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SYSTEMIC AND OPPORTUNISTIC MYCOSES - Coggle Diagram
SYSTEMIC AND OPPORTUNISTIC MYCOSES
Coccidioidomycosis
Antigen
Spherulin
Coccidioidin
Gejala
flu-like syndrome, self-limiting, Fever, cough, arthralgia, cephalgia
Makros : gray to tan, cotton appearance (formation of arthroconnidi)
Mikros
Hifa : spherules
Dinding spherule dapat ruptur dan mengeluarkan endospore untuk menjadi organisme lagi (life cycle)
Hifa thick walled, barrel shaped structure
Diagnosis
Fresh specimen : spherules
Kultur sangat infectious
Serology test
Skin test: coccidioidintest - induration Ø ≥ 5 mm,
"Valley fever", "California fever","desert rheumatism", dan "San Joaquin Valley fever"
Terapi
Azoles : fluconazole, ketoconazole, itraconazole; amphotericin B
Surgical resection of pulmonary cavity
Histoplasmosis
Morfo : mold, cokelat, tuberculated macroconidia
Antigen : histoplasmin - delayed hipersensitivity
Histoplasma capsulatum
Patogenesis
Spore - per inhalation - acute pulmonary histoplasmosis - either chronic pulmonary histoplasmosis - calcification
Darling's disease
Diagnosis : Biopsi, skin test (histoplasmin skin test)
Terapi : itraconazole, amphotericin B
Blastomycosis
Patogenesis: spore per inhalation - acute pulmonary blastomycosis: PMNs infiltration, granulomas & giant cells - penyebaran lewat pembuluh darah ke kulit, tulang, urogenetalia tract
Double-wall yeast cells, diameter 8-15 mikron
Blastomyces (Ajellomyces) dermatitidis
Diagnosis
Specimens: sputum, pus, urine, CSF
Direct examination: broad-based budding yeast cells
"North American blastomycosis", "Blastomyceticdermatitis", dan "Gilchrist's disease"
Terapi : ketoconazole, itraconazole, apmhotericin B
Paracoccidioidomycosis
Pathogenesis: spores per inhalation - pulmonary lesion - progressive or spread - mucocutaneous, liver, adrenal gland
Diagnosis
Specimen: sputum, exudates, tissue biopsy
Culture: sputum, blood, bone marrow
Chlamydosposes (+), multiple budding
Terapi
Amphotericin B
Itraconazole, ketoconazole
Cotrimoxazole
Paracoccidioides brasiliensis
Candidiasis
Morfo : yeast, 2-6 mikron, pseudohyphae (+)
Manifestasi Klinis
Diaper rash pada bayi : macular erythematous
Vulvovaginal thrush : vaginal discharge, iritasi, pruritus
Sariawan mulut : mempengaruhi lidah, gusi atau palate - lesi putih (pseudomembrane)
Normal flora di kulit, membra mukosa, GIT
Diagnosis
Germ tube test: pseudohyphae(+)
kultur & direct exam
Candida albicans
90%
Terapi
Flucytosine, amphotericinB, fluconazole
Nystatin, gentian violet 1%
Cryptococcosis
Crptococcus neoformans
Yeast, 4-6 mikron, thick capsules
Manifestasi klinis
Meningitis kronis
Tumor otak
Abses otak
Diagnosis : India ink - thick capsule
Terapi : Amphotericin B, flucytosine, fluconazole
Aspergillosis
pertumbuhan cepat, hifa septate, conidiophores, pada SDA koloni hitam
Diagnosis
Direct exam + KOH
Kultur : SDA, sheep blood agar
A.flavus, A.niger, A.fumigatus
Manifestasi klinis : allergic bronchopulmonaryaspergillosis
Terapi
Alergi: corticosteroid & antifungal
Aspergilloma: antifungal & surgery