thera final fungus

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coal
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272862
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thera final fungus
Updated:
2014-05-02 14:36:38
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thera final fungus
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thera final fungus
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thera final fungus
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  1. polyene antifungals
    • amphotericin B
    • nystatin
  2. antimetabolite antifungal
    flucytosine
  3. imidazole antifungals
    • clotrimazole
    • ketoconazole
    • miconazole
  4. triazole antigungals
    • fluconazole
    • itraconazole
    • voriconazole
    • posaconazole
  5. echinocandin antifungals
    • caspofungin
    • micafungin
    • anidulafungin
  6. risk factors for candidemia
    • TPN
    • central venous catheter
    • extensive burns/surgery
    • receipt of multiple antibiotics
  7. Tx of less critically ill (non ICU) candidemia
    fluconazole
  8. Tx of critically ill (ICU)
    • echinocandin
    • ¬† de-escalate to fluconazole if C. albicans isolated

    continue Tx for 2 wks after last positive blood culture
  9. Tx of oral candidiasis (thrush) and vulvogaginal candidasis
    oral fluconazole
  10. Tx of esophageal candidiasis
    fluconazole or itraconazole for 14-21 days
  11. location of histoplasmosis
    central US along ohio and Mississippi river valleys
  12. where is histoplasmosis found
    soil contaminated by bat or chicken excrement
  13. which fungal has a non-productive cough
    histoplasmosis
  14. features that tell you histoplasmosis is disseminated
    • CD4 < 150
    • development of granulomas
    • wt loss
    • weakness
    • fatigue
  15. Tx of mild-moderate pulmonary disease from histoplasmosis
    intraconazole 6-12 wks
  16. Tx of less severe disseminated histoplasmosis
    itraconazole - minimum of 1 year
  17. Tx of moderately severe to severely disseminated histoplasmosis
    amphotericin B for 1-2 wks followed by itraconazole for minimum of 1 year
  18. Tx of meningitis caused by histoplasmosis
    • amphotericin B 4-6 weeks
    • then
    • itraconazole for minimum of 1 year
  19. location of blastomycosis
    eastern US near great lakes
  20. fungi diagnosed with fish RNA
    candida
  21. fungus diagnosed with KOH
    • blastomycosis
    • mucormycosis
  22. where is blastomycosis found
    decomposing organic matter such as wood or leaves, moist soil
  23. Tx of mild-moderate pulmonary blastomycosis
    itraconazole - 6-12 months
  24. Tx of mild-moderate disseminated disease from blastomycosis
    itraconazole minimum of 1 year
  25. Tx of moderate - severe pulmonary disease from blastomycosis
    • amphotericin B
    • then
    • itraconazole for 6-12 months
  26. Tx of moderate - severe  disseminated disease from blastomycosis
    • amphotericin B
    • then
    • itraconazole for minimum of 1 year
  27. Tx of meningitis from blastomycosis
    • amphotericin B
    • then
    • azole for minimum of 1 year
  28. location of coccidiomycosis
    endemic to southwestern US
  29. where is coccidiomycosis found
    soil and proliferates in the rainy season
  30. which fungus have a blood streaked productive cough
    • coccidiomycosis
    • aspergillus
  31. which fungal is associated with valley fever
    coccidiomycosis
  32. Tx of mild infection/ pneumonia or chronic/subacute disease from coccidiomycosis
    fluconazole
  33. Tx of severe non-meningitis infection from coccidiomycosis
    • amphoterisin B
    • then
    • switch to azole when possible
  34. Tx of meningitis from coccidiomycosis
    fluconazole IV - lifelong Tx
  35. which fungal is test with India ink stain
    cryptococcosis
  36. where is cryptococcosis found
    soil with pigeon droppings
  37. Tx of symptomatic cryptococcosis
    fluconazole
  38. Tx of meningitis caused by cryptococcosis
    • amphotericin B
    • +
    • flucytosine for 2 wks
    • then
    • fluconazole 8-10 weeks
  39. where is aspergillosis found
    soil w/ decaying vegetation, moldy hay, or organic debris
  40. Tx of allergic bronchopulmonay from aspergillosis
    prednisone and manage asthma attacks
  41. which fungus can show a crescent sign on CT scan
    aspergilloma
  42. Tx of aspergillosis
    voriconazole - treat until all s/s resolved
  43. which fungus is caused by rhizopus
    mucormycosis
  44. which fungal is the most fulminant
    mucormycosis
  45. which fungus is inhaled and spread to the CNS
    mucormycosis
  46. treatment target for mucormycosis
    treat hyperglycemia
  47. Tx of mucormycosis
    • amphotericin B until clinical improvement
    • then
    • posaconazole (w/fatty meal) until clinical resolution
  48. what do we monitor with amphotericin B
    • nephrotoxicity
    • hypokalemia
    • hypomagnesemia
  49. monitoring of azoles
    • hepatotoxicity
    • not for use in pregnancy
    • posaconazole requires high fat meal for absorption
    • voriconazole - visual disturbances
  50. what could we prophylax against and with what
    • candida and aspergillus
    • fluconazole 400 mg QD

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