → apical / resemble TB pneum…
Published	06/26/2023	histoplasmosis → diagnosis varies depending on clinical syndrome usually based on demonstrating, H. capsulatum by culture or histopathologic…
Published	06/26/2023	histoplasmosis → treatment primary pulmonary histoplasmosis → no treatment requiredif severe or progressive → {{c1::Amphotericin B 1g dose}}…
Published	06/26/2023	histoplasmosis → treatment chronic pulmonary histoplasmosis pneumonitic form → resolve spontaenously progressive or marching cavitary d…
Published	06/26/2023	histoplasmosis → treatment disseminated histoplasmosis {{c1::amphotericin}} B and Itraconazole AIDS prophylaxis → Itraconazole and fluc…
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