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Block 5 Microbiology (Viral Infections ((RNA Virions (Single Stranded…

- - - - Double Stranded
        
        Naked
        Capsid
        
        Icosahedral
        
        Linear
        
        Reoviridae
        
        Rotavirus
        
        5 more items...
      - Single Stranded
        
        Negative Sense
        (-)
        
        Enveloped
        Capsid
        
        Helical
        
        Multi-Segmented
        
        Arenaviridae
        
        6 more items...
        
        Bunyaviridae
        
        6 more items...
        
        Orthomyxoviridae
        
        1 more item...
        
        Non-Segmented
        
        Filoviridae
        
        5 more items...
        
        Rhabdoviridae
        
        3 more items...
        
        Paramyxoviridae
        
        4 more items...
        
        Positive Sense
        (+)
        
        Naked
        Capsid
        
        Icosahedral
        
        Caliciviridae
        
        Norovirus
        
        2 more items...
        
        (HEV)
        
        Picornaviridae
        
        Enterovirus
        
        3 more items...
        
        Rhinovirus
        
        1 more item...
        
        Hepatovirus
        
        1 more item...
        
        REPLICATION
        
        1 more item...
        
        DX:
        
        3 more items...
        
        TX:
        
        1 more item...
        
        Astroviridae
        
        Astrovirus
        
        Enveloped
        Capsid
        
        Icosahedral
        
        Flaviviridae
        
        (HCV)
        
        West Nile
        
        Dengue
        
        Yellow Fever
        
        Togaviridae
        
        Rubella
        
        3 more items...
        
        Alphaviruses
        
        Retroviridae
        
        HIV
        
        Helical
        
        Coronaviridae
        
        Coronavirus
        
        1 more item...
    - - Double Stranded
        
        Enveloped
        Capsid
        
        Icosahedral
        
        Circular
        
        partial DS
        
        Hepadnaviridae
        
        Hepatitis B
        
        Linear
        
        Herpesviridae
        
        (VZV)
        
        (EBV)
        
        (CMV)
        
        (HHV-6 / HHV-8)
        
        Herpes Simplex Virus
        (HSV)
        
        Complex
        
        Linear
        
        Poxviridae
        
        Variola
        
        1 more item...
        
        Cytoplasm Replicaiton
        using DdRp
        
        Orthopoxvius
        
        Parapox
        
        1 more item...
        
        Yatapox
        
        Mulluscipox
        
        Naked
        Capsid
        
        Icosahedral
        
        Circular
        
        Papoviridae
        
        (HPV)
        
        (JCV)
        
        Polyoma
        
        (BKV)
        
        Linear
        
        Adenoviridae
        
        Adenovirus
        
        2 more items...
      - Single-Stranded
        
        Naked
        Capsid
        
        Icosahedral
        
        Linear
        
        Parvoviridiae
        
        B19
- - - - Cell Membrane
      - Thermal Dimorphism
        
        Yeast = Heat
        Mold = Cold
        
        Histoplasma
        
        Blastomyces
        
        Coccidioides
        
        Sporothrix
      - Cell Wall
    - - Superficial
        
        Tinea versicolor
        
        Malassezia furfur
        
        DX: KOH Prep
        
        "Spaghetti and Meatballs"
        
        TX: Topical
        
        Superficial = Stratum corneum
      - Cutaneous
        
        Tinea
        
        capitis
        
        "Ringworm"
        
        Head
        
        favosa
        
        highly contagious
        
        inflammatory version
        
        barbae
        
        folliculitis of head
        
        corporis
        
        Lesions w/ pustular/vesicular boader
        
        cruris
        
        "Jock Itch"
        
        foot/nail involvement
        
        pedis
        
        Feet
        
        ALL MOLDS
        
        Etiology
        
        Microsporum
        
        Trichophyton
        
        Epidermophyton
        
        Septate
        
        Branching hyphae
        
        DX: KOH Prep
        
        TREATMENT
        
        PO Medications
        
        Fluconazole
        
        Griseofulvin
        
        Terbinafine
        
        INHIBS
        Squalene --> Lanosterol
        
        Itraconazole
        
        Onychomycosis
        
        Nails
        
        Dermatophytes
        
        DX: KOH Prep
      - Subcutaneous
        
        Sporothrix
        
        Nodules along
        lymphatics
        
        "Rose Gardener's
        Disease"
        
        Thermal
        Dimorphism
        
        DX:
        
        Intracellular w/ elongated
        cigar shape
        
        Culture more sensitive
        
        TX:
        
        Itraconazole
        
        Potassium iodide
        solution
        
        Eumycetoma
        
        Chronic, lower extremity, foot
        
        Primary Pathogens
        
        Madurella mycetomatis
        
        Trematosphaeria grisea
        
        HistoPath - Granules
        
        Black
        
        fungal
        
        White
        
        Yellow
        
        TX:
        
        Itraconazole
        
        Alternatives
        
        Vori
        
        Posa
        
        Chromoblastomycosis
        
        Melanized fungi
        
        No granules
        
        DX:
        
        HistoPath
        
        Culture
        
        TX:
        
        Sx for small
        
        Systemic
        Antifungals
        
        Itraconazole
        
        Terbinafine
        
        Adjunctive
        Therapy
        
        Cryotherapy
        
        Heat therapy
        
        Light-Based
        
        Primary
        Genera
        
        Fonsecae
        
        Cladophialophora
    - - Yeast
        
        Candida
        
        Normal Flora
        
        Skin/GI
        
        Pathology
        
        Invasive
        
        Bloodstream
        
        endocarditis
        
        Intra-Abdominal
        
        Mucocutaneous
        Disease
        
        Dermatitis
        
        Thrush
        
        Vaginitis
        
        Risk Factors
        
        Genetics
        
        Antibiotics
        
        Steroids
        
        DX:
        
        Clinical Presentation
        
        Adjunctive
        
        Culture/HistoPath
        
        TX:
        
        Echinocandins
        
        Invasive
        
        MOA
        
        INHIBS
        1,3-beta-D-glucan Synthesis
        
        3 more items...
        
        IV ONLY
        
        RESISTANCE
        
        Mutations of FKS
        
        Glucan Synthase Gene
        
        Fluconazole
        
        mucocutaneous &
        stepdown
        
        No activity against invasive molds
        
        Mold-active azoles &
        Amphotericin
        
        MOA
        
        INHIBS
        C-14-alpha demethylation
        of lanosterol
        
        2 more items...
        
        RESISTANCE
        
        Drug Efflux
        
        Increase C-14-alpha demethylase
        
        Cryptococcus
        
        Species
        
        neoformans
        
        gattii
        
        Encapsulated
        
        Budding yeast
        
        OI
        
        AIDS
        
        Transplants, Liver Dis.,
        Chronic steroids
        
        Tropisms
        
        Meningitis
        
        Pneumonia
        
        Skin/Subcutaneous
        
        Osteomyelitis
        
        Prostatitis
        
        DX:
        
        Antigen - Blood/CSF
        -Titer = Severity
        
        India Ink
        
        Replaced by Ag Titer
        
        HistoPath
        
        Mucicarmine stain = PolySacch Capsule
        
        TX:
        
        Disseminated
        
        Amphotericin plus
        flucytosine
        
        Amphotericin
        
        5 more items...
        
        StepDown = Fluconazole
      - Dimorphic
        Fungi
        
        Histoplasma
        
        Spelunking
        
        Bat/Bird PooP
        
        Dissemination
        
        Reticuloendothelial
        System
        
        OI
        
        Narrow-based Budding
        
        Blastomyces
        
        Excavation
        
        Beaver Dams
        
        Dissemination
        
        Hematogenously
        
        Broad-based Budding
        
        ROUTE
        
        Inhalation of
        Spores
        
        Spectrum of Disease
        
        Pulmonary
        
        Acute PNA --> Chronic
        Cavitary Disease
        
        DX:
        
        Culture
        
        HistoPath
        
        Ag Testing
        
        urine = highest
        sensitivity
        
        TX:
        
        Amphotericin
        
        STEPDOWN
        
        Azoles
        
        Itraconazole
        
        Bioavailability Unreliable
        
        MOA:
        
        Blocks biosynthesis of
        ergosterol
      - Mold
        
        Aspergillus
        
        Septate hyphae
        
        Highest Risk
        
        Prolonged neutropenia
        
        Transplant
        
        Prolonged ICU Stay
        
        Dissemination
        
        Pulmonary --> Skin/CNS
        
        Nodular --> Cavitaiton
        
        Classic Pulmonary Finding
        
        Halo Sign on CT
        
        dense nodule surrounded
        by ground glass
        
        DX:
        
        Culture / HistoPath w/ tissue
        
        Adjunctive test
        
        Galactomannan
        
        1,3-beta-D-glucan
        
        poor specificity
        
        TX:
        
        Mold active
        Triazole
        
        Voriconazole
        
        Excellent bioavailability
        
        Ineffective for Mucorales
        
        Posaconazole
        
        Isavuconazole
        
        Mucorales
        
        Pauci-septate mold
        
        Aggressive --> expect
        necrosis
        
        Disease Processes
        
        Rhino-sino-cerebral disease
        
        Diabetics in DKA
        
        Transplants
        
        Pulmonary
        
        Skin
        
        Genera
        
        Mucor
        
        Rhizopus
        
        Apophysomyces
        
        DX:
        
        Culture
        
        pauciseptate structure = fragile
        
        HistoPath
        
        Angio-invasion, Necrosis
        
        Classic Reverse Halo Sign on CT
        
        central ground glass surround by consolidation
        
        TX:
        
        Sx plus Amphotericin
        
        Multiple debridements
        
        StepDown
        
        Posa
        
        Isavu
        
        Vori lacks activity
      - Pneumocystosis
        
        causative fungus
        
        Pneumocystis jirovecii
        
        Tropisms
        
        Lung
        
        Hypoxia w/ elevated LDH
        
        Vascular
        
        OI
        
        AIDS
        
        Transplant
        
        DX:
        
        GMS/Silver Stain
        
        PCR
        
        TX:
        
        Therapy &
        Prophylaxis
        
        Trimethoprim/Sulfa
        
        Alternatives
        
        Atovaquone
        
        Primaquine / Clindamycin
        
        Pentamidine
        
        (+) Hypoxemia
        
        Glucocorticosteroids